The TESTMED Project Experience. Process-aware Enactment of Clinical Guidelines through Multimodal Interfaces

Healthcare is one of the largest business segments in the world and is a critical area for future growth. In order to ensure efficient access to medical and patient-related information, hospitals have invested heavily in improving clinical mobile technologies and spread their use among doctors. Notwithstanding the benefits of mobile technologies towards a more efficient and personalized delivery of care procedures, there are also indications that their use may have a negative impact on patient-centeredness and often places many cognitive and physical demands on doctors, making them prone to make medical errors. To tackle this issue, in this paper we present the main outcomes of the project TESTMED, which aimed at realizing a clinical system that provides operational support to doctors using mobile technologies for delivering care to patients, in a bid to minimize medical errors. The system exploits concepts from Business Process Management on how to manage a specific class of care procedures, called clinical guidelines, and how to support their execution and mobile orchestration among doctors. As a viable solution for doctors' interaction with the system, we investigated the use of vocal and touch interfaces. User evaluation results indicate a good usability of the system

Leveraging Latent Features for Local Explanations

As the application of deep neural networks proliferates in numerous areas such as medical imaging, video surveillance, and self driving cars, the need for explaining the decisions of these models has become a hot research topic, both at the global and local level. Locally, most explanation methods have focused on identifying relevance of features, limiting the types of explanations possible. In this paper, we investigate a new direction by leveraging latent features to generate contrastive explanations; predictions are explained not only by highlighting aspects that are in themselves sufficient to justify the classification, but also by new aspects which if added will change the classification. The key contribution of this paper lies in how we add features to rich data in a formal yet humanly interpretable way that leads to meaningful results. Our new definition of "addition" uses latent features to move beyond the limitations of previous explanations and resolve an open question laid out in Dhurandhar, et. al. (2018), which creates local contrastive explanations but is limited to simple datasets such as grayscale images. The strength of our approach in creating intuitive explanations that are also quantitatively superior to other methods is demonstrated on three diverse image datasets (skin lesions, faces, and fashion apparel). A user study with 200 participants further exemplifies the benefits of contrastive information, which can be viewed as complementary to other state-of-the-art interpretability methods.Comment: Accepted to KDD 202

Big data analytics:Computational intelligence techniques and application areas

Big Data has significant impact in developing functional smart cities and supporting modern societies. In this paper, we investigate the importance of Big Data in modern life and economy, and discuss challenges arising from Big Data utilization. Different computational intelligence techniques have been considered as tools for Big Data analytics. We also explore the powerful combination of Big Data and Computational Intelligence (CI) and identify a number of areas, where novel applications in real world smart city problems can be developed by utilizing these powerful tools and techniques. We present a case study for intelligent transportation in the context of a smart city, and a novel data modelling methodology based on a biologically inspired universal generative modelling approach called Hierarchical Spatial-Temporal State Machine (HSTSM). We further discuss various implications of policy, protection, valuation and commercialization related to Big Data, its applications and deployment

The NNN Formalization: Review and Development of Guideline Specification in the Care Domain

Due to an ageing society, it can be expected that less nursing personnel will be responsible for an increasing number of patients in the future. One way to address this challenge is to provide system-based support for nursing personnel in creating, executing, and adapting patient care processes. In care practice, these processes are following the general care process definition and individually specified according to patient-specific data as well as diagnoses and guidelines from the NANDA, NIC, and NOC (NNN) standards. In addition, adaptations to running patient processes become necessary frequently and are to be conducted by nursing personnel including NNN knowledge. In order to provide semi-automatic support for design and adaption of care processes, a formalization of NNN knowledge is indispensable. This technical report presents the NNN formalization that is developed targeting at goals such as completeness, flexibility, and later exploitation for creating and adapting patient care processes. The formalization also takes into consideration an extensive evaluation of existing formalization standards for clinical guidelines. The NNN formalization as well as its usage are evaluated based on case study FATIGUE

Explainability in Human-Agent Systems

This paper presents a taxonomy of explainability in Human-Agent Systems. We consider fundamental questions about the Why, Who, What, When and How of explainability. First, we define explainability, and its relationship to the related terms of interpretability, transparency, explicitness, and faithfulness. These definitions allow us to answer why explainability is needed in the system, whom it is geared to and what explanations can be generated to meet this need. We then consider when the user should be presented with this information. Last, we consider how objective and subjective measures can be used to evaluate the entire system. This last question is the most encompassing as it will need to evaluate all other issues regarding explainability

On The Stability of Interpretable Models

Interpretable classification models are built with the purpose of providing a comprehensible description of the decision logic to an external oversight agent. When considered in isolation, a decision tree, a set of classification rules, or a linear model, are widely recognized as human-interpretable. However, such models are generated as part of a larger analytical process. Bias in data collection and preparation, or in model's construction may severely affect the accountability of the design process. We conduct an experimental study of the stability of interpretable models with respect to feature selection, instance selection, and model selection. Our conclusions should raise awareness and attention of the scientific community on the need of a stability impact assessment of interpretable models

Assuring the Machine Learning Lifecycle: Desiderata, Methods, and Challenges

Machine learning has evolved into an enabling technology for a wide range of highly successful applications. The potential for this success to continue and accelerate has placed machine learning (ML) at the top of research, economic and political agendas. Such unprecedented interest is fuelled by a vision of ML applicability extending to healthcare, transportation, defence and other domains of great societal importance. Achieving this vision requires the use of ML in safety-critical applications that demand levels of assurance beyond those needed for current ML applications. Our paper provides a comprehensive survey of the state-of-the-art in the assurance of ML, i.e. in the generation of evidence that ML is sufficiently safe for its intended use. The survey covers the methods capable of providing such evidence at different stages of the machine learning lifecycle, i.e. of the complex, iterative process that starts with the collection of the data used to train an ML component for a system, and ends with the deployment of that component within the system. The paper begins with a systematic presentation of the ML lifecycle and its stages. We then define assurance desiderata for each stage, review existing methods that contribute to achieving these desiderata, and identify open challenges that require further research

Auditing Black-box Models for Indirect Influence

Data-trained predictive models see widespread use, but for the most part they are used as black boxes which output a prediction or score. It is therefore hard to acquire a deeper understanding of model behavior, and in particular how different features influence the model prediction. This is important when interpreting the behavior of complex models, or asserting that certain problematic attributes (like race or gender) are not unduly influencing decisions. In this paper, we present a technique for auditing black-box models, which lets us study the extent to which existing models take advantage of particular features in the dataset, without knowing how the models work. Our work focuses on the problem of indirect influence: how some features might indirectly influence outcomes via other, related features. As a result, we can find attribute influences even in cases where, upon further direct examination of the model, the attribute is not referred to by the model at all. Our approach does not require the black-box model to be retrained. This is important if (for example) the model is only accessible via an API, and contrasts our work with other methods that investigate feature influence like feature selection. We present experimental evidence for the effectiveness of our procedure using a variety of publicly available datasets and models. We also validate our procedure using techniques from interpretable learning and feature selection, as well as against other black-box auditing procedures.Comment: Final version of paper that appears in the IEEE International Conference on Data Mining (ICDM), 201

Genomics models in radiotherapy: from mechanistic to machine learning

Machine learning provides a broad framework for addressing high-dimensional prediction problems in classification and regression. While machine learning is often applied for imaging problems in medical physics, there are many efforts to apply these principles to biological data towards questions of radiation biology. Here, we provide a review of radiogenomics modeling frameworks and efforts towards genomically-guided radiotherapy. We first discuss medical oncology efforts to develop precision biomarkers. We next discuss similar efforts to create clinical assays for normal tissue or tumor radiosensitivity. We then discuss modeling frameworks for radiosensitivity and the evolution of machine learning to create predictive models for radiogenomics.Comment: 32 pages, 3 figures, 3 table