Medical Diagnosis with Large Scale Multimodal Transformers: Leveraging Diverse Data for More Accurate Diagnosis
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）
Firas Khader, Gustav Mueller-Franzes, Tianci Wang, Tianyu Han, Soroosh Tayebi Arasteh, Christoph Haarburger, Johannes Stegmaier, Keno Bressem, Christiane Kuhl, … 展开作者
Firas Khader, Gustav Mueller-Franzes, Tianci Wang, Tianyu Han, Soroosh Tayebi Arasteh, Christoph Haarburger, Johannes Stegmaier, Keno Bressem, Christiane Kuhl, Sven Nebelung, Jakob Nikolas Kather, Daniel Truhn
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 easily scalable and naturally adapts to multimodal data inputs from clinical routine. We demonstrate this approach on three large multimodal datasets from radiology and ophthalmology and show that it outperforms state-of-the-art models in clinically relevant diagnosis tasks. Our new approach is transferable and will allow the application of multimodal deep learning to a broad set of clinically relevant problems.
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…
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…
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.
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 …
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) p…
Medical Multimodal Foundation Models in Clinical Diagnosis and Treatment: Applications, Challenges, and Future Directions
School of Biomedical Engineering, Tsinghua University（清华大学生物医学工程学院）；Department of Computer Science and Technology, Tsinghua University（清华大学计算机科学与技术系）；Hepato-Pancreato-Biliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University（清华大学临床医学院北京清华长庚医院肝胆胰中心）；School of Computer and Communication Engineering, University of Science and Technology Beijing（北京科技大学计算机与通信工程学院）；College of Electronic Information Engineering, Tongji University（同济大学电子与信息工程学院）
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 …
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）
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）
Rethinking the Potential of Multimodality in Collaborative Problem Solving Diagnosis with Large Language Models
UCL Knowledge Lab, Institute of Education, University College London, UK（伦敦大学学院教育研究所知识实验室）；AI Centre, Dept. of Computer Science, University College London, UK（伦敦大学学院人工智能中心）
Shenzhen University（深圳大学）；Second People’s Hospital of Guangdong Province（广东省第二人民医院）
Recent studies show that deep learning models achieve good performance on medical imaging tasks such as diagnosis prediction. Among the models, multimodality has been an emerging trend, integrating different forms of data such as chest X-ray (CXR) images and electronic medical records (EMRs). However, most existing methods incorporate them in a model-free manner, which lacks theoretical support and ignores the intrinsic relations between different data sources. To address this problem, we propose a knowledge-driven and data-driven framework for lung disease diagnosis. By incorporating domain k…
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）
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…
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…
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-…
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 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…
A Multimodal Deep Learning Framework for Early Diagnosis of Liver Cancer via Optimized BiLSTM-AM-VMD Architecture
Department of Encephalopathy, Chengdu Pidu District Hospital of Traditional Chinese Medicine, Chengdu 611730, China（成都Pidu区中医医院神经病科）；Department of Tuina, Chengdu Pidu District Hospital of Traditional Chinese Medicine, Chengdu 611730, China（成都Pidu区中医医院推拿科）；Department of Electrical and Computer Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA（卡内基梅隆大学电气与计算机工程系）
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）
HuatuoGPT-Vision, Towards Injecting Medical Visual Knowledge into Multimodal LLMs at Scale
Shenzhen Research Institute of Big Data（深圳大数据研究院）；The Chinese University of Hong Kong, Shenzhen（香港中文大学（深圳））；National Health Data Institute, Shenzhen（深圳国家健康数据研究院）
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）
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…
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…
Enriched text-guided variational multimodal knowledge distillation network (VMD) for automated diagnosis of plaque vulnerability in 3D carotid artery MRI
department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University（放射医学与核医学科，宣武医院，首都医科大学）；Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics（北京磁共振成像与脑信息学重点实验室）；Beijing United Imaging Research Institute of Intelligent Imaging（北京智能成像联合研究院）
Microsoft Research（微软研究院）；TuSimple（图森未来）；Baidu Research（百度研究院）；Tencent Medical AI Labs（腾讯医疗AI实验室）；PingAn Tech（平安科技）
Medical imaging is an essential tool in many areas of medical applications, used for both diagnosis and treatment. However, reading medical images and making diagnosis or treatment recommendations require specially trained medical specialists. The current practice of reading medical images is labor-intensive, time-consuming, costly, and error-prone. It would be more desirable to have a computer-aided system that can automatically make diagnosis and treatment recommendations. Recent advances in deep learning enable us to rethink the ways of clinician diagnosis based on medical images. In this t…
Bipolar disorder is a mental health disorder that causes mood swings that range from depression to mania. Diagnosis of bipolar disorder is usually done based on patient interviews, and reports obtained from the caregivers of the patients. Subsequently, the diagnosis depends on the experience of the expert, and it is possible to have confusions of the disorder with other mental disorders. Automated processes in the diagnosis of bipolar disorder can help providing quantitative indicators, and allow easier observations of the patients for longer periods. Furthermore, the need for remote treatment…
Multimodal image fusion aims to combine relevant information from images acquired with different sensors. In medical imaging, fused images play an essential role in both standard and automated diagnosis. In this paper, we propose a novel multimodal image fusion method based on coupled dictionary learning. The proposed method is general and can be employed for different medical imaging modalities. Unlike many current medical fusion methods, the proposed approach does not suffer from intensity attenuation nor loss of critical information. Specifically, the images to be fused are decomposed into …
An estimated 300 million people worldwide suffer from asthma, and this number is expected to increase to 400 million by 2025. Approximately 250,000 people die prematurely each year from asthma out of which, almost all deaths are avoidable. Most of these deaths occur because the patients are unaware of their asthmatic morbidity. If detected early, asthmatic mortality rate can be reduced by 78%, provided that the patients carry appropriate medication for the same and/or are in lose vicinity to medical equipment like nebulizers. This study focuses on the development and valuation of algorithms to…
Social media has been considered as a data source for tracking disease. However, most analyses are based on models that prioritize strong correlation with population-level disease rates over determining whether or not specific individual users are actually sick. Taking a different approach, we develop a novel system for social-media based disease detection at the individual level using a sample of professionally diagnosed individuals. Specifically, we develop a system for making an accurate influenza diagnosis based on an individual's publicly available Twitter data. We find that about half (1…
Thomas Jefferson High School for Science and Technology（托马斯·杰斐逊科学技术高中）
According to the WHO, Cerebrovascular Stroke, or CS, is the second largest cause of death worldwide. Current diagnosis of CS relies on labor and cost intensive neuroimaging techniques, unsuitable for areas with inadequate access to quality medical facilities. Thus, there is a great need for an efficient diagnosis alternative. StrokeSave is a platform for users to self-diagnose for prevalence to stroke. The mobile app is continuously updated with heart rate, blood pressure, and blood oxygen data from sensors on the patient wrist. Once these measurements reach a threshold for possible stroke, th…
