{"id":"https://openalex.org/W7204544434","doi":"https://doi.org/10.48550/arxiv.2608.26915","title":"A Digital Twin for Individualized Treatment Effects of Non-Invasive Respiratory Support Strategies (DINIRS)","display_name":"A Digital Twin for Individualized Treatment Effects of Non-Invasive Respiratory Support Strategies (DINIRS)","publication_year":2026,"publication_date":"2026-08-27","ids":{"openalex":"https://openalex.org/W7204544434","doi":"https://doi.org/10.48550/arxiv.2608.26915"},"language":"en","primary_location":{"id":"pmh:oai:arXiv.org:2608.26915","doi":null,"is_oa":true,"landing_page_url":"https://arxiv.org/abs/2608.26915","pdf_url":"https://arxiv.org/pdf/2608.26915","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-nc-sa","license_id":"https://openalex.org/licenses/cc-by-nc-sa","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/2608.26915","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5121524585","display_name":"Md Fantacher Islam","orcid":"https://orcid.org/0000-0002-0524-4587","observed_orcids":["https://orcid.org/0000-0002-0524-4587"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Islam, Md Fantacher","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5002885008","display_name":"Jarrod M Mosier","orcid":"https://orcid.org/0000-0002-5371-0845","observed_orcids":["https://orcid.org/0000-0002-5371-0845"]},"institutions":[{"id":"https://openalex.org/I138006243","display_name":"University of Arizona","ror":"https://ror.org/03m2x1q45","country_code":"US","type":"education","lineage":["https://openalex.org/I138006243"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Mosier, Jarrod","raw_affiliation_strings":["College of Medicine -Tucson , The University of Arizona , Tucson , AZ , USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"College of Medicine -Tucson , The University of Arizona , Tucson , AZ , USA","institution_ids":["https://openalex.org/I138006243"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5148491267","display_name":"Vignesh Subbian","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I138006243","display_name":"University of Arizona","ror":"https://ror.org/03m2x1q45","country_code":"US","type":"education","lineage":["https://openalex.org/I138006243"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Subbian, Vignesh","raw_affiliation_strings":["College of Engineering , The University of Arizona , Tucson , AZ , USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"College of Engineering , The University of Arizona , Tucson , AZ , USA","institution_ids":["https://openalex.org/I138006243"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"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/T10322","display_name":"Respiratory Support and Mechanisms","score":0.8651999831199646,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10322","display_name":"Respiratory Support and Mechanisms","score":0.8651999831199646,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory 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/T13702","display_name":"Machine Learning in Healthcare","score":0.08720000088214874,"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/T10845","display_name":"Advanced Causal Inference Techniques","score":0.003599999938160181,"subfield":{"id":"https://openalex.org/subfields/2613","display_name":"Statistics and Probability"},"field":{"id":"https://openalex.org/fields/26","display_name":"Mathematics"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/non-invasive-respiratory-support","display_name":"non-invasive respiratory support","score":0.9620000123977661},{"id":"https://openalex.org/keywords/individual-treatment-effects","display_name":"individual treatment effects","score":0.7860000133514404},{"id":"https://openalex.org/keywords/acute-respiratory-failure","display_name":"acute respiratory failure","score":0.9750000238418579},{"id":"https://openalex.org/keywords/invasive-mechanical-ventilation","display_name":"invasive mechanical ventilation","score":0.7839999794960022},{"id":"https://openalex.org/keywords/ventilator-free-days","display_name":"ventilator-free days","score":0.9110000133514404},{"id":"https://openalex.org/keywords/transformer-encoder","display_name":"Transformer encoder","score":0.5600000023841858},{"id":"https://openalex.org/keywords/doubly-robust-estimation","display_name":"doubly robust estimation","score":0.6710000038146973},{"id":"https://openalex.org/keywords/mimic-iv","display_name":"MIMIC-IV","score":0.8009999990463257},{"id":"https://openalex.org/keywords/eicu-collaborative-research-database","display_name":"eICU-CRD","score":0.9139999747276306}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8324999809265137},{"id":"https://openalex.org/C2777080012","wikidata":"https://www.wikidata.org/wiki/Q3766250","display_name":"Mechanical ventilation","level":2,"score":0.6004999876022339},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.5598000288009644},{"id":"https://openalex.org/C2776888751","wikidata":"https://www.wikidata.org/wiki/Q767485","display_name":"Respiratory failure","level":2,"score":0.5514000058174133},{"id":"https://openalex.org/C2910844663","wikidata":"https://www.wikidata.org/wiki/Q767485","display_name":"Acute respiratory failure","level":3,"score":0.5450999736785889},{"id":"https://openalex.org/C2776779939","wikidata":"https://www.wikidata.org/wiki/Q1479485","display_name":"Hypoxemia","level":2,"score":0.539900004863739},{"id":"https://openalex.org/C200457457","wikidata":"https://www.wikidata.org/wiki/Q584049","display_name":"Ventilation (architecture)","level":2,"score":0.4771000146865845},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.45080000162124634},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.4221000075340271},{"id":"https://openalex.org/C2779358675","wikidata":"https://www.wikidata.org/wiki/Q3766250","display_name":"Respiratory monitoring","level":3,"score":0.40619999170303345},{"id":"https://openalex.org/C534529494","wikidata":"https://www.wikidata.org/wiki/Q7891","display_name":"Respiratory system","level":2,"score":0.3443000018596649},{"id":"https://openalex.org/C2777387402","wikidata":"https://www.wikidata.org/wiki/Q545991","display_name":"Artificial ventilation","level":4,"score":0.2944999933242798},{"id":"https://openalex.org/C188816634","wikidata":"https://www.wikidata.org/wiki/Q2113324","display_name":"Prospective cohort study","level":2,"score":0.27810001373291016},{"id":"https://openalex.org/C2778584172","wikidata":"https://www.wikidata.org/wiki/Q7579051","display_name":"Spontaneous breathing trial","level":3,"score":0.27140000462532043},{"id":"https://openalex.org/C168563851","wikidata":"https://www.wikidata.org/wiki/Q1436668","display_name":"Randomized controlled trial","level":2,"score":0.26170000433921814},{"id":"https://openalex.org/C8213797","wikidata":"https://www.wikidata.org/wiki/Q754250","display_name":"Respiratory rate","level":4,"score":0.2549000084400177},{"id":"https://openalex.org/C2776178081","wikidata":"https://www.wikidata.org/wiki/Q3286546","display_name":"Respiratory disease","level":3,"score":0.2542000114917755},{"id":"https://openalex.org/C2781326671","wikidata":"https://www.wikidata.org/wiki/Q754424","display_name":"Apnea","level":2,"score":0.25220000743865967}],"mesh":[],"locations_count":2,"locations":[{"id":"pmh:oai:arXiv.org:2608.26915","doi":null,"is_oa":true,"landing_page_url":"https://arxiv.org/abs/2608.26915","pdf_url":"https://arxiv.org/pdf/2608.26915","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-nc-sa","license_id":"https://openalex.org/licenses/cc-by-nc-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"text"},{"id":"doi:10.48550/arxiv.2608.26915","doi":"https://doi.org/10.48550/arxiv.2608.26915","is_oa":true,"landing_page_url":"https://doi.org/10.48550/arxiv.2608.26915","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-nc-sa","license_id":"https://openalex.org/licenses/cc-by-nc-sa","version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Preprint"}],"best_oa_location":{"id":"pmh:oai:arXiv.org:2608.26915","doi":null,"is_oa":true,"landing_page_url":"https://arxiv.org/abs/2608.26915","pdf_url":"https://arxiv.org/pdf/2608.26915","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-nc-sa","license_id":"https://openalex.org/licenses/cc-by-nc-sa","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","display_name":"Good health and well-being","score":0.98580002784729}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7204544434.pdf","grobid_xml":"https://content.openalex.org/works/W7204544434.grobid-xml"},"referenced_works_count":36,"referenced_works":["https://openalex.org/W1978960863","https://openalex.org/W2003336670","https://openalex.org/W2069274646","https://openalex.org/W2134843796","https://openalex.org/W2148218430","https://openalex.org/W2208550830","https://openalex.org/W2286228001","https://openalex.org/W2298338128","https://openalex.org/W2519293880","https://openalex.org/W2624816748","https://openalex.org/W2735301415","https://openalex.org/W2753000083","https://openalex.org/W2767884503","https://openalex.org/W2891400669","https://openalex.org/W2943492071","https://openalex.org/W2984947744","https://openalex.org/W2998464480","https://openalex.org/W3091954295","https://openalex.org/W4313439128","https://openalex.org/W4322397527","https://openalex.org/W4323294178","https://openalex.org/W4360605866","https://openalex.org/W4383621392","https://openalex.org/W4385896006","https://openalex.org/W4388656403","https://openalex.org/W4388980293","https://openalex.org/W4394857110","https://openalex.org/W4396796062","https://openalex.org/W4401278294","https://openalex.org/W4402208720","https://openalex.org/W4402305677","https://openalex.org/W4416986448","https://openalex.org/W4417189080","https://openalex.org/W4417267298","https://openalex.org/W7131628304","https://openalex.org/W7166551995"],"related_works":["https://openalex.org/W3184747815","https://openalex.org/W7113084988","https://openalex.org/W7223274556","https://openalex.org/W4399135017","https://openalex.org/W3177220184","https://openalex.org/W4384790417","https://openalex.org/W4416986448","https://openalex.org/W3212762889","https://openalex.org/W4386899171","https://openalex.org/W4417132024"],"abstract_inverted_index":{"Objective:":[0],"Choosing":[1],"between":[2,56],"noninvasive":[3],"respiratory":[4,14,242],"support":[5,243],"(NIRS)":[6],"and":[7,46,50,60,86,90,101,129,190],"invasive":[8],"mechanical":[9],"ventilation":[10,48,87,131,207],"(IMV)":[11],"for":[12,67],"acute":[13],"failure":[15],"is":[16,227],"a":[17,62,94,120,159],"time-sensitive":[18],"decision.":[19],"Although":[20],"guidelines":[21],"provide":[22],"population-level":[23],"guidance,":[24],"it":[25],"remains":[26],"unclear":[27],"who":[28],"benefits":[29],"more":[30],"from":[31,147,205,212],"NIRS":[32,177,202],"than":[33,211],"IMV.":[34],"The":[35,155,201,235],"standard":[36],"outcome,":[37],"ventilator-free":[38,164],"days":[39,42,165],"at":[40],"28":[41],"(VFD-28),":[43],"scores":[44],"death":[45],"prolonged":[47],"equally,":[49],"current":[51],"estimators":[52],"do":[53],"not":[54],"distinguish":[55],"them.":[57],"We":[58,92,140],"developed":[59],"validated":[61,142],"censoring-aware":[63],"Digital":[64],"Twin":[65],"framework":[66,237],"Individualized":[68],"Treatment":[69],"Effects":[70],"of":[71,162],"Non-Invasive":[72],"Respiratory":[73],"Support":[74],"(DINIRS)":[75],"to":[76,244],"estimate":[77],"individualized":[78],"treatment":[79,233],"effects":[80],"(ITEs)":[81],"that":[82,216],"capture":[83],"both":[84],"mortality":[85],"duration.":[88,132],"Materials":[89],"Methods:":[91],"emulated":[93],"target":[95],"trial":[96],"in":[97,144],"5,336":[98],"MIMIC-IV":[99],"patients":[100,146,182],"trained":[102],"DINIRS":[103,143,156],"on":[104],"23":[105],"baseline":[106],"clinical":[107],"variables":[108],"measured":[109],"during":[110],"the":[111,148,221],"first":[112],"24":[113],"ICU":[114],"hours.":[115],"A":[116,133],"transformer":[117],"encoder":[118],"with":[119,173,183],"survival":[121,127],"attention":[122],"gate":[123],"decomposed":[124],"VFD-28":[125],"into":[126],"probability":[128],"conditional":[130],"cross-fitted,":[134],"doubly":[135],"robust":[136],"learner":[137],"estimated":[138],"ITEs.":[139],"externally":[141],"2,540":[145],"multi-site":[149],"eICU-CRD":[150],"dataset":[151],"without":[152],"retraining.":[153],"Results:":[154],"policy":[157],"achieved":[158],"mean":[160],"benefit":[161,178,203],"2.07":[163],"per":[166,169],"patient":[167],"(207":[168],"100":[170],"patients)":[171],"compared":[172],"observed":[174],"practice.":[175],"Predicted":[176],"was":[179,220],"higher":[180],"among":[181,208],"less":[184],"organ":[185],"dysfunction":[186],"(88.4%":[187],"versus":[188],"49.0%)":[189],"persisted":[191],"across":[192],"hypoxemia":[193],"severity.":[194],"External":[195],"validation":[196,226],"reproduced":[197],"this":[198],"pattern.":[199],"Discussion:":[200],"stemmed":[204],"shorter":[206],"survivors":[209],"rather":[210],"reduced":[213],"mortality,":[214],"indicating":[215],"avoiding":[217],"intubation-associated":[218],"complications":[219],"primary":[222],"mechanism.":[223],"Conclusion:":[224],"Prospective":[225],"needed":[228],"before":[229],"these":[230],"estimates":[231],"inform":[232],"decisions.":[234],"decomposition":[236],"can":[238],"be":[239],"extended":[240],"beyond":[241],"any":[245],"zero-inflated":[246],"composite":[247],"outcome.":[248]},"counts_by_year":[],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2026-08-29T00:00:00"}