Common pitfalls and recommendations for using machine learning to detect and prognosticate for COVID-19 using chest radiographs and CT scans

Abstract: Machine learning methods offer great promise for fast and accurate detection and prognostication of coronavirus disease 2019 (COVID-19) from standard-of-care chest radiographs (CXR) and chest computed tomography (CT) images. Many articles have been published in 2020 describing new machine learning-based models for both of these tasks, but it is unclear which are of potential clinical utility. In this systematic review, we consider all published papers and preprints, for the period from 1 January 2020 to 3 October 2020, which describe new machine learning models for the diagnosis or prognosis of COVID-19 from CXR or CT images. All manuscripts uploaded to bioRxiv, medRxiv and arXiv along with all entries in EMBASE and MEDLINE in this timeframe are considered. Our search identified 2,212 studies, of which 415 were included after initial screening and, after quality screening, 62 studies were included in this systematic review. Our review finds that none of the models identified are of potential clinical use due to methodological flaws and/or underlying biases. This is a major weakness, given the urgency with which validated COVID-19 models are needed. To address this, we give many recommendations which, if followed, will solve these issues and lead to higher-quality model development and well-documented manuscripts

Resolving Quantitative MRI Model Degeneracy with Machine Learning via Training Data Distribution Design

Quantitative MRI (qMRI) aims to map tissue properties non-invasively via models that relate these unknown quantities to measured MRI signals. Estimating these unknowns, which has traditionally required model fitting - an often iterative procedure, can now be done with one-shot machine learning (ML) approaches. Such parameter estimation may be complicated by intrinsic qMRI signal model degeneracy: different combinations of tissue properties produce the same signal. Despite their many advantages, it remains unclear whether ML approaches can resolve this issue. Growing empirical evidence appears to suggest ML approaches remain susceptible to model degeneracy. Here we demonstrate under the right circumstances ML can address this issue. Inspired by recent works on the impact of training data distributions on ML-based parameter estimation, we propose to resolve model degeneracy by designing training data distributions. We put forward a classification of model degeneracies and identify one particular kind of degeneracies amenable to the proposed attack. The strategy is demonstrated successfully using the Revised NODDI model with standard multi-shell diffusion MRI data as an exemplar. Our results illustrate the importance of training set design which has the potential to allow accurate estimation of tissue properties with ML