Interpretable (not just posthoc-explainable) medical claims modeling for discharge placement to reduce preventable all-cause readmissions or death.

We developed an inherently interpretable multilevel Bayesian framework for representing variation in regression coefficients that mimics the piecewise linearity of ReLU-activated deep neural networks. We used the framework to formulate a survival model for using medical claims to predict hospital readmission and death that focuses on discharge placement, adjusting for confounding in estimating causal local average treatment effects. We trained the model on a 5% sample of Medicare beneficiaries from 2008 and 2011, based on their 2009-2011 inpatient episodes (approximately 1.2 million), and then tested the model on 2012 episodes (approximately 400 thousand). The model scored an out-of-sample AUROC of approximately 0.75 on predicting all-cause readmissions-defined using official Centers for Medicare and Medicaid Services (CMS) methodology-or death within 30-days of discharge, being competitive against XGBoost and a Bayesian deep neural network, demonstrating that one need-not sacrifice interpretability for accuracy. Crucially, as a regression model, it provides what blackboxes cannot-its exact gold-standard global interpretation, explicitly defining how the model performs its internal "reasoning" for mapping the input data features to predictions. In doing so, we identify relative risk factors and quantify the effect of discharge placement. We also show that the posthoc explainer SHAP provides explanations that are inconsistent with the ground truth model reasoning that our model readily admits.

Predictive Bayesian selection of multistep Markov chains, applied to the detection of the hot hand and other statistical dependencies in free throws.

Consider the problem of modelling memory effects in discrete-state random walks using higher-order Markov chains. This paper explores cross-validation and information criteria as proxies for a model's predictive accuracy. Our objective is to select, from data, the number of prior states of recent history upon which a trajectory is statistically dependent. Through simulations, I evaluate these criteria in the case where data are drawn from systems with fixed orders of history, noting trends in the relative performance of the criteria. As a real-world illustrative example of these methods, this manuscript evaluates the problem of detecting statistical dependencies in shot outcomes in free throw shooting. Over three National Basketball Association (NBA) seasons analysed, several players exhibited statistical dependencies in free throw hitting probability of various types-hot handedness, cold handedness and error correction. For the 2013-2014 to 2015-2016 NBA seasons, I detected statistical dependencies in 23% of all player-seasons. Focusing on a single player, in two of these three seasons, LeBron James shot a better percentage after an immediate miss than otherwise. Conditioning on the previous outcome makes for a more-predictive model than treating free throw makes as independent. When extended specifically to LeBron James' 2016-2017 season, a model depending on the previous shot (single-step Markovian) does not clearly beat a model with independent outcomes. An error-correcting variable length model of two parameters, where James shoots a higher percentage after a missed free throw than otherwise, is more predictive than either model.

Asymptotic convergence in distribution of the area bounded by prevalence-weighted Kaplan-Meier curves using empirical process modelling.

The Kaplan-Meier product-limit estimator is a simple and powerful tool in time to event analysis. An extension exists for populations stratified into cohorts where a population survival curve is generated by weighted averaging of cohort-level survival curves. For making population-level comparisons using this statistic, we analyse the statistics of the area between two such weighted survival curves. We derive the large sample behaviour of this statistic based on an empirical process of product-limit estimators. This estimator was used by an interdisciplinary National Institutes of Health-Social Security Administration team in the identification of medical conditions to prioritize for adjudication in disability benefits processing.