An Iterative Self-Learning Framework for Medical Domain Generalization

Deep learning models have been widely used to assist doctors with clinical decision-making. However, these models often encounter a significant performance drop when applied to data that differs from the distribution they were trained on. This challenge is known as the domain shift problem. Existing domain generalization algorithms attempt to address this problem by assuming the availability of domain IDs and training a single model to handle all domains. However, in healthcare settings, patients can be classified into numerous latent domains, where the actual domain categorizations are unknown. Furthermore, each patient domain exhibits distinct clinical characteristics, making it sub-optimal to train a single model for all domains. To overcome these limitations, we propose SLDG, a self-learning framework that iteratively discovers decoupled domains and trains personalized classifiers for each decoupled domain. We evaluate the generalizability of SLDG across spatial and temporal data distribution shifts on two real-world public EHR datasets: eICU and MIMIC-IV. Our results show that SLDG achieves up to 11% improvement in the AUPRC score over the best baseline.