Attentive State-Space Modeling of Disease Progression

Models of disease progression are instrumental for predicting patient outcomes and understanding disease dynamics. Existing models provide the patient with pragmatic (supervised) predictions of risk, but do not provide the clinician with intelligible (unsupervised) representations of disease pathophysiology. In this paper, we develop the attentive state-space model, a deep probabilistic model that learns accurate and interpretable structured representations for disease trajectories. Unlike Markovian state-space models, in which the dynamics are memoryless, our model uses an attention mechanism to create "memoryful" dynamics, whereby attention weights determine the dependence of future disease states on past medical history. To learn the model parameters from medical records, we develop an infer ence algorithm that simultaneously learns a compiled inference network and the model parameters, leveraging the attentive state-space representation to construct a "Rao-Blackwellized" variational approximation of the posterior state distribution. Experiments on data from the UK Cystic Fibrosis registry show that our model demonstrates superior predictive accuracy and provides insights into the progression of chronic disease.