MuST: Multimodal Spatiotemporal Graph-Transformer for Hospital Readmission Prediction

Hospital readmission prediction is considered an essential approach to decreasing readmission rates, which is a key factor in assessing the quality and efficacy of a healthcare system. Previous studies have extensively utilized three primary modalities, namely electronic health records (EHR), medical images, and clinical notes, to predict hospital readmissions. However, the majority of these studies did not integrate information from all three modalities or utilize the spatiotemporal relationships present in the dataset. This study introduces a novel model called the Multimodal Spatiotemporal Graph-Transformer (MuST) for predicting hospital readmissions. By employing Graph Convolution Networks and temporal transformers, we can effectively capture spatial and temporal dependencies in EHR and chest radiographs. We then propose a fusion transformer to combine the spatiotemporal features from the two modalities mentioned above with the features from clinical notes extracted by a pre-trained, domain-specific transformer. We assess the effectiveness of our methods using the latest publicly available dataset, MIMIC-IV. The experimental results indicate that the inclusion of multimodal features in MuST improves its performance in comparison to unimodal methods. Furthermore, our proposed pipeline outperforms the current leading methods in the prediction of hospital readmissions

Relabeling Minimal Training Subset to Flip a Prediction

When facing an unsatisfactory prediction from a machine learning model, it is crucial to investigate the underlying reasons and explore the potential for reversing the outcome. We ask: can we result in the flipping of a test prediction $x_t$ by relabeling the smallest subset $\mathcal{S}_t$ of the training data before the model is trained? We propose an efficient procedure to identify and relabel such a subset via an extended influence function. We find that relabeling fewer than 1% of the training points can often flip the model's prediction. This mechanism can serve multiple purposes: (1) providing an approach to challenge a model prediction by recovering influential training subsets; (2) evaluating model robustness with the cardinality of the subset (i.e., $|\mathcal{S}_t|$); we show that $|\mathcal{S}_t|$ is highly related to the noise ratio in the training set and $|\mathcal{S}_t|$ is correlated with but complementary to predicted probabilities; (3) revealing training points lead to group attribution bias. To the best of our knowledge, we are the first to investigate identifying and relabeling the minimal training subset required to flip a given prediction.Comment: Under revie

Domain-incremental Cardiac Image Segmentation with Style-oriented Replay and Domain-sensitive Feature Whitening

Contemporary methods have shown promising results on cardiac image segmentation, but merely in static learning, i.e., optimizing the network once for all, ignoring potential needs for model updating. In real-world scenarios, new data continues to be gathered from multiple institutions over time and new demands keep growing to pursue more satisfying performance. The desired model should incrementally learn from each incoming dataset and progressively update with improved functionality as time goes by. As the datasets sequentially delivered from multiple sites are normally heterogenous with domain discrepancy, each updated model should not catastrophically forget previously learned domains while well generalizing to currently arrived domains or even unseen domains. In medical scenarios, this is particularly challenging as accessing or storing past data is commonly not allowed due to data privacy. To this end, we propose a novel domain-incremental learning framework to recover past domain inputs first and then regularly replay them during model optimization. Particularly, we first present a style-oriented replay module to enable structure-realistic and memory-efficient reproduction of past data, and then incorporate the replayed past data to jointly optimize the model with current data to alleviate catastrophic forgetting. During optimization, we additionally perform domain-sensitive feature whitening to suppress model's dependency on features that are sensitive to domain changes (e.g., domain-distinctive style features) to assist domain-invariant feature exploration and gradually improve the generalization performance of the network. We have extensively evaluated our approach with the M&Ms Dataset in single-domain and compound-domain incremental learning settings with improved performance over other comparison approaches.Comment: Accepted to IEEE Transactions on Medical Imagin