Building the case for actionable ethics in digital health research supported by artificial intelligence

The digital revolution is disrupting the ways in which health research is conducted, and subsequently, changing healthcare. Direct-to-consumer wellness products and mobile apps, pervasive sensor technologies and access to social network data offer exciting opportunities for researchers to passively observe and/or track patients ‘in the wild’ and 24/7. The volume of granular personal health data gathered using these technologies is unprecedented, and is increasingly leveraged to inform personalized health promotion and disease treatment interventions. The use of artificial intelligence in the health sector is also increasing. Although rich with potential, the digital health ecosystem presents new ethical challenges for those making decisions about the selection, testing, implementation and evaluation of technologies for use in healthcare. As the ‘Wild West’ of digital health research unfolds, it is important to recognize who is involved, and identify how each party can and should take responsibility to advance the ethical practices of this work. While not a comprehensive review, we describe the landscape, identify gaps to be addressed, and offer recommendations as to how stakeholders can and should take responsibility to advance socially responsible digital health research

Optimization the initial weights of artificial neural networks via genetic algorithm applied to hip bone fracture prediction

This paper aims to find the optimal set of initial weights to enhance the accuracy of artificial neural networks (ANNs) by using genetic algorithms (GA). The sample in this study included 228 patients with first low-trauma hip fracture and 215 patients without hip fracture, both of them were interviewed with 78 questions. We used logistic regression to select 5 important factors (i.e., bone mineral density, experience of fracture, average hand grip strength, intake of coffee, and peak expiratory flow rate) for building artificial neural networks to predict the probabilities of hip fractures. Three-layer (one hidden layer) ANNs models with back-propagation training algorithms were adopted. The purpose in this paper is to find the optimal initial weights of neural networks via genetic algorithm to improve the predictability. Area under the ROC curve (AUC) was used to assess the performance of neural networks. The study results showed the genetic algorithm obtained an AUC of 0.858±0.00493 on modeling data and 0.802 ± 0.03318 on testing data. They were slightly better than the results of our previous study (0.868±0.00387 and 0.796±0.02559, resp.). Thus, the preliminary study for only using simple GA has been proved to be effective for improving the accuracy of artificial neural networks.This research was supported by the National Science Council (NSC) of Taiwan (Grant no. NSC98-2915-I-155-005), the Department of Education grant of Excellent Teaching Program of Yuan Ze University (Grant no. 217517) and the Center for Dynamical Biomarkers and Translational Medicine supported by National Science Council (Grant no. NSC 100- 2911-I-008-001)

Disease modelling using evolved discriminate function

Precocious diagnosis increases the survival time and patient quality of life. It is a binary classification, exhaustively studied in the literature. This paper innovates proposing the application of genetic programming to obtain a discriminate function. This function contains the disease dynamics used to classify the patients with as little false negative diagnosis as possible. If its value is greater than zero then it means that the patient is ill, otherwise healthy. A graphical representation is proposed to show the influence of each dataset attribute in the discriminate function. The experiment deals with Breast Cancer and Thrombosis & Collagen diseases diagnosis. The main conclusion is that the discriminate function is able to classify the patient using numerical clinical data, and the graphical representation displays patterns that allow understanding of the model

Breathing Signature as Vitality Score Index Created by Exercises of Qigong: Implications of Artificial Intelligence Tools Used in Traditional Chinese Medicine.

Rising concerns about the short- and long-term detrimental consequences of administration of conventional pharmacopeia are fueling the search for alternative, complementary, personalized, and comprehensive approaches to human healthcare. Qigong, a form of Traditional Chinese Medicine, represents a viable alternative approach. Here, we started with the practical, philosophical, and psychological background of Ki (in Japanese) or Qi (in Chinese) and their relationship to Qigong theory and clinical application. Noting the drawbacks of the current state of Qigong clinic, herein we propose that to manage the unique aspects of the Eastern 'non-linearity' and 'holistic' approach, it needs to be integrated with the Western "linearity" "one-direction" approach. This is done through developing the concepts of "Qigong breathing signatures," which can define our life breathing patterns associated with diseases using machine learning technology. We predict that this can be achieved by establishing an artificial intelligence (AI)-Medicine training camp of databases, which will integrate Qigong-like breathing patterns with different pathologies unique to individuals. Such an integrated connection will allow the AI-Medicine algorithm to identify breathing patterns and guide medical intervention. This unique view of potentially connecting Eastern Medicine and Western Technology can further add a novel insight to our current understanding of both Western and Eastern medicine, thereby establishing a vitality score index (VSI) that can predict the outcomes of lifestyle behaviors and medical conditions

Deep Learning-based Prescription of Cardiac MRI Planes.

PurposeTo develop and evaluate a system to prescribe imaging planes for cardiac MRI based on deep learning (DL)-based localization of key anatomic landmarks.Materials and methodsAnnotated landmarks on 892 long-axis (LAX) and 493 short-axis (SAX) cine steady-state free precession series from cardiac MR images were retrospectively collected between February 2012 and June 2017. U-Net-based heatmap regression was used for localization of cardiac landmarks, which were used to compute cardiac MRI planes. Performance was evaluated by comparing localization distances and plane angle differences between DL predictions and ground truth. The plane angulations from DL were compared with those prescribed by the technologist at the original time of acquisition. Data were split into 80% for training and 20% for testing, and results confirmed with fivefold cross-validation.ResultsOn LAX images, DL localized the apex within mean 12.56 mm ± 19.11 (standard deviation) and the mitral valve (MV) within 7.68 mm ± 6.91. On SAX images, DL localized the aortic valve within 5.78 mm ± 5.68, MV within 5.90 mm ± 5.24, pulmonary valve within 6.55 mm ± 6.39, and tricuspid valve within 6.39 mm ± 5.89. On the basis of these localizations, average angle bias and mean error of DL-predicted imaging planes relative to ground truth annotations were as follows: SAX, -1.27° ± 6.81 and 4.93° ± 4.86; four chambers, 0.38° ± 6.45 and 5.16° ± 3.80; three chambers, 0.13° ± 12.70 and 9.02° ± 8.83; and two chamber, 0.25° ± 9.08 and 6.53° ± 6.28, respectively.ConclusionDL-based anatomic localization is a feasible strategy for planning cardiac MRI planes. This approach can produce imaging planes comparable to those defined by ground truth landmarks.© RSNA, 2019 Supplemental material is available for this article

Disease modeling using Evolved Discriminate Function

Precocious diagnosis increases the survival time and patient quality of life. It is a binary classification, exhaustively studied in the literature. This paper innovates proposing the application of genetic programming to obtain a discriminate function. This function contains the disease dynamics used to classify the patients with as little false negative diagnosis as possible. If its value is greater than zero then it means that the patient is ill, otherwise healthy. A graphical representation is proposed to show the influence of each dataset attribute in the discriminate function. The experiment deals with Breast Cancer and Thrombosis & Collagen diseases diagnosis. The main conclusion is that the discriminate function is able to classify the patient using numerical clinical data, and the graphical representation displays patterns that allow understanding of the model

3D medical volume segmentation using hybrid multiresolution statistical approaches

This article is available through the Brunel Open Access Publishing Fund. Copyright © 2010 S AlZu’bi and A Amira.3D volume segmentation is the process of partitioning voxels into 3D regions (subvolumes) that represent meaningful physical entities which are more meaningful and easier to analyze and usable in future applications. Multiresolution Analysis (MRA) enables the preservation of an image according to certain levels of resolution or blurring. Because of multiresolution quality, wavelets have been deployed in image compression, denoising, and classification. This paper focuses on the implementation of efficient medical volume segmentation techniques. Multiresolution analysis including 3D wavelet and ridgelet has been used for feature extraction which can be modeled using Hidden Markov Models (HMMs) to segment the volume slices. A comparison study has been carried out to evaluate 2D and 3D techniques which reveals that 3D methodologies can accurately detect the Region Of Interest (ROI). Automatic segmentation has been achieved using HMMs where the ROI is detected accurately but suffers a long computation time for its calculations

How 5G wireless (and concomitant technologies) will revolutionize healthcare?

The need to have equitable access to quality healthcare is enshrined in the United Nations (UN) Sustainable Development Goals (SDGs), which defines the developmental agenda of the UN for the next 15 years. In particular, the third SDG focuses on the need to “ensure healthy lives and promote well-being for all at all ages”. In this paper, we build the case that 5G wireless technology, along with concomitant emerging technologies (such as IoT, big data, artificial intelligence and machine learning), will transform global healthcare systems in the near future. Our optimism around 5G-enabled healthcare stems from a confluence of significant technical pushes that are already at play: apart from the availability of high-throughput low-latency wireless connectivity, other significant factors include the democratization of computing through cloud computing; the democratization of Artificial Intelligence (AI) and cognitive computing (e.g., IBM Watson); and the commoditization of data through crowdsourcing and digital exhaust. These technologies together can finally crack a dysfunctional healthcare system that has largely been impervious to technological innovations. We highlight the persistent deficiencies of the current healthcare system and then demonstrate how the 5G-enabled healthcare revolution can fix these deficiencies. We also highlight open technical research challenges, and potential pitfalls, that may hinder the development of such a 5G-enabled health revolution