Treatment selection using prototyping in latent-space with application to depression treatment

Akiva Kleinerman, Ariel Rosenfeld, David Benrimoh, Robert Fratila, Caitrin Armstrong, Joseph Mehltretter, Eliyahu Shneider, Amit Yaniv-Rosenfeld, Jordan Karp, Charles F. Reynolds, Gustavo Turecki, Adam Kapelner

Research output: Contribution to journalArticlepeer-review

Abstract

Machine-assisted treatment selection commonly follows one of two paradigms: a fully personalized paradigm which ignores any possible clustering of patients; or a sub-grouping paradigm which ignores personal differences within the identified groups. While both paradigms have shown promising results, each of them suffers from important limitations. In this article, we propose a novel deep learning-based treatment selection approach that is shown to strike a balance between the two paradigms using latent-space prototyping. Our approach is specifically tailored for domains in which effective prototypes and sub-groups of patients are assumed to exist, but groupings relevant to the training objective are not observable in the non-latent space. In an extensive evaluation, using both synthetic and Major Depressive Disorder (MDD) real-world clinical data describing 4754 MDD patients from clinical trials for depression treatment, we show that our approach favorably compares with state-of-the-art approaches. Specifically, the model produced an 8% absolute and 23% relative improvement over random treatment allocation. This is potentially clinically significant, given the large number of patients with MDD. Therefore, the model can bring about a much desired leap forward in the way depression is treated today.

Original languageEnglish (US)
Article numbere0258400
JournalPloS one
Volume16
Issue number11 November
DOIs
StatePublished - Nov 2021

ASJC Scopus subject areas

  • General

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