Research has shown that personalization of health interventions can contribute to an improved effectiveness. Reinforcement learning algorithms can be used to perform such tailoring using data that is collected about users. Learning is however very fragile for health interventions as only limited time is available to learn from the user before disengagement takes place, or before the opportunity to intervene passes. In this paper, we present a cluster-based reinforcement learning approach which learns across groups of users. Such an approach can speed up the learning process while still giving a level of personalization. The clustering algorithm uses a distance metric over traces of states and rewards. We apply both online and batch learning to learn policies over the clusters and introduce a publicly available simulator which we have developed to evaluate the approach. The results show batch learning clearly outperforms online learning. Furthermore, clustering can be beneficial provided that a proper clustering is found.
The major application areas of reinforcement learning (RL) have traditionally been game playing and continuous control. In recent years, however, RL has been increasingly applied in systems that interact with humans. RL can personalize digital systems to make them more relevant to individual users. Challenges in personalization settings may be different from challenges found in traditional application areas of RL. An overview of work that uses RL for personalization, however, is lacking. In this work, we introduce a framework of personalization settings and use it in a systematic literature review. Besides setting, we review solutions and evaluation strategies. Results show that RL has been increasingly applied to personalization problems and realistic evaluations have become more prevalent. RL has become sufficiently robust to apply in contexts that involve humans and the field as a whole is growing. However, it seems not to be maturing: the ratios of studies that include a comparison or a realistic evaluation are not showing upward trends and the vast majority of algorithms are used only once. This review can be used to find related work across domains, provides insights into the state of the field and identifies opportunities for future work.
Abstract-Information in Electronic Medical Records (EMRs) can be used to generate accurate predictions for the occurrence of a variety of health states, which can contribute to more pro-active interventions. The very nature of EMRs does make the application of off-the-shelf machine learning techniques difficult. In this paper, we study two approaches to making predictions that have hardly been compared in the past: (1) extracting high-level (temporal) features from EMRs and building a predictive model, and (2) defining a patient similarity metric and predicting based on the outcome observed for similar patients. We analyze and compare both approaches on the MIMIC-II ICU dataset to predict patient mortality and find that the patient similarity approach does not scale well and results in a less accurate model (AUC of 0.68) compared to the modeling approach (0.84). We also show that mortality can be predicted within a median of 72 hours.
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