Design, construction and evaluation of systems to predict risk in obstetrics.

We present a systematic, practical approach to developing risk prediction systems, suitable for use with large databases of medical information. An important part of this approach is a novel feature selection algorithm which uses the area under the receiver operating characteristic (ROC) curve to measure the expected discriminative power of different sets of predictor variables. We describe this algorithm and use it to select variables to predict risk of a specific adverse pregnancy outcome: failure to progress in labour. Neural network, logistic regression and hierarchical Bayesian risk prediction models are constructed, all of which achieve close to the limit of performance attainable on this prediction task. We show that better prediction performance requires more discriminative clinical information rather than improved modelling techniques. It is also shown that better diagnostic criteria in clinical records would greatly assist the development of systems to predict risk in pregnancy.

Risk-sensitivity in sensorimotor control.

Recent advances in theoretical neuroscience suggest that motor control can be considered as a continuous decision-making process in which uncertainty plays a key role. Decision-makers can be risk-sensitive with respect to this uncertainty in that they may not only consider the average payoff of an outcome, but also consider the variability of the payoffs. Although such risk-sensitivity is a well-established phenomenon in psychology and economics, it has been much less studied in motor control. In fact, leading theories of motor control, such as optimal feedback control, assume that motor behaviors can be explained as the optimization of a given expected payoff or cost. Here we review evidence that humans exhibit risk-sensitivity in their motor behaviors, thereby demonstrating sensitivity to the variability of "motor costs." Furthermore, we discuss how risk-sensitivity can be incorporated into optimal feedback control models of motor control. We conclude that risk-sensitivity is an important concept in understanding individual motor behavior under uncertainty.

Risk-sensitivity and the mean-variance trade-off: decision making in sensorimotor control.

Numerous psychophysical studies suggest that the sensorimotor system chooses actions that optimize the average cost associated with a movement. Recently, however, violations of this hypothesis have been reported in line with economic theories of decision-making that not only consider the mean payoff, but are also sensitive to risk, that is the variability of the payoff. Here, we examine the hypothesis that risk-sensitivity in sensorimotor control arises as a mean-variance trade-off in movement costs. We designed a motor task in which participants could choose between a sure motor action that resulted in a fixed amount of effort and a risky motor action that resulted in a variable amount of effort that could be either lower or higher than the fixed effort. By changing the mean effort of the risky action while experimentally fixing its variance, we determined indifference points at which participants chose equiprobably between the sure, fixed amount of effort option and the risky, variable effort option. Depending on whether participants accepted a variable effort with a mean that was higher, lower or equal to the fixed effort, they could be classified as risk-seeking, risk-averse or risk-neutral. Most subjects were risk-sensitive in our task consistent with a mean-variance trade-off in effort, thereby, underlining the importance of risk-sensitivity in computational models of sensorimotor control.

Risk-sensitive optimal feedback control accounts for sensorimotor behavior under uncertainty.

Many aspects of human motor behavior can be understood using optimality principles such as optimal feedback control. However, these proposed optimal control models are risk-neutral; that is, they are indifferent to the variability of the movement cost. Here, we propose the use of a risk-sensitive optimal controller that incorporates movement cost variance either as an added cost (risk-averse controller) or as an added value (risk-seeking controller) to model human motor behavior in the face of uncertainty. We use a sensorimotor task to test the hypothesis that subjects are risk-sensitive. Subjects controlled a virtual ball undergoing Brownian motion towards a target. Subjects were required to minimize an explicit cost, in points, that was a combination of the final positional error of the ball and the integrated control cost. By testing subjects on different levels of Brownian motion noise and relative weighting of the position and control cost, we could distinguish between risk-sensitive and risk-neutral control. We show that subjects change their movement strategy pessimistically in the face of increased uncertainty in accord with the predictions of a risk-averse optimal controller. Our results suggest that risk-sensitivity is a fundamental attribute that needs to be incorporated into optimal feedback control models.

Risk sensitivity in a motor task with speed-accuracy trade-off.

When a racing driver steers a car around a sharp bend, there is a trade-off between speed and accuracy, in that high speed can lead to a skid whereas a low speed increases lap time, both of which can adversely affect the driver's payoff function. While speed-accuracy trade-offs have been studied extensively, their susceptibility to risk sensitivity is much less understood, since most theories of motor control are risk neutral with respect to payoff, i.e., they only consider mean payoffs and ignore payoff variability. Here we investigate how individual risk attitudes impact a motor task that involves such a speed-accuracy trade-off. We designed an experiment where a target had to be hit and the reward (given in points) increased as a function of both subjects' endpoint accuracy and endpoint velocity. As faster movements lead to poorer endpoint accuracy, the variance of the reward increased for higher velocities. We tested subjects on two reward conditions that had the same mean reward but differed in the variance of the reward. A risk-neutral account predicts that subjects should only maximize the mean reward and hence perform identically in the two conditions. In contrast, we found that some (risk-averse) subjects chose to move with lower velocities and other (risk-seeking) subjects with higher velocities in the condition with higher reward variance (risk). This behavior is suboptimal with regard to maximizing the mean number of points but is in accordance with a risk-sensitive account of movement selection. Our study suggests that individual risk sensitivity is an important factor in motor tasks with speed-accuracy trade-offs.

Synopsis of researcher meeting -- Bottlenose Dolphin Health & Risk Assessment Project, February 22-24, 2005

A meeting was convened on February 22-24, 2005 in Charleston, South Carolina to bring together researchers collaborating on the Bottlenose Dolphin Health and Risk Assessment (HERA) Project to review and discuss preliminary health-related findings from captured dolphins during 2003 and 2004 in the Indian River Lagoon (IRL), FL and Charleston (CHS), SC. Over 30 researchers with diverse research expertise representing government, academic and marine institutions participated in the 2-1/2 day meeting. The Bottlenose Dolphin HERA Project is a comprehensive, integrated, multi-disciplinary research program designed to assess environmental and anthropogenic stressors, as well as the health and long-term viability of Atlantic bottlenose dolphins (Tursiops truncatus). Standardized and comprehensive protocols are being used to evaluate dolphin health in the coastal ecosystems in the IRL and CHS. The Bottlenose Dolphin Health and Risk Assessment (HERA) Project was initiated in 2003 by Dr. Patricia Fair at the National Oceanic and Atmospheric Administration/National Ocean Service/Center for Coastal Environmental Health and Biomolecular Research and Dr. Gregory Bossart at the Harbor Branch Oceanographic Institution under NMFS Scientific Research Permit No. 998-1678-00 issued to Dr. Bossart. Towards this end, this study focuses on developing tools and techniques to better identify health threats to these dolphins, and to develop links to possible environmental stressors. Thus, the primary objective of the Dolphin HERA Project is to measure the overall health and as well as the potential health hazards for dolphin populations in the two sites by performing screening-level risk assessments using standardized methods. The screening-level assessment involves capture, sampling and release activities during which physical examinations are performed on dolphins and a suite of nonlethal morphologic and clinicopathologic parameters, to be used to develop indices of dolphin health, are collected. Thus far, standardized health assessments have been performed on 155 dolphins during capture-release studies conducted in Years 2003 and 2004 at the two sites. A major collaboration has been established involving numerous individuals and institutions, which provide the project with a broad assessment capability toward accomplishing the goals and objectives of this project.