Ishanu Chattopadhyay
Assistant Professor of
Data Science
University of Chicago
The Emerging Crystal Ball:
AI in Preemptive Medicine
&
Complex Systems
zed.uchicago.edu
Dr. Shahab Asoodeh
Dr. Yi Huang
Dmytro Onishenko
Victor Rotaru
Jin Li
Ruolin Zhang
David Yang
Dr. Nicholas Sizemore
Drew Vlasnik
Lucas Mantovani
Jaydeep Dhanoa
Jasmine Mithani
Angela Zhang
Warren Mo
zed.uchicago.edu
Department of Pediatrics
UChicago
Department of Neurology & The Memory Center
UChicago
Department of Psychiatry
UChicago
Pulmonary Critical Care, Weill Cornell
Department of Anesthesia and Critical Care
UChicago
Center for Health Statistics
UChicago
Pulmonary Critical Care, Harvard Medical School
Department of Psychiatry
UIC
Demon Network, Exeter, Alan Turing Institute, UK
Dalhousie University, Canada
Pritzker School of Molecular ENgineering
Social Science
UChicago
AI Awakens
Explains better than human students taking an introductory course
End
of
Theory?
Rapid Universal Point-of-care Screening for ILD/IPF Using Comorbidity Signatures in Electronic Health Records
shortness of breath
dry cough
doctor can hear velcro crackles
Common Symptoms
>50 years old
more men than women
IPF
Rare disease
~5 in 10,000
Post-Dx
Survival
~4 years
At least one misdiagnosis
~55%
Two or more misdiagnoses
38%
Initially attributed to age- related symptoms:
72%
Cannot always be seen on CXR
Non-specific symptoms
PCP workflow demands
Initial midiagnoses
~ 4yrs
current
post-Dx survival ~4yrs
~ 4yrs
current clinical DX
ZCoR screening
Onishchenko, D., Marlowe, R.J., Ngufor, C.G. et al. Screening for idiopathic pulmonary fibrosis using comorbidity signatures in electronic health records. Nat Med 28, 2107–2116 (2022). https://doi.org/10.1038/s41591-022-02010-y
n=~3M
AUC~90%
Likelihood ratio ~30
Conventional AI/ML attempts to model the physician
AI in IPF Research
Primary Care
Pulmonologist
ZCoR Flag
ICD administrative codes
IPF
ILD
target codes appear
Past medical history
No target codes appear
case
control
2yrs
2yrs
1YR
IPF drugs prescribed
Signature of IPF diagnostic sequence
pirfenidone or nintedanib
target codes appear
Past medical history
No target codes appear
case
control
2yrs
2yrs
1YR
Truven MarketScan (IBM) Commerical Claims & Encounters Database 2003-2018
>100M patients visible
>7B individual claims
>87K unique diagnostic codes
>7% Medicare data present
2,053,277 patients included in study
University of Chicago Medical Center 2012-2021
68,658 patients
Random sample from Optumlabs Data Warehouse courtsey Mayo Clinic
861,280 patients
2,983,215 patients
performance tables
Marketscan Out-of-sample Results
specificity ~99%
NPV >99.9%
IPF
ILD
performance tables
UCM Out-of-sample Results
specificity ~99%
NPV >99.9%
IPF
ILD
False Positives:
Ethics:
For every 20-30 flags,
1 is positive
minimal
acceptable?
Better outcomes
Collard, Harold R., Alex J. Ward, Stephan Lanes, D. Cortney Hayflinger, Daniel M. Rosenberg, and Elke Hunsche. "Burden of illness in idiopathic pulmonary fibrosis." Journal of medical economics 15, no. 5 (2012): 829-835.
Future
ZCoR 2.0
1
2
3
Deploy as an Epic App
primary care
secondary care
ZCoR
Measure
ZCoR
clinical notes
imaging analytics
The Team
Gary Hunninghake, Pulmonary Care, Harvard Medical School
Fernando Martinez, Pulmonary Critical Care, Weill Cornell
Andrew Limper, Thoracic Research Unit, Mayo Clinic
Dmytro Onishchenko, UChicago
Robert Marlowe,
Medical Comm
Che G. Ngufor
Mayo Clinic
Louis J. Faust
Mayo Clinic
ishanu@uchicago.edu
Method Details
Longitudinal history is important, cannot simply process snapshots
* For IPF screening
*
Comparison of ZCoR with off-the-shelf AI
Leveraging Longitudinal Patterns
Specialized HMM models from code sequences
Model control and case cohorts seprately
given a new test case, compute likelihood of sample arising from case models vs control models
sequence likelihood defect
ZeD Lab: Predictive Screening from Comorbidity Footprints
Nature Medicine
JAHA
CELL Reports
Science Adv.
ZeD Lab: Predictive Screening from Comorbidity Footprints
ZED performance | Competition | |
---|---|---|
Autism | >80% AUC at 2 yrs | Double false positives |
Alzheimer's Disease | ~90% AUC | 60-70% AUC |
Idiopathic Pulmonary Fibrosis | ~90% AUC | NA |
MACE | ~80% AUC | ~70% AUC |
Bipolar Disorder | ~85% AUC | NA |
CKD | ~85% AUC | NA |
Cancers | ~75% AUC | NA |
The ZeD Pipeline prototype for risk estimation from co-morbidity signatures
Primary Care
Risk
No additional tests
Clinically Useful
Advance Science
Bio-AI
Machine Learning
Information Theory
Economics
Healthcare Policy
Ethics
Comorbidities
Unknown Risk factors
Known risks
Knowledge of underlying genetic and epigenetic pathways
Clinically Useful
Advance Science
Bio-AI
Machine Learning
Information Theory
Economics
Healthcare Policy
Ethics
Comorbidities
Unknown Risk factors
Known risks
Knowledge of underlying genetic and epigenetic pathways
Unknown Risk factors
Machine Learning
Machine Learning
Features are known
Does not work for complex systems
rare/extreme events
weather
seismic phenomena
urban crime
Rotaru, V., Huang, Y., Li, T. et al.
Event-level prediction of urban crime reveals a signature of enforcement bias in US cities. Nature Human Behavior 6, 1056–1068 (2022).
Urban Crime
Conflicts & Terrorism
Extreme weather phenomena
Seismic events
Irreducible
Complexity
Long-range memory
Non-trivial stochastic effects
Predictive Policing
Broad patterns are easily predictable
The Problem of Free Will
Hotspots?
actual patterns are more non-trivial
complex urban topology
Complex Urban Topology
2 weeks, Chicago, 2017
property crime
violent crime
Not everything is predictable
Not everything is random
Find and use patterns that predict future events
Validate such patterns in out-of-sample data
Some historical patterns are predictive
Generating Event Streams
variables: <location,category>
arrests | |
violent crimes | |
nonviolent crimes |
~3000 location tiles
~9000 variables
~40 million binary interactions
~ 1 billion possible models of binary interaction
ID,Case Number,Date,Block,IUCR,Primary Type,Description,Location Description,Arrest,Domestic,Beat,District,Ward,Community Area,FBI Code,X Coordinate,Y Coordinate,Year,Updated On,Latitude,Longitude,Location\\
8316800,HT550945,08/11/2011 11:00:00 AM,086XX S MARQUETTE AVE,1120,DECEPTIVE PRACTICE,FORGERY,RESIDENCE,false,false,0423,004,7,46,10,1195654,1848294,2011,02/04/2016 06:33:39 AM,41.738615478,-87.558741896\\
8316805,HT550781,10/20/2011 05:00:00 AM,056XX S ABERDEEN ST,0890,THEFT,FROM BUILDING,RESIDENCE,false,false,0712,007,16,68,06,1169943,1867457,2011,02/04/2016 06:33:39 AM,41.791797599,-87.652385205\\
8316806,HT550706,10/20/2011 05:45:00 AM,079XX S LOOMIS BLVD,031A,ROBBERY,ARMED: HANDGUN,STREET,false,false,0612,006,21,71,03,1168370,1852331,2011,02/04/2016 06:33:39 AM,41.750323974,-87.658588247\\
8316811,HT539324,10/12/2011 12:23:52 PM,003XX E 75TH ST,2027,NARCOTICS,POSS: CRACK,SMALL RETAIL STORE,true,false,0323,003,6,69,18,1179641,1855355,2011,02/04/2016 06:33:39 AM,41.758372192,-87.61719416\\
8316822,HT551031,10/19/2011 02:00:00 AM,071XX W DICKENS AVE,0910,MOTOR VEHICLE THEFT,AUTOMOBILE,SIDEWALK,false,false,2512,025,36,25,07,1127877,1913161,2011,02/04/2016 06:33:39 AM,41.918027518,-87.805606689\\
8316824,HT551032,10/20/2011 12:00:00 AM,034XX N NATCHEZ AVE,2825,OTHER OFFENSE,HARASSMENT BY TELEPHONE,RESIDENCE,false,false,1632,016,36,17,26,1132429,1922272,2011,02/04/2016 06:33:39 AM,41.94295109,-87.788669409\\
8316825,HT549690,10/19/2011 12:51:00 PM,079XX S ADA ST,2820,OTHER OFFENSE,TELEPHONE THREAT,APARTMENT,false,false,0612,006,21,71,26,1168711,1852015,2011,02/04/2016 06:33:39 AM,41.749449482,-87.657347764\\
8316826,HT549865,10/19/2011 06:00:00 AM,011XX N LEAMINGTON AVE,0810,THEFT,OVER \$500,RESIDENTIAL YARD (FRONT/BACK),false,false,1531,015,37,25,06,1141821,1907155,2011,02/04/2016 06:33:39 AM,41.9012995,-87.754523767\\
8316827,HT550963,09/01/2011 04:00:00 PM,079XX S LOOMIS BLVD,0610,BURGLARY,FORCIBLE ENTRY,RESIDENCE-GARAGE,false,false,0612,006,21,71,05,1168380,1851969,2011,02/04/2016 06:33:39 AM,41.749330381,-87.658562005\\
8316838,HT548010,10/17/2011 03:20:00 PM,055XX N KEDZIE AVE,0820,THEFT,\$500 AND UNDER,"SCHOOL, PUBLIC, GROUNDS",true,false,1712,017,40,13,06,1154047,1936545,2011,02/04/2016 06:33:39 AM,41.981712678,-87.708829703\\
8316839,HT551049,10/20/2011 08:50:00 AM,102XX S AVENUE N,0430,BATTERY,AGGRAVATED: OTHER DANG WEAPON,STREET,false,false,0432,004,10,52,04B,1201166,1837763,2011,02/04/2016 06:33:39 AM,41.709579698,-87.538903651\\
8316871,HT549680,10/19/2011 01:03:00 PM,044XX N BROADWAY,0460,BATTERY,SIMPLE,DEPARTMENT STORE,false,false,2313,019,46,3,08B,1168460,1929880,2011,02/04/2016 06:33:39 AM,41.963123126,-87.65601675\\
8316872,HT551071,10/19/2011 03:10:00 PM,053XX S CALUMET AVE,0810,THEFT,OVER \$500,RESIDENCE,false,false,0234,002,3,40,06,1179390,1869685,2011,02/04/2016 06:33:39 AM,41.797700881,-87.617676981\\
8316873,HT551063,10/20/2011 11:10:00 AM,003XX E 47TH ST,1811,NARCOTICS,POSS: CANNABIS 30GMS OR LESS,SIDEWALK,true,false,0222,002,3,38,18,1178980,1873925,2011,02/04/2016 06:33:39 AM,41.809345175,-87.619051287\\
8316874,HT550901,10/20/2011 09:11:00 AM,033XX W OGDEN AVE,2022,NARCOTICS,POSS: COCAINE,POLICE FACILITY/VEH PARKING LOT,true,false,1024,010,24,29,18,1154489,1891024,2011,02/04/2016 06:33:39 AM,41.856790413,-87.708424071\\
8316875,HT549739,10/19/2011 01:30:00 PM,002XX E GARFIELD BLVD,0820,THEFT,\$500 AND UNDER,CTA BUS,false,false,0232,002,3,40,06,1178645,1868596,2011,02/04/2016 06:33:39 AM,41.794729551,-87.620442108\\
8316880,HT549802,10/19/2011 12:00:00 PM,011XX W WILSON AVE,0460,BATTERY,SIMPLE,COLLEGE/UNIVERSITY GROUNDS,false,false,2311,019,46,3,08B,1167612,1930696,2011,02/04/2016 06:33:39 AM,41.96538061,-87.659110921\\
8316881,HT431449,08/04/2011 11:00:00 AM,027XX W CHICAGO AVE,0820,THEFT,\$500 AND UNDER,STREET,false,false,1313,012,26,24,06,1157782,1905211,2011,02/04/2016 06:33:39 AM,41.895654523,-87.69595021\\
8316882,HT549162,10/19/2011 06:42:00 AM,105XX S WESTERN AVE,0610,BURGLARY,FORCIBLE ENTRY,TAVERN/LIQUOR STORE,false,false,2211,022,19,72,05,1162255,1834721,2011,02/04/2016 06:33:39 AM,41.702128701,-87.681485145\\
8316884,HT544972,10/16/2011 04:30:00 AM,103XX S HALSTED ST,1310,CRIMINAL DAMAGE,TO PROPERTY,SMALL RETAIL STORE,false,false,2232,022,34,73,14,1172807,1836192,2011,02/04/2016 06:33:39 AM,41.705939683,-87.642803521\\
8316886,HT549777,10/19/2011 02:10:00 PM,014XX W PRATT BLVD,0850,THEFT,ATTEMPT THEFT,SMALL RETAIL STORE,false,false,2431,024,49,1,06,1165565,1945281,2011,02/04/2016 06:33:39 AM,42.005446228,-87.666219555\\
8316887,HT551046,10/20/2011 11:10:00 AM,050XX N WINTHROP AVE,2820,OTHER OFFENSE,TELEPHONE THREAT,RESIDENCE,false,false,2033,020,48,3,26,1167955,1933907,2011,02/04/2016 06:33:39 AM,41.974184283,-87.657756697\\
8316889,HT550997,10/20/2011 09:10:00 AM,041XX N DICKINSON AVE,1121,DECEPTIVE PRACTICE,COUNTERFEITING DOCUMENT,STREET,true,false,1624,016,45,15,10,1142513,1926900,2011,02/04/2016 06:33:39 AM,41.955468935,-87.751489799\\
8316890,HT532649,10/07/2011 11:46:00 PM,062XX S VERNON AVE,2092,NARCOTICS,SOLICIT NARCOTICS ON PUBLICWAY,SIDEWALK,true,false,0313,003,20,42,26,1180324,1863694,2011,02/04/2016 06:33:39 AM,41.781239632,-87.614435596\\
8316893,HT551023,10/20/2011 02:00:00 AM,081XX S STEWART AVE,0810,THEFT,OVER \$500,STREET,false,false,0622,006,21,44,06,1175042,1850896,2011,02/04/2016 06:33:39 AM,41.746239973,-87.634181801\\
8316894,HT550772,10/20/2011 07:10:00 AM,048XX N TALMAN AVE,1320,CRIMINAL DAMAGE,TO VEHICLE,STREET,false,false,2031,020,40,4,14,1157831,1931974,2011,02/04/2016 06:33:39 AM,41.969093078,-87.695038453\\
8316898,HT551055,10/16/2011 09:00:00 AM,018XX S LAFLIN ST,1365,CRIMINAL TRESPASS,TO RESIDENCE,APARTMENT,false,false,1222,012,25,31,26,1166665,1891065,2011,02/04/2016 06:33:39 AM,41.856651049,-87.663730374\\
8316899,HT550695,10/20/2011 05:30:00 AM,122XX S HALSTED ST,1310,CRIMINAL DAMAGE,TO PROPERTY,RESIDENCE PORCH/HALLWAY,false,false,0524,005,34,53,14,1173210,1823636,2011,02/04/2016 06:33:39 AM,41.671475169,-87.641696924\\
8316901,HT549052,10/19/2011 12:01:00 AM,064XX S DR MARTIN LUTHER KING JR DR,1811,NARCOTICS,POSS: CANNABIS 30GMS OR LESS,STREET,true,false,0312,003,20,42,18,1180027,1862432,2011,02/04/2016 06:33:39 AM,41.777783389,-87.615563072\\
8316902,HT550988,10/20/2011 10:25:00 AM,066XX S KENNETH AVE,0486,BATTERY,DOMESTIC BATTERY SIMPLE,RESIDENCE,false,false,0833,008,13,65,08B,1147854,1860166,2011,02/04/2016 06:33:39 AM,41.772241474,-87.733568892\\
8316909,HT550957,10/20/2011 04:45:00 AM,051XX S MONITOR AVE,2825,OTHER OFFENSE,HARASSMENT BY TELEPHONE,RESIDENCE,false,true,0811,008,23,56,26,1138234,1869952,2011,02/04/2016 06:33:39 AM,41.79927468,-87.768598031\\
Input: Event Log (What happened, When and Where)
No manual selection of features!
The Problem:
1 Week in advance
Within ~2 city blocks
ONLY Past eventlog as input
"crime forecast"
93% accuracy
87% AUC
~70% specificity at ~80% sensitivity
10 actual crimes:
11 predicted:
8 correct:
2 missed:
3 false alarms
Chicago Predictive Performance
The Underlying Math
Not based on standard "Deep Learning"
Applies to any rare/extreme event phenomena
Ishanu Chattopadhyay, Yi Huang, James Evans et al. Deep Learning Without Neural Networks: Fractal-nets for Rare Event Modeling, 26 October 2020, PREPRINT (Version https://doi.org/10.21203/rs.3.rs-86045/v1
Digital Twin
Not just a predictor
Focusing on dynamics of observables
unmodeled factors
Observable future is a function of the observable past
Why no "features" ?
Philadelphia
Predicting crime sufficiently ahead of time to be actionable
>3 days in advance
Within ~2 city blocks
ONLY Past eventlog as input
Mean AUC
Property crime: 81%
Violent crime: 84%
Spatial tiles:
0.003 deg latitude, 0.003 deg longitude
0.25 miles across
Time-period:
Training: Jan 1 2016 - Dec 31 2018
Out-of-sample test: Jan 1 2019 - April 1 2019
Prediction Performance (Philadelphia)
sensitivity 0.90
ppv 0.87
100 crimes
Raise 103 flags
90 correct flags
13 false positives
10 missed
3 day ahead prediction
Jan 1 2019
to
April 1 2019
Play Movie
Triangles: actual events
heatmap: predicted risk 3 days ahead
Could we have predicted this?
Double homicide
Jan 7 2019
Triple homicide incident
Jan 7 2019
https://www.inquirer.com/crime/kensington-triple-shooting-homicide-philadelphia-police-20190107.html
Triangles: actual events
heatmap: predicted risk 3 days ahead
2019, Jan - 2022, Mar: Training
2022, Apr - 2022 Sep: Testing
Property and Violent Crimes
Every 10 events, about 8 flags are raised, with almost no false alarms
Rates of different crimes
Spatial Resolution
(~1000 yards)
Average sensitivity: 0.85
Average positive predictive value: 1.0
Horizon: 7 days +/- 1 Day
142 spatial tiles (~1000 yards tile size)
2020 - 2022, May: Training
2022, June - 2022 Dec: Testing
Property and Violent Crimes
Rates of different crimes
Out-of-sample Prediction
Average sensitivity: 0.83
Average positive predictive value: 0.98
Horizon: 7 days +/- 1 Day
220 spatial tiles
Training: Jan 1 2021 - March 31 2022
Out-of-sample test: Apr 1 2022 - July 22 2022
Spatial tiles:
0.0028 deg latitude, 0.0019 deg longitude
0.2 miles across
(100 x 300 yds)
Boston Districts: B2 B3 C1
Jan 1 2021 - July 22 2022
Total # of events: 7419
Boston MA, USA
fp 1.840708
tp 21.530973
fn 2.946903
sens 0.878993
ppv 0.909565
fp 0.106195
tp 3.982301
fn 0.522124
sens 0.881521
ppv 0.960446
property
violent
Property:
Other_Larceny-Larceny_from_MV-Auto_Theft-Residential_Burglary-Robbery-Commercial_Burglary
Violent:
Aggravated_Assault-Rape_&_Attempted-Homicide
Mean AUC
Property crime: 81%
Violent crime: 84%
Predicting
extreme weather
Predicting
extreme weather
Outperforms pure physics-based models at longer horizons
No point learning individual sample paths
Can we learn stochastic phenomena non-parametrically?
Can we learn stochastic phenomena non-parametrically?
?
Chattopadhyay, Ishanu, and Hod Lipson. "Abductive learning of quantized stochastic processes with probabilistic finite automata." Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences 371, no. 1984 (2013): 20110543.
State structure :
self-similarity in dynamical systems
Deep Learning without Neural Networks
Fractal Net: Information gradient doe not decay from the computation
Fractal Net
Neural Net
fixed non-linear activation
The Fractal Net architecture
No back-propagation
Deep Learning without Neural Networks
Physics Introduction as structural and other constraints
Nearly
Hands-free
No feature-engineering
Next:
Model and predict world events
Predicting World Events
Temporal resolution: 1 day
Spatial Resolution: \(1^\circ \times 2^\circ\)
Global Terrorism DataBase
Where do we go next?
How can this model be extened?
Extreme Event Prediction
Simulate
the world
The Risk of Unchecked State Control and Abrogation of Individual Liberties
Perhaps it is really not a question about AI, but about clarity on the principles by which we wish to govern ourselves
AI