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Main Authors: Londschien, Malte, Burger, Manuel, Rätsch, Gunnar, Bühlmann, Peter
Format: Preprint
Published: 2025
Subjects:
Online Access:https://arxiv.org/abs/2507.21783
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author Londschien, Malte
Burger, Manuel
Rätsch, Gunnar
Bühlmann, Peter
author_facet Londschien, Malte
Burger, Manuel
Rätsch, Gunnar
Bühlmann, Peter
contents The performance of predictive models in clinical settings often degrades when deployed in new hospitals due to distribution shifts. This paper presents a large-scale study of causality-inspired domain generalization on heterogeneous multi-center intensive care unit (ICU) data. We apply anchor regression and introduce anchor boosting, a novel, tree-based nonlinear extension, to a large dataset comprising 400,000 patients from nine distinct ICU databases. We find that anchor regularization yields improvements of out-of-distribution performance, particularly for the most dissimilar target domains. The methods appear robust to violations of theoretical assumptions, such as anchor exogeneity. Furthermore, we propose a novel conceptual framework to quantify the utility of large external data datasets. By evaluating performance as a function of available target-domain data, we identify three regimes: (i) a domain generalization regime, where only the external model should be used, (ii) a domain adaptation regime, where refitting the external model is optimal, and (iii) a data-rich regime, where external data provides no additional value.
format Preprint
id arxiv_https___arxiv_org_abs_2507_21783
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Domain Generalization and Adaptation in Intensive Care with Anchor Regression
Londschien, Malte
Burger, Manuel
Rätsch, Gunnar
Bühlmann, Peter
Applications
Machine Learning
Methodology
The performance of predictive models in clinical settings often degrades when deployed in new hospitals due to distribution shifts. This paper presents a large-scale study of causality-inspired domain generalization on heterogeneous multi-center intensive care unit (ICU) data. We apply anchor regression and introduce anchor boosting, a novel, tree-based nonlinear extension, to a large dataset comprising 400,000 patients from nine distinct ICU databases. We find that anchor regularization yields improvements of out-of-distribution performance, particularly for the most dissimilar target domains. The methods appear robust to violations of theoretical assumptions, such as anchor exogeneity. Furthermore, we propose a novel conceptual framework to quantify the utility of large external data datasets. By evaluating performance as a function of available target-domain data, we identify three regimes: (i) a domain generalization regime, where only the external model should be used, (ii) a domain adaptation regime, where refitting the external model is optimal, and (iii) a data-rich regime, where external data provides no additional value.
title Domain Generalization and Adaptation in Intensive Care with Anchor Regression
topic Applications
Machine Learning
Methodology
url https://arxiv.org/abs/2507.21783