FHIR-DHP: A standardized clinical data harmonisation pipeline for scalable AI application deployment

Background Increasing digitalisation in the medical domain gives rise to large amounts of healthcare data which has the potential to expand clinical knowledge and transform patient care if leveraged through artificial intelligence (AI). Yet, big data and AI oftentimes cannot unlock their full potential at scale, owing to non-standardised data formats, lack of technical and semantic data interoperability, and limited cooperation between stakeholders in the healthcare system. Despite the existence of standardised data formats for the medical domain, such as Fast Healthcare Interoperability Resources (FHIR), their prevalence and usability for AI remains limited.Objective We developed a data harmonisation pipeline (DHP) for clinical data sets relying on the common FHIR data standard.Methods We validated the performance and usability of our FHIR-DHP with data from the MIMIC IV database including > 40,000 patients admitted to an intensive care unit.Results We present the FHIR-DHP workflow in respect of transformation of “raw” hospital records into a harmonised, AI-friendly data representation. The pipeline consists of five key preprocessing steps: querying of data from hospital database, FHIR mapping, syntactic validation, transfer of harmonised data into the patient-model database and export of data in an AI-friendly format for further medical applications. A detailed example of FHIR-DHP execution was presented for clinical diagnoses records.Conclusions Our approach enables scalable and needs-driven data modelling of large and heterogenous clinical data sets. The FHIR-DHP is a pivotal step towards increasing cooperation, interoperability and quality of patient care in the clinical routine and for medical research

Transparency and Trust in Human-AI-Interaction: The Role of Model-Agnostic Explanations in Computer Vision-Based Decision Support

Computer Vision, and hence Artificial Intelligence-based extraction of information from images, has increasingly received attention over the last years, for instance in medical diagnostics. While the algorithms' complexity is a reason for their increased performance, it also leads to the "black box" problem, consequently decreasing trust towards AI. In this regard, "Explainable Artificial Intelligence" (XAI) allows to open that black box and to improve the degree of AI transparency. In this paper, we first discuss the theoretical impact of explainability on trust towards AI, followed by showcasing how the usage of XAI in a health-related setting can look like. More specifically, we show how XAI can be applied to understand why Computer Vision, based on deep learning, did or did not detect a disease (malaria) on image data (thin blood smear slide images). Furthermore, we investigate, how XAI can be used to compare the detection strategy of two different deep learning models often used for Computer Vision: Convolutional Neural Network and Multi-Layer Perceptron. Our empirical results show that i) the AI sometimes used questionable or irrelevant data features of an image to detect malaria (even if correctly predicted), and ii) that there may be significant discrepancies in how different deep learning models explain the same prediction. Our theoretical discussion highlights that XAI can support trust in Computer Vision systems, and AI systems in general, especially through an increased understandability and predictability

Tc9 cells, a new subset of CD8(+) T cells, support Th2-mediated airway inflammation

Pathogenesis and treatment of chronic pulmonary disease