In medical diagnosis, physicians predict the state of a patient by checking measurements (features) obtained from a sequence of tests, e.g., blood test, urine test, followed by invasive tests. As tests are often costly, one would like to obtain only those features (tests) that can establish the presence or absence of the state conclusively. Another aspect of medical diagnosis is that we are often faced with unsupervised prediction tasks as the true state of the patients may not be known. Motivated by such medical diagnosis problems, we consider a {\it Cost-Sensitive Medical Diagnosis} (CSMD) problem, where the true state of patients is unknown. We formulate the CSMD problem as a feature selection problem where each test gives a feature that can be used in a prediction model. Our objective is to learn strategies for selecting the features that give the best trade-off between accuracy and costs. We exploit the `Weak Dominance' property of problem to develop online algorithms that identify a set of features which provides an `optimal' trade-off between cost and accuracy of prediction without requiring to know the true state of the medical condition. Our empirical results validate the performance of our algorithms on problem instances generated from real-world datasets.
Background and purpose: Heart disease has been one of the most important causes of death in the last 10 years, so the use of classification methods to diagnose and predict heart disease is very important. If this disease is predicted before menstruation, it is possible to prevent high mortality of the disease and provide more accurate and efficient treatment methods. Materials and Methods: Due to the selection of input features, the use of basic algorithms can be very time-consuming. Reducing dimensions or choosing a good subset of features, without risking accuracy, has great importance for b…
The purpose of write-missing diagnosis detection is to find diseases that have been clearly diagnosed from medical records but are missed in the discharge diagnosis. Unlike the definition of missed diagnosis, the write-missing diagnosis is clearly manifested in the medical record without further reasoning. The write-missing diagnosis is a common problem, often caused by physician negligence. The write-missing diagnosis will result in an incomplete diagnosis of medical records. While under DRG grouping, the write-missing diagnoses will miss important additional diagnoses (CC, MCC), thus affecti…
The claims data, containing medical codes, services information, and incurred expenditure, can be a good resource for estimating an individual's health condition and medical risk level. In this study, we developed Transformer-based Multimodal AutoEncoder (TMAE), an unsupervised learning framework that can learn efficient patient representation by encoding meaningful information from the claims data. TMAE is motivated by the practical needs in healthcare to stratify patients into different risk levels for improving care delivery and management. Compared to previous approaches, TMAE is able to 1…
Harbin Institute of Technology（哈尔滨工业大学）；Second Affiliated Hospital of Harbin Medical University（哈尔滨医科大学附属第二医院）
The representation of knowledge based on first-order logic captures the richness of natural language and supports multiple probabilistic inference models. Although symbolic representation enables quantitative reasoning with statistical probability, it is difficult to utilize with machine learning models as they perform numerical operations. In contrast, knowledge embedding (i.e., high-dimensional and continuous vectors) is a feasible approach to complex reasoning that can not only retain the semantic information of knowledge but also establish the quantifiable relationship among them. In this …
The Quick Medical Reference (QMR) is a compendium of statistical knowledge connecting diseases to findings (symptoms). The information in QMR can be represented as a Bayesian network. The inference problem (or, in more medical language, giving a diagnosis) for the QMR is to, given some findings, find the probability of each disease. Rejection sampling and likelihood weighted sampling (a.k.a. likelihood weighting) are two simple algorithms for making approximate inferences from an arbitrary Bayesian net (and from the QMR Bayesian net in particular). Heretofore, the samples for these two algorit…
We propose a Bayesian approach for both medical inquiry and disease inference, the two major phases in differential diagnosis. Unlike previous work that simulates data from given probabilities and uses ML algorithms on them, we directly use the Quick Medical Reference (QMR) belief network, and apply Bayesian inference in the inference phase and Bayesian experimental design in the inquiry phase. Moreover, we improve the inquiry phase by extending the Bayesian experimental design framework from one-step search to multi-step search. Our approach has some practical advantages as it is interpretabl…
King Mongkut’s University of Technology North Bangkok（曼谷北部金蒙固科技大学）；Suan Sunandha Rajabhat University（素安塔尼皇家大学）
This paper discusses the knowledge integration of clinical information extracted from distributed medical ontology in order to ameliorate a machine learning-based multi-label coding assignment system. The proposed approach is implemented using a decision tree based cascade hierarchical technique on the university hospital data for patients with Coronary Heart Disease (CHD). The preliminary results obtained show a satisfactory finding.
School of Mechanical Engineering, Federal University of Uberlândia（Uberlândia联邦大学机械工程学院）；University of Padova（帕多瓦大学）；Federal University of São João del Rei（圣若昂德尔雷伊联邦大学）
The monitoring of rotating machinery is an essential task in today's production processes. Currently, several machine learning and deep learning-based modules have achieved excellent results in fault detection and diagnosis. Nevertheless, to further increase user adoption and diffusion of such technologies, users and human experts must be provided with explanations and insights by the modules. Another issue is related, in most cases, with the unavailability of labeled historical data that makes the use of supervised models unfeasible. Therefore, a new approach for fault detection and diagnosis…
Dynamic diagnosis is desirable when medical tests are costly or time-consuming. In this work, we use reinforcement learning (RL) to find a dynamic policy that selects lab test panels sequentially based on previous observations, ensuring accurate testing at a low cost. Clinical diagnostic data are often highly imbalanced; therefore, we aim to maximize the $F_1$ score instead of the error rate. However, optimizing the non-concave $F_1$ score is not a classic RL problem, thus invalidates standard RL methods. To remedy this issue, we develop a reward shaping approach, leveraging properties of the …
University Hospital Aachen（亚琛大学医院）；RWTH Aachen University（亚琛工业大学）；Ocumeda GmbH（Ocumeda 有限公司）；RWTH Aachen（亚琛工业大学）；Charité – Universitätsmedizin Berlin（柏林夏里特医学院）；Freie Universität Berlin（柏林自由大学）；Technical University Dresden（德累斯顿工业大学）；University of Leeds（利兹大学）；University Hospital Heidelberg（海德堡大学医院）
Multimodal deep learning has been used to predict clinical endpoints and diagnoses from clinical routine data. However, these models suffer from scaling issues: they have to learn pairwise interactions between each piece of information in each data type, thereby escalating model complexity beyond manageable scales. This has so far precluded a widespread use of multimodal deep learning. Here, we present a new technical approach of "learnable synergies", in which the model only selects relevant interactions between data modalities and keeps an "internal memory" of relevant data. Our approach is …
Machine-learned diagnosis models have shown promise as medical aides but are trained under a closed-set assumption, i.e. that models will only encounter conditions on which they have been trained. However, it is practically infeasible to obtain sufficient training data for every human condition, and once deployed such models will invariably face previously unseen conditions. We frame machine-learned diagnosis as an open-set learning problem, and study how state-of-the-art approaches compare. Further, we extend our study to a setting where training data is distributed across several healthcare …
This paper proposes an unsupervised anomaly detection technique for image-based plant disease diagnosis. The construction of large and publicly available datasets containing labeled images of healthy and diseased crop plants led to growing interest in computer vision techniques for automatic plant disease diagnosis. Although supervised image classifiers based on deep learning can be a powerful tool for plant disease diagnosis, they require a huge amount of labeled data. The data mining technique of anomaly detection includes unsupervised approaches that do not require rare samples for training…
Arison School of Business, Interdisciplinary Center（阿里森商学院，跨学科中心）
A key step in medical diagnosis is giving the patient a universally recognized label (e.g. Appendicitis) which essentially assigns the patient to a class(es) of patients with similar body failures. However, two patients having the same disease label(s) with high probability may still have differences in their feature manifestation patterns implying differences in the required treatments. Additionally, in many cases, the labels of the primary diagnoses leave some findings unexplained. Medical diagnosis is only partially about probability calculations for label X or Y. Diagnosis is not complete …
Misdiagnosis rates are one of the leading causes of medical errors in hospitals, affecting over 12 million adults across the US. To address the high rate of misdiagnosis, this study utilizes 4 NLP-based algorithms to determine the appropriate health condition based on an unstructured transcription report. From the Logistic Regression, Random Forest, LSTM, and CNNLSTM models, the CNN-LSTM model performed the best with an accuracy of 97.89%. We packaged this model into a authenticated web platform for accessible assistance to clinicians. Overall, by standardizing health care diagnosis and struct…
Gradient Boosting Decision Trees on Medical Diagnosis over Tabular Data
Department of Electrical and Computer Engineering（电气与计算机工程系）；Northeastern University（东北大学）；The Business School（商学院）；Worcester Polytechnic Institute（沃思利理工学院）
South China University of Technology（华南理工大学）；Tencent AI Lab（腾讯人工智能实验室）
Deep learning based medical image diagnosis has shown great potential in clinical medicine. However, it often suffers two major difficulties in practice: 1) only limited labeled samples are available due to expensive annotation costs over medical images; 2) labeled images may contain considerable label noises (e.g., mislabeling labels) due to diagnostic difficulties. In this paper, we seek to exploit rich labeled data from relevant domains to help the learning in the target task with unsupervised domain adaptation (UDA). Unlike most existing UDA methods which rely on clean labeled data or assu…
We develop and approach to unsupervised semantic medical image segmentation that extends previous work with generative adversarial networks. We use existing edge detection methods to construct simple edge diagrams, train a generative model to convert them into synthetic medical images, and construct a dataset of synthetic images with known segmentations using variations on extracted edge diagrams. This synthetic dataset is then used to train a supervised image segmentation model. We test our approach on a clinical dataset of kidney ultrasound images and the benchmark ISIC 2018 skin lesion data…
Beijing University of Posts and Telecommunications（北京邮电大学）；Carnegie Mellon University（卡内基梅隆大学）；Tsinghua University（清华大学）；Petuum Inc（Petuum公司）
A primary goal of computational phenotype research is to conduct medical diagnosis. In hospital, physicians rely on massive clinical data to make diagnosis decisions, among which laboratory tests are one of the most important resources. However, the longitudinal and incomplete nature of laboratory test data casts a significant challenge on its interpretation and usage, which may result in harmful decisions by both human physicians and automatic diagnosis systems. In this work, we take advantage of deep generative models to deal with the complex laboratory tests. Specifically, we propose an end…
Random Token Fusion for Multi-View Medical Diagnosis
KTH Royal Institute of Technology（皇家理工学院）；Science for Life Laboratory（生命科学实验室）；Karolinska Institutet（卡罗林斯卡学院）；Karolinska University Hospital（卡罗林斯卡大学医院）
Tsinghua University（清华大学）；Tsinghua National Laboratory of Information Science and Technology（清华信息科学与技术国家实验室）；Beijing University of Posts and Telecommunications（北京邮电大学）；Huangshi Central Hospital of Edong Healthcare Group, Hubei Polytechnic University（湖北理工学院鄂东医疗集团黄石市中心医院）
Automatically extracting useful information from electronic medical records along with conducting disease diagnoses is a promising task for both clinical decision support(CDS) and neural language processing(NLP). Most of the existing systems are based on artificially constructed knowledge bases, and then auxiliary diagnosis is done by rule matching. In this study, we present a clinical intelligent decision approach based on Convolutional Neural Networks(CNN), which can automatically extract high-level semantic information of electronic medical records and then perform automatic diagnosis witho…
While facial biometrics has been widely used for identification purpose, it has recently been researched as medical biometrics for a range of diseases. In this chapter, we investigate the facial landmark detection for atypical 3D facial modelling in facial palsy cases, while potentially such modelling can assist the medical diagnosis using atypical facial features. In our work, a study of landmarks localisation methods such as stacked hourglass networks is conducted and evaluated to ascertain their accuracy when presented with unseen atypical faces. The evaluation highlights that the state-of-…
Massachusetts General Hospital（麻省总医院）；Harvard Medical School（哈佛医学院）；Beth Israel Deaconess Medical Center（贝斯以色列女执事医疗中心）；Nankai University（南开大学）；The Hong Kong Polytechnic University（香港理工大学）；University of Southern California（南加州大学）；China University of Mining and Technology（中国矿业大学）；Beijing University of Posts and Telecommunications（北京邮电大学）
Recent advances in unsupervised domain adaptation (UDA) show that transferable prototypical learning presents a powerful means for class conditional alignment, which encourages the closeness of cross-domain class centroids. However, the cross-domain inner-class compactness and the underlying fine-grained subtype structure remained largely underexplored. In this work, we propose to adaptively carry out the fine-grained subtype-aware alignment by explicitly enforcing the class-wise separation and subtype-wise compactness with intermediate pseudo labels. Our key insight is that the unlabeled subt…
University of Memphis（孟菲斯大学）；Adobe Research（奥多比研究院）；Johns Hopkins University（约翰斯·霍普金斯大学）
Clinical notes in Electronic Health Records (EHR) present rich documented information of patients to inference phenotype for disease diagnosis and study patient characteristics for cohort selection. Unsupervised user embedding aims to encode patients into fixed-length vectors without human supervisions. Medical concepts extracted from the clinical notes contain rich connections between patients and their clinical categories. However, existing unsupervised approaches of user embeddings from clinical notes do not explicitly incorporate medical concepts. In this study, we propose a concept-aware …
Interpretation of medical images for diagnosis and treatment of complex disease from high-dimensional and heterogeneous data remains a key challenge in transforming healthcare. In the last few years, both supervised and unsupervised deep learning achieved promising results in the area of medical imaging and image analysis. Unlike supervised learning which is biased towards how it is being supervised and manual efforts to create class label for the algorithm, unsupervised learning derive insights directly from the data itself, group the data and help to make data driven decisions without any ex…
Institute for Systems and Robotics（系统与机器人研究所）；Interactive Technologies Institute（交互技术研究所）
This paper describes the field research, design and comparative deployment of a multimodal medical imaging user interface for breast screening. The main contributions described here are threefold: 1) The design of an advanced visual interface for multimodal diagnosis of breast cancer (BreastScreening); 2) Insights from the field comparison of single vs multimodality screening of breast cancer diagnosis with 31 clinicians and 566 images, and 3) The visualization of the two main types of breast lesions in the following image modalities: (i) MammoGraphy (MG) in both Craniocaudal (CC) and Mediolat…
University of New South Wales（新南威尔士大学）；National Acoustic Laboratories（国家声学实验室）；Macquarie University（麦考瑞大学）
EEG-based tinnitus classification is a valuable tool for tinnitus diagnosis, research, and treatments. Most current works are limited to a single dataset where data patterns are similar. But EEG signals are highly non-stationary, resulting in model's poor generalization to new users, sessions or datasets. Thus, designing a model that can generalize to new datasets is beneficial and indispensable. To mitigate distribution discrepancy across datasets, we propose to achieve Disentangled and Side-aware Unsupervised Domain Adaptation (DSUDA) for cross-dataset tinnitus diagnosis. A disentangled auto…
Rethinking Human-AI Collaboration in Complex Medical Decision Making: A Case Study in Sepsis Diagnosis
Northeastern University（东北大学）；Massachusetts Institute of Technology（麻省理工学院）；The Ohio State University（俄亥俄州立大学）；Rensselaer Polytechnic Institute（伦斯勒理工学院）；The Ohio State University Wexner Medical Center（俄亥俄州立大学韦克斯纳医学中心）
Peking University（北京大学）；Yale University（耶鲁大学）；Tencent（腾讯）；University of Washington（华盛顿大学）
Medical report generation, which aims to automatically generate a long and coherent report of a given medical image, has been receiving growing research interests. Existing approaches mainly adopt a supervised manner and heavily rely on coupled image-report pairs. However, in the medical domain, building a large-scale image-report paired dataset is both time-consuming and expensive. To relax the dependency on paired data, we propose an unsupervised model Knowledge Graph Auto-Encoder (KGAE) which accepts independent sets of images and reports in training. KGAE consists of a pre-constructed know…
A ChatGPT Aided Explainable Framework for Zero-Shot Medical Image Diagnosis
Zhejiang University-University of Illinois at Urbana-Champaign Institute（浙江大学伊利诺伊大学厄巴纳香槟校区联合学院）；Zhejiang University（浙江大学）；National University of Singapore（新加坡国立大学）；Angelalign Inc.（时代天使公司）
Beijing Institute of Technology（北京理工大学）；Xuanwu Hospital, Capital Medical University（首都医科大学宣武医院）；National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College（中国医学科学院北京协和医学院肿瘤医院（国家癌症中心/国家肿瘤临床医学研究中心））
Current Computer-Aided Diagnosis (CAD) methods mainly depend on medical images. The clinical information, which usually needs to be considered in practical clinical diagnosis, has not been fully employed in CAD. In this paper, we propose a novel deep learning-based method for fusing Magnetic Resonance Imaging (MRI)/Computed Tomography (CT) images and clinical information for diagnostic tasks. Two paths of neural layers are performed to extract image features and clinical features, respectively, and at the same time clinical features are employed as the attention to guide the extraction of imag…
The University of Sydney（悉尼大学）；Medicinovo Inc.（Medicinovo公司）
In medical real-world study (RWS), how to fully utilize the fragmentary and scarce information in model training to generate the solid diagnosis results is a challenging task. In this work, we introduce a novel multi-instance neural network, AMI-Net+, to train and predict from the incomplete and extremely imbalanced data. It is more effective than the state-of-art method, AMI-Net. First, we also implement embedding, multi-head attention and gated attention-based multi-instance pooling to capture the relations of symptoms themselves and with the given disease. Besides, we propose var-ious impro…
Huazhong University of Science and Technology（华中科技大学）；Guizhou Normal University（贵州师范大学）；Hubei University（湖北大学）
Mapping X-ray images, radiology reports, and other medical data as binary codes in the common space, which can assist clinicians to retrieve pathology-related data from heterogeneous modalities (i.e., hashing-based cross-modal medical data retrieval), provides a new view to promot computeraided diagnosis. Nevertheless, there remains a barrier to boost medical retrieval accuracy: how to reveal the ambiguous semantics of medical data without the distraction of superfluous information. To circumvent this drawback, we propose Deep Supervised Information Bottleneck Hashing (DSIBH), which effectivel…
Diagnosing Shoulder Disorders Using Multimodal Large Language Models and Consumer-Grade Cameras
Bytedance（字节跳动）；Peking University（北京大学）；Peking University People’s Hospital（北京大学人民医院）；Mohamed bin Zayed University of Artificial Intelligence（穆罕默德·本·扎耶德人工智能大学）；The Chinese University of Hong Kong（香港中文大学）
ActiveMedAgent: Cost-Aware Trajectory Learning for Multimodal Medical Diagnosis
Washington University in St. Louis（圣路易斯华盛顿大学）；Icahn School of Medicine at Mount Sinai（西奈山伊坎医学院）；Arizona State University（亚利桑那州立大学）；Yale University（耶鲁大学）；Amazon（亚马逊公司）
University of Copenhagen（哥本哈根大学）；Rigshospitalet（哥本哈根大学国立医院）
Generative models such as Generative Adversarial Networks (GANs) and Variational Autoencoders (VAEs) play an increasingly important role in medical image analysis. The latent spaces of these models often show semantically meaningful directions corresponding to human-interpretable image transformations. However, until now, their exploration for medical images has been limited due to the requirement of supervised data. Several methods for unsupervised discovery of interpretable directions in GAN latent spaces have shown interesting results on natural images. This work explores the potential of a…
University of Cambridge（剑桥大学）；The Alan Turing Institute（艾伦·图灵研究所）
We investigate the influence of adversarial training on the interpretability of convolutional neural networks (CNNs), specifically applied to diagnosing skin cancer. We show that gradient-based saliency maps of adversarially trained CNNs are significantly sharper and more visually coherent than those of standardly trained CNNs. Furthermore, we show that adversarially trained networks highlight regions with significant color variation within the lesion, a common characteristic of melanoma. We find that fine-tuning a robust network with a small learning rate further improves saliency maps' sharp…
BIDMC（贝斯以色列女执事医疗中心）；Harvard Medical School（哈佛医学院）；Carnegie Mellon University（卡内基梅隆大学）；Johns Hopkins University（约翰斯·霍普金斯大学）；Beijing University of Posts and Telecommunications（北京邮电大学）
The labels in medical diagnosis task are usually discrete and successively distributed. For example, the Diabetic Retinopathy Diagnosis (DR) involves five health risk levels: no DR (0), mild DR (1), moderate DR (2), severe DR (3) and proliferative DR (4). This labeling system is common for medical disease. Previous methods usually construct a multi-binary-classification task or propose some re-parameter schemes in the output unit. In this paper, we target on this task from the perspective of loss function. More specifically, the Wasserstein distance is utilized as an alternative, explicitly in…
Graph Neural Networks (GNNs) have been shown to be a powerful tool for generating predictions from biological data. Their application to neuroimaging data such as functional magnetic resonance imaging (fMRI) scans has been limited. However, applying GNNs to fMRI scans may substantially improve predictive accuracy and could be used to inform clinical diagnosis in the future. In this paper, we present a novel approach to representing resting-state fMRI data as a graph containing nodes and edges without omitting any of the voxels and thus reducing information loss. We compare multiple GNN archite…
University of Rome Tor Vergata（罗马第二大学）；University of Cambridge（剑桥大学）；Athinoula A. Martinos Center for Biomedical Imaging（阿西诺拉·A·马蒂诺斯生物医学成像中心）
The lack of large labeled medical imaging datasets, along with significant inter-individual variability compared to clinically established disease classes, poses significant challenges in exploiting medical imaging information in a precision medicine paradigm, where in principle dense patient-specific data can be employed to formulate individual predictions and/or stratify patients into finer-grained groups which may follow more homogeneous trajectories and therefore empower clinical trials. In order to efficiently explore the effective degrees of freedom underlying variability in medical imag…
Millions of unsolicited medical inquiries are received by pharmaceutical companies every year. It has been hypothesized that these inquiries represent a treasure trove of information, potentially giving insight into matters regarding medicinal products and the associated medical treatments. However, due to the large volume and specialized nature of the inquiries, it is difficult to perform timely, recurrent, and comprehensive analyses. Here, we propose a machine learning approach based on natural language processing and unsupervised learning to automatically discover key topics in real-world m…
