{"id":"https://openalex.org/W7168136271","doi":"https://doi.org/10.48550/arxiv.2607.08793","title":"EHR-MPC: Inference-Time Control for Sepsis Treatment with Generative Patient Digital Twins","display_name":"EHR-MPC: Inference-Time Control for Sepsis Treatment with Generative Patient Digital Twins","publication_year":2026,"publication_date":"2026-07-07","ids":{"openalex":"https://openalex.org/W7168136271","doi":"https://doi.org/10.48550/arxiv.2607.08793"},"language":"en","primary_location":{"id":"pmh:oai:arXiv.org:2607.08793","doi":null,"is_oa":true,"landing_page_url":"https://arxiv.org/abs/2607.08793","pdf_url":"https://arxiv.org/pdf/2607.08793","source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":"2331-8422","issn":["2331-8422"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"text"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["arxiv","datacite"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://arxiv.org/pdf/2607.08793","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5022282608","display_name":"Joshua Pickard","orcid":"https://orcid.org/0000-0002-8763-3200","observed_orcids":["https://orcid.org/0000-0002-8763-3200"]},"institutions":[{"id":"https://openalex.org/I107606265","display_name":"Broad Institute","ror":"https://ror.org/05a0ya142","country_code":"US","type":"nonprofit","lineage":["https://openalex.org/I107606265"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Pickard, Joshua","raw_affiliation_strings":["Broad Institute of MIT and Harvard"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Broad Institute of MIT and Harvard","institution_ids":["https://openalex.org/I107606265"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5140541327","display_name":"Wei Qi","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I107606265","display_name":"Broad Institute","ror":"https://ror.org/05a0ya142","country_code":"US","type":"nonprofit","lineage":["https://openalex.org/I107606265"]},{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Qi, Wei","raw_affiliation_strings":["Broad Institute of MIT and Harvard","Harvard University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Broad Institute of MIT and Harvard","institution_ids":["https://openalex.org/I107606265"]},{"raw_affiliation_string":"Harvard University","institution_ids":["https://openalex.org/I136199984"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5100368048","display_name":"Na Li","orcid":"https://orcid.org/0000-0001-9545-3050","observed_orcids":["https://orcid.org/0000-0001-9545-3050"]},"institutions":[{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Li, Na","raw_affiliation_strings":["Harvard University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Harvard University","institution_ids":["https://openalex.org/I136199984"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5109908970","display_name":"Ann E. Woolley","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Woolley, Ann","raw_affiliation_strings":["Harvard University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Harvard University","institution_ids":["https://openalex.org/I136199984"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5081374773","display_name":"Lisa A. Cosimi","orcid":"https://orcid.org/0000-0002-5269-1881","observed_orcids":["https://orcid.org/0000-0002-5269-1881"]},"institutions":[{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Cosimi, Lisa","raw_affiliation_strings":["Harvard University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Harvard University","institution_ids":["https://openalex.org/I136199984"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5062737173","display_name":"Roy Kishony","orcid":"https://orcid.org/0000-0002-5013-5072","observed_orcids":["https://orcid.org/0000-0002-5013-5072"]},"institutions":[{"id":"https://openalex.org/I174306211","display_name":"Technion \u2013 Israel Institute of Technology","ror":"https://ror.org/03qryx823","country_code":"IL","type":"education","lineage":["https://openalex.org/I174306211"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Kishony, Roy","raw_affiliation_strings":["Technion-Israel Institute of Technology"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Technion-Israel Institute of Technology","institution_ids":["https://openalex.org/I174306211"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5038739772","display_name":"Deborah Tan Hung","orcid":"https://orcid.org/0000-0003-4262-0673","observed_orcids":["https://orcid.org/0000-0003-4262-0673"]},"institutions":[{"id":"https://openalex.org/I107606265","display_name":"Broad Institute","ror":"https://ror.org/05a0ya142","country_code":"US","type":"nonprofit","lineage":["https://openalex.org/I107606265"]},{"id":"https://openalex.org/I174306211","display_name":"Technion \u2013 Israel Institute of Technology","ror":"https://ror.org/03qryx823","country_code":"IL","type":"education","lineage":["https://openalex.org/I174306211"]}],"countries":["IL","US"],"is_corresponding":false,"raw_author_name":"Hung, Deborah","raw_affiliation_strings":["Broad Institute of Harvard and MIT","Technion-Israel Institute of Technology"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Broad Institute of Harvard and MIT","institution_ids":["https://openalex.org/I107606265"]},{"raw_affiliation_string":"Technion-Israel Institute of Technology","institution_ids":["https://openalex.org/I174306211"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":3,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":1,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T13702","display_name":"Machine Learning in Healthcare","score":0.9883000254631042,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},"topics":[{"id":"https://openalex.org/T13702","display_name":"Machine Learning in Healthcare","score":0.9883000254631042,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T10218","display_name":"Sepsis Diagnosis and Treatment","score":0.00989999994635582,"subfield":{"id":"https://openalex.org/subfields/2706","display_name":"Critical Care and Intensive Care Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.0006000000284984708,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/sepsis-treatment","display_name":"sepsis treatment","score":0.9179999828338623},{"id":"https://openalex.org/keywords/model-predictive-control","display_name":"model predictive control","score":0.9599999785423279},{"id":"https://openalex.org/keywords/patient-digital-twins","display_name":"patient digital twins","score":0.7639999985694885},{"id":"https://openalex.org/keywords/inference-time-control","display_name":"inference-time control","score":0.7850000262260437},{"id":"https://openalex.org/keywords/treatment-optimization","display_name":"treatment optimization","score":0.5690000057220459},{"id":"https://openalex.org/keywords/simulation-based-assessment","display_name":"simulation-based assessment","score":0.7440000176429749},{"id":"https://openalex.org/keywords/reinforcement-learning-comparison","display_name":"reinforcement learning comparison","score":0.5350000262260437}],"concepts":[{"id":"https://openalex.org/C97541855","wikidata":"https://www.wikidata.org/wiki/Q830687","display_name":"Reinforcement learning","level":2,"score":0.6227999925613403},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.61080002784729},{"id":"https://openalex.org/C2778384902","wikidata":"https://www.wikidata.org/wiki/Q183134","display_name":"Sepsis","level":2,"score":0.5544999837875366},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.49810001254081726},{"id":"https://openalex.org/C39890363","wikidata":"https://www.wikidata.org/wiki/Q36108","display_name":"Generative grammar","level":2,"score":0.49050000309944153},{"id":"https://openalex.org/C2775924081","wikidata":"https://www.wikidata.org/wiki/Q55608371","display_name":"Control (management)","level":2,"score":0.4408999979496002},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.3869999945163727},{"id":"https://openalex.org/C119857082","wikidata":"https://www.wikidata.org/wiki/Q2539","display_name":"Machine learning","level":1,"score":0.3833000063896179},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.3424000144004822},{"id":"https://openalex.org/C2779974597","wikidata":"https://www.wikidata.org/wiki/Q28448986","display_name":"Clinical Practice","level":2,"score":0.3336000144481659},{"id":"https://openalex.org/C188198153","wikidata":"https://www.wikidata.org/wiki/Q1613840","display_name":"Limiting","level":2,"score":0.33239999413490295},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.3246000111103058},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.3122999966144562},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.2971000075340271},{"id":"https://openalex.org/C2989179672","wikidata":"https://www.wikidata.org/wiki/Q6806500","display_name":"Clinical decision making","level":2,"score":0.2847000062465668},{"id":"https://openalex.org/C81917197","wikidata":"https://www.wikidata.org/wiki/Q628760","display_name":"Selection (genetic algorithm)","level":2,"score":0.27000001072883606},{"id":"https://openalex.org/C177606310","wikidata":"https://www.wikidata.org/wiki/Q5674297","display_name":"Adaptability","level":2,"score":0.2615000009536743}],"mesh":[],"locations_count":2,"locations":[{"id":"pmh:oai:arXiv.org:2607.08793","doi":null,"is_oa":true,"landing_page_url":"https://arxiv.org/abs/2607.08793","pdf_url":"https://arxiv.org/pdf/2607.08793","source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":"2331-8422","issn":["2331-8422"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"text"},{"id":"doi:10.48550/arxiv.2607.08793","doi":"https://doi.org/10.48550/arxiv.2607.08793","is_oa":true,"landing_page_url":"https://doi.org/10.48550/arxiv.2607.08793","pdf_url":null,"source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":"2331-8422","issn":["2331-8422"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Preprint"}],"best_oa_location":{"id":"pmh:oai:arXiv.org:2607.08793","doi":null,"is_oa":true,"landing_page_url":"https://arxiv.org/abs/2607.08793","pdf_url":"https://arxiv.org/pdf/2607.08793","source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":"2331-8422","issn":["2331-8422"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"text"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.8371999859809875,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7168136271.pdf","grobid_xml":"https://content.openalex.org/works/W7168136271.grobid-xml"},"referenced_works_count":7,"referenced_works":["https://openalex.org/W2768978543","https://openalex.org/W2806905826","https://openalex.org/W2901839060","https://openalex.org/W2996582215","https://openalex.org/W3010701194","https://openalex.org/W3178504712","https://openalex.org/W4417134201"],"related_works":["https://openalex.org/W3010701194","https://openalex.org/W2901839060","https://openalex.org/W6926682247","https://openalex.org/W4293589470","https://openalex.org/W4401990772","https://openalex.org/W4312520804","https://openalex.org/W3180809143","https://openalex.org/W2619989803","https://openalex.org/W4407693924","https://openalex.org/W7154615237"],"abstract_inverted_index":{"Sepsis":[0],"is":[1],"a":[2,35,47,55,88,141],"leading":[3],"cause":[4],"of":[5,54],"mortality,":[6],"yet":[7],"optimal":[8],"treatment":[9,44,131],"policies":[10],"remain":[11],"contested.":[12],"Existing":[13],"reinforcement":[14],"learning":[15,39],"(RL)":[16],"approaches":[17],"learn":[18],"fixed":[19],"strategies":[20],"for":[21,144],"sepsis":[22,91,130],"treatment,":[23],"limiting":[24],"adaptability":[25],"to":[26,76,113],"changing":[27],"clinical":[28,66,149],"objectives":[29],"during":[30],"inference.":[31],"We":[32,84],"propose":[33],"EHRMPC,":[34],"framework":[36,143],"that":[37],"decouples":[38],"patient":[40,48,138],"dynamics":[41],"from":[42],"optimizing":[43],"by":[45],"training":[46],"digital":[49,63],"twin":[50,64],"in":[51,96],"the":[52,97],"form":[53],"generative":[56,148],"electronic":[57],"health":[58,101],"record":[59],"(EHR)":[60],"model.":[61],"The":[62],"predicts":[65],"trajectories":[67],"under":[68],"interventions":[69],"and":[70,108,121],"enables":[71],"model":[72],"predictive":[73],"control":[74,135],"(MPC)":[75],"optimize":[77],"treatments":[78],"via":[79],"inference-time":[80,134],"planning":[81],"over":[82,136],"simulations.":[83],"evaluate":[85],"EHR-MPC":[86,116],"on":[87],"multicenter":[89],"ICU":[90],"cohort":[92],"spanning":[93],"8":[94],"hospitals":[95],"Mass":[98],"General":[99],"Brigham":[100],"system":[102],"using":[103],"both":[104],"off-policy":[105,119],"importance":[106],"sampling":[107],"on-policy":[109],"simulation-based":[110],"evaluation.":[111],"Relative":[112],"RL":[114],"baselines,":[115],"achieves":[117],"comparable":[118],"performance":[120],"improved":[122],"simulation":[123],"performance.":[124],"Unlike":[125],"RL,":[126],"this":[127],"work":[128],"frames":[129],"optimization":[132],"as":[133],"learned":[137],"dynamics,":[139],"establishing":[140],"general":[142],"decision":[145],"making":[146],"with":[147],"models.":[150]},"counts_by_year":[{"year":2026,"cited_by_count":1}],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2026-07-14T00:00:00"}