MotivationThe identification of biomarkers to support decision-making is central to personalized medicine, in both clinical and research scenarios. The challenge can be seen in two halves: identifying predictive markers, which guide the development/use of tailored therapies; and identifying prognostic markers, which guide other aspects of care and clinical trial planning, i.e. prognostic markers can be considered as covariates for stratification. Mistakenly assuming a biomarker to be predictive, when it is in fact largely prognostic (and vice-versa) is highly undesirable, and can result in financial, ethical and personal consequences. We present a framework for data-driven ranking of biomarkers on their prognostic/predictive strength, using a novel information theoretic method. This approach provides a natural algebra to discuss and quantify the individual predictive and prognostic strength, in a self-consistent mathematical framework.ResultsOur contribution is a novel procedure, INFO+, which naturally distinguishes the prognostic versus predictive role of each biomarker and handles higher order interactions. In a comprehensive empirical evaluation INFO+ outperforms more complex methods, most notably when noise factors dominate, and biomarkers are likely to be falsely identified as predictive, when in fact they are just strongly prognostic. Furthermore, we show that our methods can be 1–3 orders of magnitude faster than competitors, making it useful for biomarker discovery in ‘big data’ scenarios. Finally, we apply our methods to identify predictive biomarkers on two real clinical trials, and introduce a new graphical representation that provides greater insight into the prognostic and predictive strength of each biomarker.Availability and implementationR implementations of the suggested methods are available at https://github.com/sechidis.Supplementary information Supplementary data are available at Bioinformatics online.

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Deep learning systems can be fooled by small, worst-case perturbations of their inputs, known as adversarial examples. This has been almost exclusively studied in supervised learning, on vision tasks. However, adversarial examples in counterfactual modelling, which sits outside the traditional supervised scenario, is an overlooked challenge. We introduce the concept of adversarial patients, in the context of counterfactual models for clinical trials-this turns out to introduce several new dimensions to the literature. We describe how there exist multiple types of adversarial example-and demonstrate different consequences, e.g. ethical, when they arise. The study of adversarial examples in this area is rich in challenges for accountability and trustworthiness in ML-we highlight future directions that may be of interest to the community.

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Virtual assistants are becoming popular in a variety of domains, responsible for automating repetitive tasks or allowing users to seamlessly access useful information. With the advances in Machine Learning and Natural Language Processing, there has been an increasing interest in applying such assistants in new areas and with new capabilities. In particular, their application in e-healthcare is becoming attractive and is driven by the need to access medically-related knowledge, as well as providing first-level assistance in an efficient manner. In such types of virtual assistants, localization is of utmost importance, since the general population (especially the aging population) is not familiar with the needed “healthcare vocabulary” to communicate facts properly; and state-of-practice proves relatively poor in performance when it comes to specialized virtual assistants for less frequently spoken languages. In this context, we present a Greek ML-based virtual assistant specifically designed to address some commonly occurring tasks in the healthcare domain, such as doctor’s appointments or distress (panic situations) management. We build on top of an existing open-source framework, discuss the necessary modifications needed to address the language-specific characteristics and evaluate various combinations of word embeddings and machine learning models to enhance the assistant’s behaviour. Results show that we are able to build an efficient Greek-speaking virtual assistant to support e-healthcare, while the NLP pipeline proposed can be applied in other (less frequently spoken) languages, without loss of generality.