Detecting of a Patient's Condition From Clinical Narratives Using Natural Language Representation

The rapid progress in clinical data management systems and artificial intelligence approaches enable the era of personalized medicine. Intensive care units (ICUs) are the ideal clinical research environment for such development because they collect many clinical data and are highly computerized environments. We designed a retrospective clinical study on a prospective ICU database using clinical natural language to help in the early diagnosis of heart failure in critically ill children. The methodology consisted of empirical experiments of a learning algorithm to learn the hidden interpretation and presentation of the French clinical note data. This study included 1386 patients' clinical notes with 5444 single lines of notes. There were 1941 positive cases (36 % of total) and 3503 negative cases classified by two independent physicians using a standardized approach. The multilayer perceptron neural network outperforms other discriminative and generative classifiers. Consequently, the proposed framework yields an overall classification performance with 89 % accuracy, 88 % recall, and 89 % precision. Furthermore, a generative autoencoder learning algorithm was proposed to leverage the sparsity reduction that achieved 91% accuracy, 91% recall, and 91% precision. This study successfully applied learning representation and machine learning algorithms to detect heart failure from clinical natural language in a single French institution. Further work is needed to use the same methodology in other institutions and other languages.Comment: Submitting to IEEE Transactions on Biomedical Engineering. arXiv admin note: text overlap with arXiv:2104.0393

Applications of Machine Learning in Medical Prognosis Using Electronic Medical Records

Approximately 84 % of hospitals are adopting electronic medical records (EMR) In the United States. EMR is a vital resource to help clinicians diagnose the onset or predict the future condition of a specific disease. With machine learning advances, many research projects attempt to extract medically relevant and actionable data from massive EMR databases using machine learning algorithms. However, collecting patients\u27 prognosis factors from Electronic EMR is challenging due to privacy, sensitivity, and confidentiality. In this study, we developed medical generative adversarial networks (GANs) to generate synthetic EMR prognosis factors using minimal information collected during routine care in specialized healthcare facilities. The generated prognosis variables used in developing predictive models for (1) chronic wound healing in patients diagnosed with Venous Leg Ulcers (VLUs) and (2) antibiotic resistance in patients diagnosed with Skin and soft tissue infections (SSTIs). Our proposed medical GANs, EMR-TCWGAN and DermaGAN, can produce both continuous and categorical features from EMR. We utilized conditional training strategies to enhance training and generate classified data regarding healing vs. non-healing in EMR-TCWGAN and susceptibility vs. resistance in DermGAN. The ability of the proposed GAN models to generate realistic EMR data was evaluated by TSTR (test on the synthetic, train on the real), discriminative accuracy, and visualization. We analyzed the synthetic data augmentation technique\u27s practicality in improving the wound healing prognostic model and antibiotic resistance classifier. We achieved the area under the curve (AUC) of 0.875 in the wound healing prognosis model and an average AUC of 0.830 in the antibiotic resistance classifier by using the synthetic samples generated by GANs in the training process. These results suggest that GANs can be considered a data augmentation method to generate realistic EMR data

The Multimodal Brain Tumor Image Segmentation Benchmark (BRATS)

In this paper we report the set-up and results of the Multimodal Brain Tumor Image Segmentation Benchmark (BRATS) organized in conjunction with the MICCAI 2012 and 2013 conferences. Twenty state-of-the-art tumor segmentation algorithms were applied to a set of 65 multi-contrast MR scans of low-and high-grade glioma patients-manually annotated by up to four raters-and to 65 comparable scans generated using tumor image simulation software. Quantitative evaluations revealed considerable disagreement between the human raters in segmenting various tumor sub-regions (Dice scores in the range 74%-85%), illustrating the difficulty of this task. We found that different algorithms worked best for different sub-regions (reaching performance comparable to human inter-rater variability), but that no single algorithm ranked in the top for all sub-regions simultaneously. Fusing several good algorithms using a hierarchical majority vote yielded segmentations that consistently ranked above all individual algorithms, indicating remaining opportunities for further methodological improvements. The BRATS image data and manual annotations continue to be publicly available through an online evaluation system as an ongoing benchmarking resource

A mathematical framework for combining decisions of multiple experts toward accurate and remote diagnosis of malaria using tele-microscopy.

We propose a methodology for digitally fusing diagnostic decisions made by multiple medical experts in order to improve accuracy of diagnosis. Toward this goal, we report an experimental study involving nine experts, where each one was given more than 8,000 digital microscopic images of individual human red blood cells and asked to identify malaria infected cells. The results of this experiment reveal that even highly trained medical experts are not always self-consistent in their diagnostic decisions and that there exists a fair level of disagreement among experts, even for binary decisions (i.e., infected vs. uninfected). To tackle this general medical diagnosis problem, we propose a probabilistic algorithm to fuse the decisions made by trained medical experts to robustly achieve higher levels of accuracy when compared to individual experts making such decisions. By modelling the decisions of experts as a three component mixture model and solving for the underlying parameters using the Expectation Maximisation algorithm, we demonstrate the efficacy of our approach which significantly improves the overall diagnostic accuracy of malaria infected cells. Additionally, we present a mathematical framework for performing 'slide-level' diagnosis by using individual 'cell-level' diagnosis data, shedding more light on the statistical rules that should govern the routine practice in examination of e.g., thin blood smear samples. This framework could be generalized for various other tele-pathology needs, and can be used by trained experts within an efficient tele-medicine platform