Artificial Intelligence in Medicine最新文献

Various studies have been published on the remote assessment of eczema severity from digital camera images. Successful deployment of an accurate and robust AI-powered tool for such purposes can aid the formulation of eczema treatment plans and assist in patient monitoring. This review aims to provide an overview of the quality of published studies on this topic and to identify challenges and suggestions to improve the robustness and reliability of existing tools. We identified 25 articles from the Scopus database that aimed to assess eczema severity automatically from digital camera images by eczema area detection (n=13), which is important for prior delineation of the most relevant clinical features, and/or severity prediction (n=12). Deep learning methods (n=14) were more commonly used in recent years over conventional machine learning (n=11). A set of 20 pre-defined criteria were used for critical appraisal in this study. Study quality was hindered in many cases due to dataset challenges, with only 28% of studies reporting patient age range and 16% reporting skin phototype range. Furthermore, 52% of studies utilised solely non-public datasets and only 17% provided open-source access to code repositories, making validation of experimental results a significant challenge. In terms of algorithm design, attempts to improve model accuracy and process automation are widely reported. However, there remains limited implementation of methods for explicitly improving model trustworthiness and robustness. There is a need for a high-quality dataset with a sufficient number of bias-free images and consistent labels, as well as improved image analytics methods, to enhance the state of remote eczema severity assessment algorithms. Improving the interpretability and explainability of developed tools will further improve long-term reliability and trustworthiness.

Anticancer peptides (ACPs) are a class of molecules that have gained significant attention in the field of cancer research and therapy. ACPs are short chains of amino acids, the building blocks of proteins, and they possess the ability to selectively target and kill cancer cells. One of the key advantages of ACPs is their ability to selectively target cancer cells while sparing healthy cells to a greater extent. This selectivity is often attributed to differences in the surface properties of cancer cells compared to normal cells. That is why ACPs are being investigated as potential candidates for cancer therapy. ACPs may be used alone or in combination with other treatment modalities like chemotherapy and radiation therapy. While ACPs hold promise as a novel approach to cancer treatment, there are challenges to overcome, including optimizing their stability, improving selectivity, and enhancing their delivery to cancer cells, continuous increasing in number of peptide sequences, developing a reliable and precise prediction model. In this work, we propose an efficient transformer-based framework to identify ACPs for by performing accurate a reliable and precise prediction model. For this purpose, four different transformer models, namely ESM, ProtBERT, BioBERT, and SciBERT are employed to detect ACPs from amino acid sequences. To demonstrate the contribution of the proposed framework, extensive experiments are carried on widely-used datasets in the literature, two versions of AntiCp2, cACP-DeepGram, ACP-740. Experiment results show the usage of proposed model enhances classification accuracy when compared to the literature studies. The proposed framework, ESM, exhibits 96.45% of accuracy for AntiCp2 dataset, 97.66% of accuracy for cACP-DeepGram dataset, and 88.51% of accuracy for ACP-740 dataset, thence determining new state-of-the-art. The code of proposed framework is publicly available at github (https://github.com/mstf-yalcin/acp-esm).

Pediatric obesity can drastically heighten the risk of cardiometabolic alterations later in life, with insulin resistance standing as the cornerstone linking adiposity to the increased cardiovascular risk. Puberty has been pointed out as a critical stage after which obesity-associated insulin resistance is more difficult to revert. Timely prediction of insulin resistance in pediatric obesity is therefore vital for mitigating the risk of its associated comorbidities. The construction of effective and robust predictive systems for a complex health outcome like insulin resistance during the early stages of life demands the adoption of longitudinal designs for more causal inferences, and the integration of factors of varying nature involved in its onset. In this work, we propose an eXplainable Artificial Intelligence-based decision support pipeline for early diagnosis of insulin resistance in a longitudinal cohort of 90 children. For that, we leverage multi-omics (genomics and epigenomics) and clinical data from the pre-pubertal stage. Different data layers combinations, pre-processing techniques (missing values, feature selection, class imbalance, etc.), algorithms, training procedures were considered following good practices for Machine Learning. SHapley Additive exPlanations were provided for specialists to understand both the decision-making mechanisms of the system and the impact of the features on each automatic decision, an essential issue in high-risk areas such as this one where system decisions may affect people’s lives. The system showed a relevant predictive ability (AUC and G-mean of 0.92). A deep exploration, both at the global and the local level, revealed promising biomarkers of insulin resistance in our population, highlighting classical markers, such as Body Mass Index z-score or leptin/adiponectin ratio, and novel ones such as methylation patterns of relevant genes, such as HDAC4, PTPRN2, MATN2, RASGRF1 and EBF1. Our findings highlight the importance of integrating multi-omics data and following eXplainable Artificial Intelligence trends when building decision support systems.

Background

Assigning International Classification of Diseases (ICD) codes to clinical texts is a common and crucial practice in patient classification, hospital management, and further statistics analysis. Current auto-coding methods mainly transfer this task to a multi-label classification problem. Such solutions are suffering from high-dimensional mapping space and excessive redundant information in long clinical texts. To alleviate such a situation, we introduce text summarization methods to the ICD coding regime and apply text matching to select ICD codes.

Method

We focus on the tenth revision of the ICD (ICD-10) coding and design a novel summarization-based approach (SuM) with an end-to-end strategy to efficiently assign ICD-10 code to clinical texts. In this approach, a knowledge-guided pointer network is purposed to distill and summarize key information in clinical texts precisely. Then a matching model with matching-aggregation architecture follows to align the summary result with code, tuning the one-vs-all scenario to one-vs-one matching so that the large-label-space obstacle laid in classification approaches would be avoided.

Result

The 12,788 ICD-10 coded discharge summaries from a Chinese hospital were collected to evaluate the proposed approach. Compared with existing methods, the purposed model achieves the greatest coding results with Micro AUC of 0.9548, MRR@10 of 0.7977, Precision@10 of 0.0944, and Recall@10 of 0.9439 for the TOP-50 Dataset. Results on the FULL-Dataset remain consistent. Also, the proposed knowledge encoder and applied end-to-end strategy are proven to facilitate the whole model to gain efficacy in selecting the most suitable code.

Conclusion

The proposed automatic ICD-10 code assignment approach via text summarization can effectively capture critical messages in long clinical texts and improve the performance of ICD-10 coding of clinical texts.

Dose prediction is a crucial step in automated radiotherapy planning for liver cancer. Several deep learning-based approaches for dose prediction have been proposed to enhance the design efficiency and quality of radiotherapy plan. However, these approaches usually take CT images and contours of organs at risk (OARs) and planning target volume (PTV) as a multi-channel input and is thus difficult to extract sufficient feature information from each input, which results in unsatisfactory dose distribution. In this paper, we propose a novel dose prediction network for liver cancer based on hierarchical feature fusion and interactive attention. A feature extraction module is first constructed to extract multi-scale features from different inputs, and a hierarchical feature fusion module is then built to fuse these multi-scale features hierarchically. A decoder based on attention mechanism is designed to gradually reconstruct the fused features into dose distribution. Additionally, we design an autoencoder network to generate a perceptual loss during training stage, which is used to improve the accuracy of dose prediction. The proposed method is tested on private clinical dataset and obtains HI and CI of 0.31 and 0.87, respectively. The experimental results are better than those by several existing methods, indicating that the dose distribution generated by the proposed method is close to that approved in clinics. The codes are available at https://github.com/hired-ld/FA-Net.

The lack of annotated medical images limits the performance of deep learning models, which usually need large-scale labelled datasets. Few-shot learning techniques can reduce data scarcity issues and enhance medical image analysis speed and robustness. This systematic review gives a comprehensive overview of few-shot learning methods for medical image analysis, aiming to establish a standard methodological pipeline for future research reference. With a particular emphasis on the role of meta-learning, we analysed 80 relevant articles published from 2018 to 2023, conducting a risk of bias assessment and extracting relevant information, especially regarding the employed learning techniques. From this, we delineated a comprehensive methodological pipeline shared among all studies. In addition, we performed a statistical analysis of the studies’ results concerning the clinical task and the meta-learning method employed while also presenting supplemental information such as imaging modalities and model robustness evaluation techniques. We discussed the findings of our analysis, providing a deep insight into the limitations of the state-of-the-art methods and the most promising approaches. Drawing on our investigation, we yielded recommendations on potential future research directions aiming to bridge the gap between research and clinical practice.

The advanced learning paradigm, learning using privileged information (LUPI), leverages information in training that is not present at the time of prediction. In this study, we developed privileged logistic regression (PLR) models under the LUPI paradigm to detect acute respiratory distress syndrome (ARDS), with mechanical ventilation variables or chest x-ray image features employed in the privileged domain and electronic health records in the base domain. In model training, the objective of privileged logistic regression was designed to incorporate data from the privileged domain and encourage knowledge transfer across the privileged and base domains. An asymptotic analysis was also performed, yielding sufficient conditions under which the addition of privileged information increases the rate of convergence in the proposed model. Results for ARDS detection show that PLR models achieve better classification performances than logistic regression models trained solely on the base domain, even when privileged information is partially available. Furthermore, PLR models demonstrate performance on par with or superior to state-of-the-art models under the LUPI paradigm. As the proposed models are effective, easy to interpret, and highly explainable, they are ideal for other clinical applications where privileged information is at least partially available.