5 research outputs found
Neurobrucellosis in systemic lupus erythematosus
Background: Brucellosis is a zoonotic infection which is endemic in many countries. It is a multisystem disease which may present with a broad spectrum of clinical manifestations and complications. Neurobrucellosis is an uncommon complication of brucellosis.
Case presentation: A 25-year-old woman with a history of lupus for 5 months referred to the emergency ward of Shahid Beheshti Hospital of Qom due to vertigo, drop attack and a convulsion episode from the previous day. She was unable to move at initial evaluation, and her upper and lower extremities were spastic. She had blurred vision one day after admission. Based on her past history and suspecting neurological pulmonary presentations, treatment with immunosuppressive drugs was started and brain MRI was performed. According to the MRI mode and endemic area, neurobrucellosis was suspected and 2ME and Wright tests were performed. Wight test was 1.5120 while 2ME test was 1.640 which were strongly positive. So, with neurobrucellosis diagnosis, the patient was treated but unfortunately 4 days later, after respiratory apnea, she was pronounced dead.
Conclusion: In endemic areas for brucellosis, neurobrucellosis should always be kept in mind in the differential diagnosis of neurological and psychiatric cases that are encountered
Differential privacy preserved federated learning for prognostic modeling in COVID‐19 patients using large multi‐institutional chest CT dataset
Background
Notwithstanding the encouraging results of previous studies reporting on the efficiency of deep learning (DL) in COVID‐19 prognostication, clinical adoption of the developed methodology still needs to be improved. To overcome this limitation, we set out to predict the prognosis of a large multi‐institutional cohort of patients with COVID‐19 using a DL‐based model.
Purpose
This study aimed to evaluate the performance of deep privacy‐preserving federated learning (DPFL) in predicting COVID‐19 outcomes using chest CT images.
Methods
After applying inclusion and exclusion criteria, 3055 patients from 19 centers, including 1599 alive and 1456 deceased, were enrolled in this study. Data from all centers were split (randomly with stratification respective to each center and class) into a training/validation set (70%/10%) and a hold‐out test set (20%). For the DL model, feature extraction was performed on 2D slices, and averaging was performed at the final layer to construct a 3D model for each scan. The DensNet model was used for feature extraction. The model was developed using centralized and FL approaches. For FL, we employed DPFL approaches. Membership inference attack was also evaluated in the FL strategy. For model evaluation, different metrics were reported in the hold‐out test sets. In addition, models trained in two scenarios, centralized and FL, were compared using the DeLong test for statistical differences.
Results
The centralized model achieved an accuracy of 0.76, while the DPFL model had an accuracy of 0.75. Both the centralized and DPFL models achieved a specificity of 0.77. The centralized model achieved a sensitivity of 0.74, while the DPFL model had a sensitivity of 0.73. A mean AUC of 0.82 and 0.81 with 95% confidence intervals of (95% CI: 0.79–0.85) and (95% CI: 0.77–0.84) were achieved by the centralized model and the DPFL model, respectively. The DeLong test did not prove statistically significant differences between the two models ( p ‐value = 0.98). The AUC values for the inference attacks fluctuate between 0.49 and 0.51, with an average of 0.50 ± 0.003 and 95% CI for the mean AUC of 0.500 to 0.501.
Conclusion
The performance of the proposed model was comparable to centralized models while operating on large and heterogeneous multi‐institutional datasets. In addition, the model was resistant to inference attacks, ensuring the privacy of shared data during the training process.</p
Differentiation of COVID‐19 pneumonia from other lung diseases using CT radiomic features and machine learning : A large multicentric cohort study
To derive and validate an effective machine learning and radiomics‐based model to differentiate COVID‐19 pneumonia from other lung diseases using a large multi‐centric dataset. In this retrospective study, we collected 19 private and five public datasets of chest CT images, accumulating to 26 307 images (15 148 COVID‐19; 9657 other lung diseases including non‐COVID‐19 pneumonia, lung cancer, pulmonary embolism; 1502 normal cases). We tested 96 machine learning‐based models by cross‐combining four feature selectors (FSs) and eight dimensionality reduction techniques with eight classifiers. We trained and evaluated our models using three different strategies: #1, the whole dataset (15 148 COVID‐19 and 11 159 other); #2, a new dataset after excluding healthy individuals and COVID‐19 patients who did not have RT‐PCR results (12 419 COVID‐19 and 8278 other); and #3 only non‐COVID‐19 pneumonia patients and a random sample of COVID‐19 patients (3000 COVID‐19 and 2582 others) to provide balanced classes. The best models were chosen by one‐standard‐deviation rule in 10‐fold cross‐validation and evaluated on the hold out test sets for reporting. In strategy#1, Relief FS combined with random forest (RF) classifier resulted in the highest performance (accuracy = 0.96, AUC = 0.99, sensitivity = 0.98, specificity = 0.94, PPV = 0.96, and NPV = 0.96). In strategy#2, Recursive Feature Elimination (RFE) FS and RF classifier combination resulted in the highest performance (accuracy = 0.97, AUC = 0.99, sensitivity = 0.98, specificity = 0.95, PPV = 0.96, NPV = 0.98). Finally, in strategy #3, the ANOVA FS and RF classifier combination resulted in the highest performance (accuracy = 0.94, AUC =0.98, sensitivity = 0.96, specificity = 0.93, PPV = 0.93, NPV = 0.96). Lung radiomic features combined with machine learning algorithms can enable the effective diagnosis of COVID‐19 pneumonia in CT images without the use of additional tests
COVID-19 prognostic modeling using CT radiomic features and machine learning algorithms: Analysis of a multi-institutional dataset of 14,339 patients
Background: We aimed to analyze the prognostic power of CT-based radiomics models using data of 14,339 COVID-19 patients.
Methods: Whole lung segmentations were performed automatically using a deep learning-based model to extract 107 intensity and texture radiomics features. We used four feature selection algorithms and seven classifiers. We evaluated the models using ten different splitting and cross-validation strategies, including non-harmonized and ComBat-harmonized datasets. The sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were reported.
Results: In the test dataset (4,301) consisting of CT and/or RT-PCR positive cases, AUC, sensitivity, and specificity of 0.83 ± 0.01 (CI95%: 0.81-0.85), 0.81, and 0.72, respectively, were obtained by ANOVA feature selector + Random Forest (RF) classifier. Similar results were achieved in RT-PCR-only positive test sets (3,644). In ComBat harmonized dataset, Relief feature selector + RF classifier resulted in the highest performance of AUC, reaching 0.83 ± 0.01 (CI95%: 0.81-0.85), with a sensitivity and specificity of 0.77 and 0.74, respectively. ComBat harmonization did not depict statistically significant improvement compared to a non-harmonized dataset. In leave-one-center-out, the combination of ANOVA feature selector and RF classifier resulted in the highest performance.
Conclusion: Lung CT radiomics features can be used for robust prognostic modeling of COVID-19. The predictive power of the proposed CT radiomics model is more reliable when using a large multicentric heterogeneous dataset, and may be used prospectively in clinical setting to manage COVID-19 patients.</p