148 research outputs found
ManyDG: Many-domain Generalization for Healthcare Applications
The vast amount of health data has been continuously collected for each
patient, providing opportunities to support diverse healthcare predictive tasks
such as seizure detection and hospitalization prediction. Existing models are
mostly trained on other patients data and evaluated on new patients. Many of
them might suffer from poor generalizability. One key reason can be overfitting
due to the unique information related to patient identities and their data
collection environments, referred to as patient covariates in the paper. These
patient covariates usually do not contribute to predicting the targets but are
often difficult to remove. As a result, they can bias the model training
process and impede generalization. In healthcare applications, most existing
domain generalization methods assume a small number of domains. In this paper,
considering the diversity of patient covariates, we propose a new setting by
treating each patient as a separate domain (leading to many domains). We
develop a new domain generalization method ManyDG, that can scale to such
many-domain problems. Our method identifies the patient domain covariates by
mutual reconstruction and removes them via an orthogonal projection step.
Extensive experiments show that ManyDG can boost the generalization performance
on multiple real-world healthcare tasks (e.g., 3.7% Jaccard improvements on
MIMIC drug recommendation) and support realistic but challenging settings such
as insufficient data and continuous learning.Comment: The paper has been accepted by ICLR 2023, refer to
https://openreview.net/forum?id=lcSfirnflpW. We will release the data and
source codes here https://github.com/ycq091044/ManyD
Should a Sentinel Node Biopsy Be Performed in Patients with High-Risk Breast Cancer?
A negative sentinel lymph node (SLN) biopsy spares many breast cancer patients the complications associated with lymph node irradiation or additional surgery. However, patients at high risk for nodal involvement based on clinical characteristics may remain at unacceptably high risk of axillary disease even after a negative SLN biopsy result. A Bayesian nomogram was designed to combine the probability of axillary disease prior to nodal biopsy with customized test characteristics for an SLN biopsy and provides the probability of axillary disease despite a negative SLN biopsy. Users may individualize the sensitivity of an SLN biopsy based on factors known to modify the sensitivity of the procedure. This tool may be useful in identifying patients who should have expanded upfront exploration of the axilla or comprehensive axillary irradiation
SCRIB: Set-classifier with Class-specific Risk Bounds for Blackbox Models
Despite deep learning (DL) success in classification problems, DL classifiers
do not provide a sound mechanism to decide when to refrain from predicting.
Recent works tried to control the overall prediction risk with classification
with rejection options. However, existing works overlook the different
significance of different classes. We introduce Set-classifier with
Class-specific RIsk Bounds (SCRIB) to tackle this problem, assigning multiple
labels to each example. Given the output of a black-box model on the validation
set, SCRIB constructs a set-classifier that controls the class-specific
prediction risks with a theoretical guarantee. The key idea is to reject when
the set classifier returns more than one label. We validated SCRIB on several
medical applications, including sleep staging on electroencephalogram (EEG)
data, X-ray COVID image classification, and atrial fibrillation detection based
on electrocardiogram (ECG) data. SCRIB obtained desirable class-specific risks,
which are 35\%-88\% closer to the target risks than baseline methods
Real-time segmentation and tracking of brain metabolic state in ICU EEG recordings of burst suppression
We provide a method for estimating brain metabolic state based on a reduced-order model of EEG burst suppression. The model, derived from previously suggested biophysical mechanisms of burst suppression, describes important electrophysiological features and provides a direct link to cerebral metabolic rate. We design and fit the estimation method from EEG recordings of burst suppression from a neurological intensive care unit and test it on real and synthetic data.National Institutes of Health (U.S.) (Grant DP1-OD003646
Propofol and sevoflurane induce distinct burst suppression patterns in rats
Burst suppression is an EEG pattern characterized by alternating periods of high-amplitude activity (bursts) and relatively low amplitude activity (suppressions). Burst suppression can arise from several different pathological conditions, as well as from general anesthesia. Here we review current algorithms that are used to quantify burst suppression, its various etiologies, and possible underlying mechanisms. We then review clinical applications of anesthetic-induced burst suppression. Finally, we report the results of our new study showing clear electrophysiological differences in burst suppression patterns induced by two common general anesthetics, sevoflurane and propofol. Our data suggest that the circuit mechanisms that generate burst suppression activity may differ among general anesthetics
Spatial variation in automated burst suppression detection in pharmacologically induced coma
Burst suppression is actively studied as a control signal to guide anesthetic dosing in patients undergoing medically induced coma. The ability to automatically identify periods of EEG suppression and compactly summarize the depth of coma using the burst suppression probability (BSP) is crucial to effective and safe monitoring and control of medical coma. Current literature however does not explicitly account for the potential variation in burst suppression parameters across different scalp locations. In this study we analyzed standard 19-channel EEG recordings from 8 patients with refractory status epilepticus who underwent pharmacologically induced burst suppression as medical treatment for refractory seizures. We found that although burst suppression is generally considered a global phenomenon, BSP obtained using a previously validated algorithm varies systematically across different channels. A global representation of information from individual channels is proposed that takes into account the burst suppression characteristics recorded at multiple electrodes. BSP computed from this representative burst suppression pattern may be more resilient to noise and a better representation of the brain state of patients. Multichannel data integration may enhance the reliability of estimates of the depth of medical coma.National Institutes of Health (U.S.) (Grant K23 NS090900)National Institute of Neurological Diseases and Stroke (U.S.) (Grant K23 NS090900)National Institutes of Health (U.S.) (Grant DP2-OD006454)National Institutes of Health (U.S.) (Grant TROI-GMI04948
- …