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Mar 6

Cost-effectiveness analysis for therapy sequence in advanced cancer: A microsimulation approach with application to metastatic prostate cancer

Purpose. Patients with advanced cancer may undergo multiple lines of treatment, switching therapies as their disease progresses. Motivated by a study of metastatic prostate cancer, we develop a microsimulation framework to study therapy sequence. Methods. We propose a discrete-time state transition model to study two lines of anti-cancer therapy. Based on digitized published progression-free survival (PFS) and overall survival (OS) curves, we infer event types (progression or death), and estimate transition probabilities using cumulative incidence functions with competing risks. Our model incorporates within-patient dependence over time, such that response to first-line therapy informs subsequent event probabilities. Parameters governing the degree of within-patient dependence can be used to calibrate the model-based results to those of a target trial. We demonstrate these methods in a study of two therapy sequences for metastatic prostate cancer, where Docetaxel (DCT) and Abiraterone Acetate (AA) are both appropriate for use in either first or second line treatment. We assess costs, Quality-Adjusted Life Years (QALYs) and Incremental Cost Effectiveness Ratio (ICER) for two treatment strategies: DCT then AA vs AA then DCT. Results. Using digitized survival curves from relevant clinical trials, we identified 8.6-13.9% of PFS times that should be categorized as deaths, allowing for estimation of cumulative incidence functions. Models assuming within-patient independence overestimated OS time, corrected with our calibration approach. Correction resulted in meaningful changes in the difference in QALYs between treatment strategies (0.07 vs 0.15) and the ICER (-\76,836/QALY vs -21,030/QALY). Conclusions. Microsimulation models can be successfully used to study cost-effectiveness of therapy sequences, taking care to account correctly for within-patient dependence.

  • 5 authors
·
Oct 10, 2022

A Hybrid Deep Learning Model for Robust Biometric Authentication from Low-Frame-Rate PPG Signals

Photoplethysmography (PPG) signals, which measure changes in blood volume in the skin using light, have recently gained attention in biometric authentication because of their non-invasive acquisition, inherent liveness detection, and suitability for low-cost wearable devices. However, PPG signal quality is challenged by motion artifacts, illumination changes, and inter-subject physiological variability, making robust feature extraction and classification crucial. This study proposes a lightweight and cost-effective biometric authentication framework based on PPG signals extracted from low-frame-rate fingertip videos. The CFIHSR dataset, comprising PPG recordings from 46 subjects at a sampling rate of 14 Hz, is employed for evaluation. The raw PPG signals undergo a standard preprocessing pipeline involving baseline drift removal, motion artifact suppression using Principal Component Analysis (PCA), bandpass filtering, Fourier-based resampling, and amplitude normalization. To generate robust representations, each one-dimensional PPG segment is converted into a two-dimensional time-frequency scalogram via the Continuous Wavelet Transform (CWT), effectively capturing transient cardiovascular dynamics. We developed a hybrid deep learning model, termed CVT-ConvMixer-LSTM, by combining spatial features from the Convolutional Vision Transformer (CVT) and ConvMixer branches with temporal features from a Long Short-Term Memory network (LSTM). The experimental results on 46 subjects demonstrate an authentication accuracy of 98%, validating the robustness of the model to noise and variability between subjects. Due to its efficiency, scalability, and inherent liveness detection capability, the proposed system is well-suited for real-world mobile and embedded biometric security applications.

  • 2 authors
·
Nov 5, 2025

A Little Bit Attention Is All You Need for Person Re-Identification

Person re-identification plays a key role in applications where a mobile robot needs to track its users over a long period of time, even if they are partially unobserved for some time, in order to follow them or be available on demand. In this context, deep-learning based real-time feature extraction on a mobile robot is often performed on special-purpose devices whose computational resources are shared for multiple tasks. Therefore, the inference speed has to be taken into account. In contrast, person re-identification is often improved by architectural changes that come at the cost of significantly slowing down inference. Attention blocks are one such example. We will show that some well-performing attention blocks used in the state of the art are subject to inference costs that are far too high to justify their use for mobile robotic applications. As a consequence, we propose an attention block that only slightly affects the inference speed while keeping up with much deeper networks or more complex attention blocks in terms of re-identification accuracy. We perform extensive neural architecture search to derive rules at which locations this attention block should be integrated into the architecture in order to achieve the best trade-off between speed and accuracy. Finally, we confirm that the best performing configuration on a re-identification benchmark also performs well on an indoor robotic dataset.

  • 4 authors
·
Feb 28, 2023

Illuminating search spaces by mapping elites

Many fields use search algorithms, which automatically explore a search space to find high-performing solutions: chemists search through the space of molecules to discover new drugs; engineers search for stronger, cheaper, safer designs, scientists search for models that best explain data, etc. The goal of search algorithms has traditionally been to return the single highest-performing solution in a search space. Here we describe a new, fundamentally different type of algorithm that is more useful because it provides a holistic view of how high-performing solutions are distributed throughout a search space. It creates a map of high-performing solutions at each point in a space defined by dimensions of variation that a user gets to choose. This Multi-dimensional Archive of Phenotypic Elites (MAP-Elites) algorithm illuminates search spaces, allowing researchers to understand how interesting attributes of solutions combine to affect performance, either positively or, equally of interest, negatively. For example, a drug company may wish to understand how performance changes as the size of molecules and their cost-to-produce vary. MAP-Elites produces a large diversity of high-performing, yet qualitatively different solutions, which can be more helpful than a single, high-performing solution. Interestingly, because MAP-Elites explores more of the search space, it also tends to find a better overall solution than state-of-the-art search algorithms. We demonstrate the benefits of this new algorithm in three different problem domains ranging from producing modular neural networks to designing simulated and real soft robots. Because MAP- Elites (1) illuminates the relationship between performance and dimensions of interest in solutions, (2) returns a set of high-performing, yet diverse solutions, and (3) improves finding a single, best solution, it will advance science and engineering.

  • 2 authors
·
Apr 19, 2015

vLLM Semantic Router: Signal Driven Decision Routing for Mixture-of-Modality Models

As large language models (LLMs) diversify across modalities, capabilities, and cost profiles, the problem of intelligent request routing -- selecting the right model for each query at inference time -- has become a critical systems challenge. We present vLLM Semantic Router, a signal-driven decision routing framework for Mixture-of-Modality (MoM) model deployments. The central innovation is composable signal orchestration: the system extracts heterogeneous signal types from each request -- from sub-millisecond heuristic features (keyword patterns, language detection, context length, role-based authorization) to neural classifiers (domain, embedding similarity, factual grounding, modality) -- and composes them through configurable Boolean decision rules into deployment-specific routing policies. Different deployment scenarios -- multi-cloud enterprise, privacy-regulated, cost-optimized, latency-sensitive -- are expressed as different signal-decision configurations over the same architecture, without code changes. Matched decisions drive semantic model routing: over a dozen of selection algorithms analyze request characteristics to find the best model cost-effectively, while per-decision plugin chains enforce privacy and safety constraints (jailbreak detection, PII filtering, hallucination detection via the three-stage HaluGate pipeline). The system provides OpenAI API support for stateful multi-turn conversations, multi-endpoint and multi-provider routing across heterogeneous backends (vLLM, OpenAI, Anthropic, Azure, Bedrock, Gemini, Vertex AI), and a pluggable authorization factory supporting multiple auth providers. Deployed in production as an Envoy external processor, the architecture demonstrates that composable signal orchestration enables a single routing framework to serve diverse deployment scenarios with differentiated cost, privacy, and safety policies.

  • 28 authors
·
Feb 23