{"id":"https://openalex.org/W7117105476","doi":"https://doi.org/10.1109/jbhi.2025.3647877","title":"Tailored to Fit Sepsis Individuals: Medical Knowledge Aware Reinforcement Learning Model Offers Optimized Therapeutic Strategies","display_name":"Tailored to Fit Sepsis Individuals: Medical Knowledge Aware Reinforcement Learning Model Offers Optimized Therapeutic Strategies","publication_year":2025,"publication_date":"2025-12-24","ids":{"openalex":"https://openalex.org/W7117105476","doi":"https://doi.org/10.1109/jbhi.2025.3647877","pmid":"https://pubmed.ncbi.nlm.nih.gov/41442288"},"language":"en","primary_location":{"id":"doi:10.1109/jbhi.2025.3647877","is_oa":false,"landing_page_url":"https://doi.org/10.1109/jbhi.2025.3647877","pdf_url":null,"source":{"id":"https://openalex.org/S2495854775","display_name":"IEEE Journal of Biomedical and Health Informatics","issn_l":"2168-2194","issn":["2168-2194","2168-2208"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310319808","host_organization_name":"Institute of Electrical and Electronics Engineers","host_organization_lineage":["https://openalex.org/P4310319808"],"host_organization_lineage_names":["Institute of Electrical and Electronics Engineers"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"IEEE Journal of Biomedical and Health Informatics","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5121184597","display_name":"Xue Feng","orcid":null},"institutions":[{"id":"https://openalex.org/I55712492","display_name":"Zhejiang University of Technology","ror":"https://ror.org/02djqfd08","country_code":"CN","type":"education","lineage":["https://openalex.org/I55712492"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Xue Feng","raw_affiliation_strings":["College of Information Engineering, Zhejiang University of Technology, Hangzhou, China"],"raw_orcid":"https://orcid.org/0000-0002-3758-421X","affiliations":[{"raw_affiliation_string":"College of Information Engineering, Zhejiang University of Technology, Hangzhou, China","institution_ids":["https://openalex.org/I55712492"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5103012454","display_name":"Siyi Zhu","orcid":null},"institutions":[{"id":"https://openalex.org/I76130692","display_name":"Zhejiang University","ror":"https://ror.org/00a2xv884","country_code":"CN","type":"education","lineage":["https://openalex.org/I76130692"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Siyi Zhu","raw_affiliation_strings":["Department of Biomedical Engineering, Zhejiang University, Hangzhou, China"],"raw_orcid":"https://orcid.org/0009-0003-2905-6104","affiliations":[{"raw_affiliation_string":"Department of Biomedical Engineering, Zhejiang University, Hangzhou, China","institution_ids":["https://openalex.org/I76130692"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5000941007","display_name":"Luping Fang","orcid":"https://orcid.org/0000-0001-7752-4839"},"institutions":[{"id":"https://openalex.org/I55712492","display_name":"Zhejiang University of Technology","ror":"https://ror.org/02djqfd08","country_code":"CN","type":"education","lineage":["https://openalex.org/I55712492"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Luping Fang","raw_affiliation_strings":["College of Information Engineering, Zhejiang University of Technology, Hangzhou, China"],"raw_orcid":"https://orcid.org/0000-0001-7752-4839","affiliations":[{"raw_affiliation_string":"College of Information Engineering, Zhejiang University of Technology, Hangzhou, China","institution_ids":["https://openalex.org/I55712492"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5121175063","display_name":"Huaiping Zhu","orcid":null},"institutions":[{"id":"https://openalex.org/I192455969","display_name":"York University","ror":"https://ror.org/05fq50484","country_code":"CA","type":"education","lineage":["https://openalex.org/I192455969"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Huaiping Zhu","raw_affiliation_strings":["Department of Mathematics and Statistics, York University, Toronto, ON, Canada"],"raw_orcid":"https://orcid.org/0000-0003-2718-595X","affiliations":[{"raw_affiliation_string":"Department of Mathematics and Statistics, York University, Toronto, ON, Canada","institution_ids":["https://openalex.org/I192455969"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5101740948","display_name":"Guolong Cai","orcid":"https://orcid.org/0000-0003-0056-663X"},"institutions":[{"id":"https://openalex.org/I4210119853","display_name":"Zhejiang Hospital","ror":"https://ror.org/02kzr5g33","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210119853"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Guolong Cai","raw_affiliation_strings":["Department of Intensive Care Unit, Zhejiang Hospital, Hangzhou, China"],"raw_orcid":"https://orcid.org/0000-0003-0056-663X","affiliations":[{"raw_affiliation_string":"Department of Intensive Care Unit, Zhejiang Hospital, Hangzhou, China","institution_ids":["https://openalex.org/I4210119853"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5121228742","display_name":"Yanfei Shen","orcid":null},"institutions":[{"id":"https://openalex.org/I4210119853","display_name":"Zhejiang Hospital","ror":"https://ror.org/02kzr5g33","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210119853"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Yanfei Shen","raw_affiliation_strings":["Department of Intensive Care Unit, Zhejiang Hospital, Hangzhou, China"],"raw_orcid":"https://orcid.org/0000-0002-6752-2829","affiliations":[{"raw_affiliation_string":"Department of Intensive Care Unit, Zhejiang Hospital, Hangzhou, China","institution_ids":["https://openalex.org/I4210119853"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5035068745","display_name":"Gangmin Ning","orcid":"https://orcid.org/0000-0001-9107-5785"},"institutions":[{"id":"https://openalex.org/I76130692","display_name":"Zhejiang University","ror":"https://ror.org/00a2xv884","country_code":"CN","type":"education","lineage":["https://openalex.org/I76130692"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Gangmin Ning","raw_affiliation_strings":["Department of Biomedical Engineering, Zhejiang University, Hangzhou, China"],"raw_orcid":"https://orcid.org/0000-0001-9107-5785","affiliations":[{"raw_affiliation_string":"Department of Biomedical Engineering, Zhejiang University, Hangzhou, China","institution_ids":["https://openalex.org/I76130692"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":4,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.8521,"has_fulltext":false,"cited_by_count":1,"citation_normalized_percentile":{"value":0.80873023,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":94,"max":97},"biblio":{"volume":"30","issue":"7","first_page":"5692","last_page":"5705"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10218","display_name":"Sepsis Diagnosis and Treatment","score":0.7748000025749207,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"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/T10218","display_name":"Sepsis Diagnosis and Treatment","score":0.7748000025749207,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"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":0.17949999868869781,"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/T10867","display_name":"Intensive Care Unit Cognitive Disorders","score":0.0044999998062849045,"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"}}],"keywords":[{"id":"https://openalex.org/keywords/reinforcement-learning","display_name":"Reinforcement learning","score":0.7760999798774719},{"id":"https://openalex.org/keywords/transfer-of-learning","display_name":"Transfer of learning","score":0.5943999886512756},{"id":"https://openalex.org/keywords/ontology","display_name":"Ontology","score":0.5076000094413757},{"id":"https://openalex.org/keywords/sepsis","display_name":"Sepsis","score":0.4569000005722046},{"id":"https://openalex.org/keywords/deep-learning","display_name":"Deep learning","score":0.4339999854564667},{"id":"https://openalex.org/keywords/disease","display_name":"Disease","score":0.4059000015258789},{"id":"https://openalex.org/keywords/generalization","display_name":"Generalization","score":0.39800000190734863}],"concepts":[{"id":"https://openalex.org/C97541855","wikidata":"https://www.wikidata.org/wiki/Q830687","display_name":"Reinforcement learning","level":2,"score":0.7760999798774719},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.6549999713897705},{"id":"https://openalex.org/C119857082","wikidata":"https://www.wikidata.org/wiki/Q2539","display_name":"Machine learning","level":1,"score":0.6377000212669373},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.6086000204086304},{"id":"https://openalex.org/C150899416","wikidata":"https://www.wikidata.org/wiki/Q1820378","display_name":"Transfer of learning","level":2,"score":0.5943999886512756},{"id":"https://openalex.org/C25810664","wikidata":"https://www.wikidata.org/wiki/Q44325","display_name":"Ontology","level":2,"score":0.5076000094413757},{"id":"https://openalex.org/C2778384902","wikidata":"https://www.wikidata.org/wiki/Q183134","display_name":"Sepsis","level":2,"score":0.4569000005722046},{"id":"https://openalex.org/C108583219","wikidata":"https://www.wikidata.org/wiki/Q197536","display_name":"Deep learning","level":2,"score":0.4339999854564667},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.4059000015258789},{"id":"https://openalex.org/C177148314","wikidata":"https://www.wikidata.org/wiki/Q170084","display_name":"Generalization","level":2,"score":0.39800000190734863},{"id":"https://openalex.org/C2987404301","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care","level":2,"score":0.39649999141693115},{"id":"https://openalex.org/C2780665704","wikidata":"https://www.wikidata.org/wiki/Q959298","display_name":"Intervention (counseling)","level":2,"score":0.390500009059906},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.33219999074935913},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.3050000071525574},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.3043999969959259},{"id":"https://openalex.org/C2776359362","wikidata":"https://www.wikidata.org/wiki/Q2145286","display_name":"Representation (politics)","level":3,"score":0.2919999957084656},{"id":"https://openalex.org/C2777267654","wikidata":"https://www.wikidata.org/wiki/Q3519023","display_name":"Test (biology)","level":2,"score":0.28769999742507935},{"id":"https://openalex.org/C50644808","wikidata":"https://www.wikidata.org/wiki/Q192776","display_name":"Artificial neural network","level":2,"score":0.28540000319480896},{"id":"https://openalex.org/C163763905","wikidata":"https://www.wikidata.org/wiki/Q17075943","display_name":"Precision medicine","level":2,"score":0.2572999894618988}],"mesh":[{"descriptor_ui":"D000098408","descriptor_name":"Reinforcement Machine Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D000098408","descriptor_name":"Reinforcement Machine Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D000098410","descriptor_name":"Transfer Machine Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000098410","descriptor_name":"Transfer Machine Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000465","descriptor_name":"Algorithms","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000465","descriptor_name":"Algorithms","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D018805","descriptor_name":"Sepsis","qualifier_ui":"Q000175","qualifier_name":"diagnosis","is_major_topic":true},{"descriptor_ui":"D018805","descriptor_name":"Sepsis","qualifier_ui":"Q000175","qualifier_name":"diagnosis","is_major_topic":true},{"descriptor_ui":"D018805","descriptor_name":"Sepsis","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true},{"descriptor_ui":"D018805","descriptor_name":"Sepsis","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true}],"locations_count":2,"locations":[{"id":"doi:10.1109/jbhi.2025.3647877","is_oa":false,"landing_page_url":"https://doi.org/10.1109/jbhi.2025.3647877","pdf_url":null,"source":{"id":"https://openalex.org/S2495854775","display_name":"IEEE Journal of Biomedical and Health Informatics","issn_l":"2168-2194","issn":["2168-2194","2168-2208"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310319808","host_organization_name":"Institute of Electrical and Electronics Engineers","host_organization_lineage":["https://openalex.org/P4310319808"],"host_organization_lineage_names":["Institute of Electrical and Electronics Engineers"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"IEEE Journal of Biomedical and Health Informatics","raw_type":"journal-article"},{"id":"pmid:41442288","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/41442288","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"IEEE journal of biomedical and health informatics","raw_type":null}],"best_oa_location":null,"sustainable_development_goals":[{"score":0.46511393785476685,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":[],"abstract_inverted_index":{"Sepsis":[0],"is":[1],"a":[2,71,109,131,182],"life-threatening":[3],"syndrome,":[4],"with":[5,45,65,169,226,249],"high":[6],"morbidity":[7],"and":[8,12,80,101,153,190,243],"mortality.":[9],"Timely":[10],"treatments":[11],"precise":[13],"interventions":[14],"are":[15],"crucial":[16],"for":[17,63,130,141,247],"improving":[18],"sepsis":[19,32,43,64,248],"patient":[20,114,133,146],"outcomes.":[21],"Reinforcement":[22],"learning":[23,86,121,137],"(RL)":[24],"models":[25,36],"have":[26],"made":[27],"promising":[28],"advances":[29],"in":[30,148,162,173,199],"associating":[31],"treatments.":[33],"However,":[34],"existing":[35],"face":[37],"obstacles":[38],"when":[39],"applied":[40],"to":[41,53,107,125,197],"heterogeneous":[42],"patients":[44],"an":[46,117,208],"imbalanced":[47],"distribution":[48],"of":[49,113,222],"disease":[50,67,81,102,251],"severity,":[51,68],"struggling":[52],"maintain":[54],"optimal":[55,59,242],"performance.":[56],"To":[57],"provide":[58],"therapeutic":[60,127],"intervention":[61,128],"strategies":[62,129,172,246],"different":[66,149,250],"we":[69],"proposed":[70,231],"novel":[72],"treatment":[73,245],"recommendation":[74],"model":[75,156,179,232],"named":[76],"Medical":[77],"ontology":[78,99],"knowledge":[79,100],"diagnosis":[82,103],"Position":[83],"aware":[84],"Transfer":[85],"-":[87],"Double":[88],"Dueling":[89],"Deep":[90],"Q":[91],"Network":[92],"(MPT-D3QN).":[93],"Through":[94],"the":[95,142,158,170,177,192,204,218,223,227,230],"attention":[96],"mechanism,":[97],"medical":[98],"positions":[104],"were":[105],"introduced":[106],"achieve":[108],"more":[110],"accurate":[111],"representation":[112],"states.":[115],"Subsequently,":[116],"offline":[118],"deep":[119],"reinforcement":[120],"algorithm":[122],"was":[123,139],"used":[124],"recommend":[126],"specific":[132],"population.":[134],"The":[135],"transfer":[136,144],"framework":[138],"responsible":[140],"information":[143],"across":[145],"groups":[147],"domains.":[150],"We":[151],"trained":[152],"tested":[154],"MPT-D3QN":[155,178],"on":[157,207],"Multi-Parameter":[159],"Intelligent":[160],"Monitoring":[161],"Intensive":[163],"Care":[164],"III":[165],"(MIMIC-III)":[166],"dataset.":[167],"Compared":[168,225],"reported":[171],"present":[174],"clinical":[175],"practice,":[176],"could":[180],"obtain":[181],"higher":[183,236],"expected":[184,237],"return":[185],"value":[186],"(12.98":[187],"vs.":[188],"10.61)":[189],"reduce":[191],"estimated":[193],"mortality":[194],"from":[195],"13.20%":[196],"6.15%":[198],"all":[200],"test":[201,206],"datasets.":[202],"Moreover,":[203],"experimental":[205],"external":[209],"dataset":[210],"eICU":[211],"Collaborative":[212],"Research":[213],"Database":[214],"(eICU)":[215],"further":[216],"demonstrated":[217],"robust":[219],"generalization":[220],"capability":[221],"model.":[224],"state-of-the-art":[228],"models,":[229],"not":[233],"only":[234],"guaranteed":[235],"returns":[238],"but":[239],"also":[240],"generated":[241],"interpretable":[244],"severity.":[252]},"counts_by_year":[{"year":2026,"cited_by_count":1}],"updated_date":"2026-07-07T06:14:10.401900","created_date":"2025-12-24T00:00:00"}