A Bayesian Model for Multi-stage Censoring

Shuvom Sadhuka, Sophia Z. Lin, Bonnie Berger, Emma Pierson

Keywords: Bayesian models, healthcare, uncertainty quantificat

TL;DR: We introduce a Bayesian model for multi-stage censoring problems. We apply our model to study gender-based differences in emergency care.

Track: Proceedings

Abstract: Many sequential decision settings in healthcare feature _funnel_ structures characterized by a series of stages, such as screenings or evaluations, where the number of patients who advance to each stage progressively decreases and decisions become increasingly costly. For example, an oncologist may first conduct a breast exam, followed by a mammogram for patients with concerning exams, followed by a biopsy for patients with concerning mammograms. A key challenge is that the ground truth outcome, such as the biopsy result, is only revealed at the end of this funnel. The selective censoring of the ground truth can introduce statistical biases in risk estimation, especially in underserved patient groups, whose outcomes are often censored at higher rates. We develop a Bayesian model for funnel decision structures, drawing from prior work on selective labels and censoring. We first show in synthetic settings that our model is able to recover the true parameters and predict outcomes for censored patients more accurately than baselines. We then apply our model to a dataset of emergency department visits, where in-hospital mortality is observed only for those who are admitted to either the hospital or ICU. We find that there are gender-based differences in hospital and ICU admissions. In particular, our model estimates that mortality risk threshold to admit women to the ICU is higher for women (5.1%) than for men (4.5%).

General Area: Impact and Society

Specific Subject Areas: Bayesian & Probabilistic Methods, Algorithmic Fairness & Bias, Uncertainty & Distribution Shift

Data And Code Availability: Yes

Ethics Board Approval: No

Entered Conflicts: I confirm the above

Anonymity: I confirm the above

Code URL: https://github.com/shuvom-s/funnel_model/tree/main

Submission Number: 84