A Design Thinking Framework for Human-Centric Explainable Artificial Intelligence in Time-Critical Systems

Artificial Intelligence (AI) has seen a surge in popularity as increased computing power has made it more viable and useful. The increasing complexity of AI, however, leads to can lead to difficulty in understanding or interpreting the results of AI procedures, which can then lead to incorrect predictions, classifications, or analysis of outcomes. The result of these problems can be over-reliance on AI, under-reliance on AI, or simply confusion as to what the results mean. Additionally, the complexity of AI models can obscure the algorithmic, data and design biases to which all models are subject, which may exacerbate negative outcomes, particularly with respect to minority populations. Explainable AI (XAI) aims to mitigate these problems by providing information on the intent, performance, and reasoning process of the AI. Where time or cognitive resources are limited, the burden of additional information can negatively impact performance. Ensuring XAI information is intuitive and relevant allows the user to quickly calibrate their trust in the AI, in turn improving trust in suggested task alternatives, reducing workload and improving task performance. This study details a structured approach to the development of XAI in time-critical systems based on a design thinking framework that preserves the agile, fast-iterative approach characteristic of design thinking and augments it with practical tools and guides. The framework establishes a focus on shared situational perspective, and the deep understanding of both users and the AI in the empathy phase, provides a model with seven XAI levels and corresponding solution themes, and defines objective, physiological metrics for concurrent assessment of trust and workload

Study of applications of bio-space technology to patient monitoring systems Final report

Investigation of application of NASA developed technology to cardiovascular and pulmonary patient monitoring to improve availability of data for medical diagnosi

Robotic Ultrasound Imaging: State-of-the-Art and Future Perspectives

Ultrasound (US) is one of the most widely used modalities for clinical intervention and diagnosis due to the merits of providing non-invasive, radiation-free, and real-time images. However, free-hand US examinations are highly operator-dependent. Robotic US System (RUSS) aims at overcoming this shortcoming by offering reproducibility, while also aiming at improving dexterity, and intelligent anatomy and disease-aware imaging. In addition to enhancing diagnostic outcomes, RUSS also holds the potential to provide medical interventions for populations suffering from the shortage of experienced sonographers. In this paper, we categorize RUSS as teleoperated or autonomous. Regarding teleoperated RUSS, we summarize their technical developments, and clinical evaluations, respectively. This survey then focuses on the review of recent work on autonomous robotic US imaging. We demonstrate that machine learning and artificial intelligence present the key techniques, which enable intelligent patient and process-specific, motion and deformation-aware robotic image acquisition. We also show that the research on artificial intelligence for autonomous RUSS has directed the research community toward understanding and modeling expert sonographers' semantic reasoning and action. Here, we call this process, the recovery of the "language of sonography". This side result of research on autonomous robotic US acquisitions could be considered as valuable and essential as the progress made in the robotic US examination itself. This article will provide both engineers and clinicians with a comprehensive understanding of RUSS by surveying underlying techniques.Comment: Accepted by Medical Image Analysi

Coronary Angiography

In the intervening 10 years tremendous advances in the field of cardiac computed tomography have occurred. We now can legitimately claim that computed tomography angiography (CTA) of the coronary arteries is available. In the evaluation of patients with suspected coronary artery disease (CAD), many guidelines today consider CTA an alternative to stress testing. The use of CTA in primary prevention patients is more controversial in considering diagnostic test interpretation in populations with a low prevalence to disease. However the nuclear technique most frequently used by cardiologists is myocardial perfusion imaging (MPI). The combination of a nuclear camera with CTA allows for the attainment of coronary anatomic, cardiac function and MPI from one piece of equipment. PET/SPECT cameras can now assess perfusion, function, and metabolism. Assessing cardiac viability is now fairly routine with these enhancements to cardiac imaging. This issue is full of important information that every cardiologist needs to now

Image guidance in cardiac electrophysiology

Thesis (M. Eng.)--Harvard-MIT Division of Health Sciences and Technology, 2006.MIT Institute Archives copy: Pages 101-130 bound in reverse order.Includes bibliographical references (p. 123-130).Cardiac arrhythmias are characterized by a disruption or abnormal conduction of electrical signals within the heart. Treatment of arrhythmias has dramatically evolved over the past half-century, and today, minimally-invasive catheter-based therapy is the preferred method of eliminating arrhythmias. Using an electroanatomical (EA) mapping system, which precisely tracks the position of catheters inside the patient's body, it is possible to construct three-dimensional maps of the ventricular and atrial chambers of the heart. Each point of these maps is annotated based on bioelectrical signals recorded from the electrodes located at the tip of the catheter. These maps are then used to guide catheter ablation within the heart. However, the electroanatomical mapping procedure results in relatively sparse sampling of the heart and a significant amount of time and skill are require to generate these maps. In this thesis, we present our software system for the integration of pre-operative, patient-specific magnetic resonance (MR) or computed tomography (CT) imaging data with real-time electroanatomical mapping (EAM) information.(cont.) Following registration between the EAM and imaging data, the system allows for real-time catheter navigation within patient-specific anatomy. We then evaluate candidate registration strategies to rapidly and accurately align the pre-operative imaging data with the intra-operative mapping data using simulated electroanatomical mapping data using the great cardiac vessels including the aorta, superior vena cava, and coronary sinus. Based on these in vitro results, we focus on a registration strategy which is constrained by the ascending and descending aorta. In vivo prospective evaluation of the resulting image integration was then performed (n>200) in both experimental and clinical electrophysiology procedure. To compensate for residual error following registration or patient movement during a procedure, we present and evaluate warping strategies for deforming the pre-operative imaging data into agreement with the intra-operative mapping information.by Zachary John Malchano.M.Eng

Blood

This book examines both the fluid and cellular components of blood. After the introductory section, the second section presents updates on various topics in hemodynamics. Chapters in this section discuss anemia, 4D flow MRI in cardiology, cardiovascular complications of robot-assisted laparoscopic pelvic surgery, altered perfusion in multiple sclerosis, and hemodynamic laminar shear stress in oxidative homeostasis. The third section focuses on thalassemia with chapters on diagnosis and screening for thalassemia, high blood pressure in beta-thalassemia, and hepatitis C infection in thalassemia patients

Histotripsy for Pediatric Cardiac Applications.

Medicine continues to move towards less invasive techniques for many cardiac conditions, especially for high-risk patients that may not tolerate the alternative, more invasive approach. For instance, patients born with the congenital heart defect hypoplastic left heart syndrome often require emergent creation of a perforation through the atrial septum for survival prior to palliative surgery. However, most approaches are catheter based, still invasive, and continue to have significant challenges, limitations, and complications. A completely non-invasive technique such as histotripsy may provide the same result in a faster, safer, and more efficient manner. Using high-pressure ultrasound pulses applied outside the body and focused to the targeted tissue, histotripsy generates a cluster of cavitating micro-bubbles that fractionate the target tissue. The goal of this work is to investigate the safety and efficacy of histotripsy for neonatal cardiac applications. To aid in this goal, therapy guidance and monitoring techniques are developed, and an integrated histotripsy therapy system, optimized for the human neonate with congenital heart disease, was designed and constructed. In this dissertation, histotripsy is first demonstrated to be capable of generating targeted intra-cardiac communications when positioned outside the body in an intact neonatal animal model with minimal collateral damage or systemic side-effects. Second, to mitigate the possibility of unintended injury due to heart motion, real-time motion correction using ultrasound imaging is developed and integrated into a histotripsy therapy system. The performance of the motion correction is quantified in vitro and a validated in a single in vivo experiment. Third, to maximize therapy efficacy, novel bubble-induced color Doppler feedback to monitor the degree of tissue damage during histotripsy treatment is developed and validated in vitro. Finally, a histotripsy therapy transducer with appropriate physical dimensions and acoustic parameters to precisely ablate cardiac tissue non-invasively in a human neonate is developed and integrated into an ultrasound guided histotripsy therapy system. The data and the integrated system accomplished from this dissertation form the essential foundation to a pioneering clinical trial for histotripsy cardiac therapy in infants, which will position histotripsy for application on a broad range of cardiac disorders in patients of all ages.PHDBiomedical EngineeringUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/108732/1/millerrm_1.pd