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Controllable Sequence Editing for Biological and Clinical Trajectories

Conference: ICLR 2026
arXiv: 2502.03569
Code: https://github.com/mims-harvard/CLEF
Area: Computational Biology / Bioinformatics
Keywords: Counterfactual Generation, Sequence Editing, Temporal Concepts, Patient Trajectories, Cellular Reprogramming

TL;DR

Clef is proposed, a controllable sequence editing model based on "temporal concepts" capable of immediate and delayed editing of biological/clinical multivariate trajectories under given conditions (e.g., drugs, surgery). On cellular reprogramming and patient lab data, it improves immediate editing MAE by 16.28%, delayed editing by 26.73%, and zero-shot counterfactual generation by up to 62.84%.

Background & Motivation

Counterfactual reasoning ("What if a patient were given a different drug?" "What if a cellular perturbation occurred ten days earlier?") is a core problem in biology and medicine. Existing methods suffer from the following:

Limitations of Prior Work: - Controllable Text Generation (CTG) methods can only perform "immediate editing" (predicting the next token) and cannot handle "delayed editing" (jumping to a future time step to predict counterfactual trajectories). CTG models must progress step-by-step to fill temporal gaps, failing to guarantee fulfillment of target conditions. - Time-series Diffusion Models support conditional generation but are limited to univariate sequences and assume conditions affect the entire sequence, lacking precise local editing capabilities. - Spatiotemporal Locality of Real Interventions: In practical scenarios, interventions (e.g., drug administration, surgery) should only take effect after specific time points and affect only a subset of variables (e.g., certain lab tests), while other variables and historical data should remain unchanged to maintain temporal causal consistency.

Key Challenge: How to perform precise, condition-guided local editing of multivariate sequences while maintaining global causal consistency?

Key Insight: Inspired by "condition guidance" in controllable text generation and "spatial context" in image in-painting, Clef introduces "temporal concepts"—vectors encoding sequence trajectory change rates—to capture how and when conditions affect a sequence, enabling precise, temporally localized controllable sequence editing.

Method

Overall Architecture

Clef addresses the problem of "editing a multivariate historical trajectory \(\mathbf{x}_{:,t_0:t_i}\) into a counterfactual future under condition \(s\) (e.g., administration of a drug, knock-in of a transcription factor)." Its data flow converges from three paths for single-step generation: a Sequence Encoder \(F\) + Time Encoder encode the historical trajectory and "how far the target time \(t_j\) is from the current time" into sequence features \(\mathbf{h}_x\) and a time difference \(\Delta_{t_i,t_j}\); a Condition Adapter \(H\) maps intervention conditions to condition embeddings \(\mathbf{h}_s\); a Concept Encoder \(E\) fuses these three paths into a "temporal concept" \(\mathbf{c}\); and finally, a Concept Decoder \(G\) treats \(\mathbf{c}\) as variable-wise change rates applied to the current state via element-wise multiplication to yield the counterfactual sequence \(\hat{\mathbf{x}}_{:,t_j}^s\) in one step. Since the target time \(t_j\) is explicitly encoded into the concept, Clef supports two types of editing: Immediate Editing (predicting the next step \(\hat{\mathbf{x}}_{:,t_{i+1}}\)) and Delayed Editing (directly jumping to predict \(\hat{\mathbf{x}}_{:,t_j}\) for a condition occurring at \(t_j \geq t_{i+1}\)), which CTG methods cannot achieve.

%%{init: {'flowchart': {'rankSpacing': 24, 'nodeSpacing': 28, 'padding': 6, 'wrappingWidth': 400, 'subGraphTitleMargin': {'top': 8, 'bottom': 16}}}%%
flowchart TD
    X["Historical Trajectory<br/>x(t0:ti)"] --> F["Sequence Encoding &<br/>Time Diff Embedding<br/>Encoder F + Time Encoder"]
    T["Target Time tj"] --> F
    S["Intervention Condition s<br/>TF / Medical Code"] --> H["Condition Adapter<br/>Frozen Pre-trained Embeddings<br/>→ Linear Projection"]
    F -->|"Feat hx, Time Diff Δ"| E["Concept Encoder<br/>Elem-wise Prod + Optional FFN"]
    H -->|"Cond Embedding hs"| E
    E --> C
    subgraph DEC["Temporal Concept & Decoding"]
        direction TB
        C["Temporal Concept c<br/>Variable Change Rates"] --> G["Concept Decoder<br/>c ⊙ x(ti) Elem-wise Prod"]
    end
    G --> O["Counterfactual Seq<br/>x̂(tj)"]

Key Designs

1. Sequence Encoding & Time Diff Embedding: Explicitly Encoding "When to Intervene"

Delayed editing is possible because the model knows the distance to the target time point. The sequence encoder \(F\) extracts temporal features \(\mathbf{h}_x = F(\mathbf{x}_{:,t_0:t_i})\) from history. It is architecture-agnostic and can use Transformer, xLSTM, or pre-trained foundation models like MOMENT, making Clef a "controllable editing enhancement module" for any encoder. Simultaneously, the Time Encoder uses sinusoidal embeddings for year/month/day/hour to get positional encodings \(\mathbf{h}_t\), representing the span explicitly as \(\Delta_{t_i,t_j} = \mathbf{h}_{t_j} - \mathbf{h}_{t_i}\). This signal allows the model to jump to any future moment without step-by-step iteration.

2. Condition Adapter: Reusing Frozen Domain Pre-trained Embeddings

Intervention conditions \(s\) are discrete symbols mapped to vectors. Clef uses frozen pre-trained models—ESM-2 for cellular experiments and clinical knowledge graph embeddings for patient data—projected via a linear layer \(H\) to \(\mathbf{h}_s = H(\mathbf{z}_s)\). Utilizing existing domain semantics enables generalization to unseen conditions based on embedding space proximity, forming the basis for zero-shot counterfactual generation.

3. Concept Encoder: Fusing Three Signals to Generate Temporal Concept \(\mathbf{c}\)

The time difference and condition embeddings are concatenated into a joint embedding \(\mathbf{h}_s^{t_j} = \Delta_{t_i,t_j} \oplus \mathbf{h}_s\), which then interacts with sequence features via element-wise multiplication. An optional FFN with GELU activation generates the temporal concept:

\[\mathbf{c} = \text{GELU}(\text{FFN}(\mathbf{h}_x \odot \mathbf{h}_s^{t_j}))\]

Element-wise multiplication allows "how the state changes" to be gated by "condition + span." FFN usage depends on data complexity: cellular data uses linear concepts (no FFN) for optimal WOT performance, while complex patient data benefits from the non-linear capacity provided by the FFN.

4. Temporal Concept & Decoding: Change Rates Over Absolute Values

Clef defines the temporal concept as a change rate (growth/decay factor per variable) between time steps rather than regressing absolute values. The decoder applies the concept to the current state: \(\hat{\mathbf{x}}_{:,t_j}^s = \mathbf{c} \odot \mathbf{x}_{:,t_i}\). This naturally ensures locality: interventions only need to shift the change rates of a few variables, while others remain near 1 (staying unchanged), satisfying the requirement that interventions affect only parts of the system. This provides rare concept-level controllability.

Loss & Training

A Huber Loss is used to balance MSE sensitivity to outliers and MAE robustness:

\[\mathcal{L}(\mathbf{x}, \hat{\mathbf{x}}) = \begin{cases} 0.5\mathbf{a}^2, & \text{if } |\mathbf{a}| \leq \delta \\ \delta(|\mathbf{a}| - 0.5\delta), & \text{otherwise} \end{cases}\]

where \(\mathbf{a} = \mathbf{x}_{:,t_j}^s - \hat{\mathbf{x}}_{:,t_j}^s\). Training was conducted on NVIDIA A100/H100 GPUs with hyperparameter search: dropout \(\in [0.3, 0.6]\), learning rate \(\in [1e-3, 1e-5]\), and layers \(\in [4, 8]\).

Key Experimental Results

Datasets

Four core datasets were utilized: - WOT: Simulated single-cell transcriptomic developmental trajectories (1479 highly variable genes). - WOT-CF: Paired counterfactual cell trajectories for zero-shot evaluation. - eICU: Patient lab test trajectories (18 tests). - MIMIC-IV: Patient lab trajectories.

Main Results

Baselines included VAR, Transformer, xLSTM, MOMENT, and their respective +Clef variants.

Immediate Editing: - Clef consistently outperformed baselines across all datasets, with an average MAE reduction of 16.28%. - Clef performed better on datasets with complex short-term dynamics.

Delayed Editing: - Clef outperformed or matched SimpleLinear and VAR on eICU and MIMIC-IV. - Clef-transformer and Clef-xLSTM achieved the lowest MAE. - Average MAE improved by 26.73%. - On WOT, linear models performed best due to smaller, potentially noisy changes in developmental trajectories.

Ablation Study

Configuration Key Result Description
SimpleLinear (Concept = 1) Competitive in some scenarios Shows linear approximation is effective when \(x_{t_j} \approx x_{t_i}\).
Clef-FFN=0 Optimal for WOT Cellular data is simple and requires no extra non-linearity.
Clef-FFN=1 Optimal for eICU/MIMIC Patient data requires more expressive capacity.
Different Encoders MOMENT performed worst 1024-d embeddings from foundation models were less effective than training from scratch.

Generalization

Using the SPECTRA method for train/test similarity splits: - Clef models remained stable as train/test distribution shift increased. - Non-Clef models showed significant performance degradation.

Zero-Shot Counterfactual Generation

Evaluated on WOT-CF paired trajectories: - Clef consistently outperformed non-Clef models in both immediate and delayed editing. - Immediate editing improved up to 14.45% MAE; delayed editing up to 63.19% MAE.

Key Findings

  • Temporal concepts allow direct intervention at the concept level (e.g., halving glucose-related concepts) without condition tokens.
  • In a T1D case study, lowering the glucose concept generated counterfactual trajectories more similar to healthy individuals.
  • Intervening on the glucose concept indirectly caused a decrease in white blood cell counts, aligning with clinical knowledge of T1D as an autoimmune disease.
  • Simultaneously intervening on multiple concepts (glucose + WBC) produced cumulative effects.

Highlights & Insights

  • Minimalist yet Effective Mechanism: Defining concepts as change rates with element-wise multiplication provides high interpretability.
  • One-Step Delayed Prediction: Unlike CTG, Clef predicts counterfactuals at any future time point in a single step.
  • Encoder-Agnostic: Clef serves as a plug-and-play enhancement module for various sequence encoders.
  • Concept Intervenability: Users can edit specific dimensions of the temporal concept to generate counterfactuals.
  • Regularization Effect: Clef reduces neural network MAE even in scenarios where linear models are traditionally stronger.

Limitations & Future Work

  • Currently lacks modeling of high-order relationships between variables; hierarchical concepts could be explored.
  • Relies on data-driven approaches without utilizing causal model priors.
  • Performance is tied to the quality of pre-trained condition embeddings (ESM-2, KG).
  • Foundation models like MOMENT performed poorly, suggesting they may not yet be suited for fine-grained counterfactual generation.
  • Controllable Text Generation: Clef extends the CTG paradigm to the temporal domain and supports delayed editing.
  • Concept Bottleneck Models: Clef adapts the idea of intermediate interpretable concept layers for conditional generation.
  • Optimal Transport: Clef builds upon OT-based developmental trajectories (WOT) to enable conditional editing.

Rating

  • Novelty: ⭐⭐⭐⭐
  • Experimental Thoroughness: ⭐⭐⭐⭐⭐
  • Writing Quality: ⭐⭐⭐⭐⭐
  • Value: ⭐⭐⭐⭐