  Sepsis is a leading cause of mortality in intensive care units (ICUs) and
costs hospitals billions annually. Treating a septic patient is highly
challenging, because individual patients respond very differently to medical
interventions and there is no universally agreed-upon treatment for sepsis.
Understanding more about a patient's physiological state at a given time could
hold the key to effective treatment policies. In this work, we propose a new
approach to deduce optimal treatment policies for septic patients by using
continuous state-space models and deep reinforcement learning. Learning
treatment policies over continuous spaces is important, because we retain more
of the patient's physiological information. Our model is able to learn
clinically interpretable treatment policies, similar in important aspects to
the treatment policies of physicians. Evaluating our algorithm on past ICU
patient data, we find that our model could reduce patient mortality in the
hospital by up to 3.6% over observed clinical policies, from a baseline
mortality of 13.7%. The learned treatment policies could be used to aid
intensive care clinicians in medical decision making and improve the likelihood
of patient survival.
