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General General

Cross-condition and cross-platform remaining useful life estimation via adversarial-based domain adaptation.

In Scientific reports ; h5-index 158.0

Supervised machine learning is a traditionally remaining useful life (RUL) estimation tool, which requires a lot of prior knowledge. For the situation lacking labeled data, supervised methods are invalid for the issue of domain shift in data distribution. In this paper, a adversarial-based domain adaptation (ADA) architecture with convolution neural networks (CNN) for RUL estimation of bearings under different conditions and platforms, referred to as ADACNN, is proposed. Specifically, ADACNN is trained in source labeled data and fine-tunes to similar target unlabeled data via an adversarial training and parameters shared mechanism. Besides a feature extractor and source domain regressive predictor, ADACNN also includes a domain classifier that tries to guide feature extractor find some domain-invariant features, which differents with traditional methods and belongs to a unsupervised learning in target domain, which has potential application value and far-reaching significance in academia. In addition, according to different first predictive time (FPT) detection mechanisms, we also explores the impact of different FPT detection mechanisms on RUL estimation performance. Finally, according to extensive experiments, the results of RUL estimation of bearing in cross-condition and cross-platform prove that ADACNN architecture has satisfactory generalization performance and great practical value in industry.

Zhao Dongdong, Liu Feng


Surgery Surgery

Machine Learning Can be Used to Predict Function but Not Pain After Surgery for Thumb Carpometacarpal Osteoarthritis.

In Clinical orthopaedics and related research ; h5-index 71.0

BACKGROUND : Surgery for thumb carpometacarpal osteoarthritis is offered to patients who do not benefit from nonoperative treatment. Although surgery is generally successful in reducing symptoms, not all patients benefit. Predicting clinical improvement after surgery could provide decision support and enhance preoperative patient selection.

QUESTIONS/PURPOSES : This study aimed to develop and validate prediction models for clinically important improvement in (1) pain and (2) hand function 12 months after surgery for thumb carpometacarpal osteoarthritis.

METHODS : Between November 2011 and June 2020, 2653 patients were surgically treated for thumb carpometacarpal osteoarthritis. Patient-reported outcome measures were used to preoperatively assess pain, hand function, and satisfaction with hand function, as well as the general mental health of patients and mindset toward their condition. Patient characteristics, medical history, patient-reported symptom severity, and patient-reported mindset were considered as possible predictors. Patients who had incomplete Michigan Hand outcomes Questionnaires at baseline or 12 months postsurgery were excluded, as these scores were used to determine clinical improvement. The Michigan Hand outcomes Questionnaire provides subscores for pain and hand function. Scores range from 0 to 100, with higher scores indicating less pain and better hand function. An improvement of at least the minimum clinically important difference (MCID) of 14.4 for the pain score and 11.7 for the function score were considered "clinically relevant." These values were derived from previous reports that provided triangulated estimates of two anchor-based and one distribution-based MCID. Data collection resulted in a dataset of 1489 patients for the pain model and 1469 patients for the hand function model. The data were split into training (60%), validation (20%), and test (20%) dataset. The training dataset was used to select the predictive variables and to train our models. The performance of all models was evaluated in the validation dataset, after which one model was selected for further evaluation. Performance of this final model was evaluated on the test dataset. We trained the models using logistic regression, random forest, and gradient boosting machines and compared their performance. We chose these algorithms because of their relative simplicity, which makes them easier to implement and interpret. Model performance was assessed using discriminative ability and qualitative visual inspection of calibration curves. Discrimination was measured using area under the curve (AUC) and is a measure of how well the model can differentiate between the outcomes (improvement or no improvement), with an AUC of 0.5 being equal to chance. Calibration is a measure of the agreement between the predicted probabilities and the observed frequencies and was assessed by visual inspection of calibration curves. We selected the model with the most promising performance for clinical implementation (that is, good model performance and a low number of predictors) for further evaluation in the test dataset.

RESULTS : For pain, the random forest model showed the most promising results based on discrimination, calibration, and number of predictors in the validation dataset. In the test dataset, this pain model had a poor AUC (0.59) and poor calibration. For function, the gradient boosting machine showed the most promising results in the validation dataset. This model had a good AUC (0.74) and good calibration in the test dataset. The baseline Michigan Hand outcomes Questionnaire hand function score was the only predictor in the model. For the hand function model, we made a web application that can be accessed via

CONCLUSION : We developed a promising model that may allow clinicians to predict the chance of functional improvement in an individual patient undergoing surgery for thumb carpometacarpal osteoarthritis, which would thereby help in the decision-making process. However, caution is warranted because our model has not been externally validated. Unfortunately, the performance of the prediction model for pain is insufficient for application in clinical practice.

LEVEL OF EVIDENCE : Level III, therapeutic study.

Loos Nina L, Hoogendam Lisa, Souer J Sebastiaan, Slijper Harm P, Andrinopoulou Eleni-Rosalina, Coppieters Michel W, Selles Ruud W


Ophthalmology Ophthalmology

Retinal age gap as a predictive biomarker for mortality risk.

In The British journal of ophthalmology

AIM : To develop a deep learning (DL) model that predicts age from fundus images (retinal age) and to investigate the association between retinal age gap (retinal age predicted by DL model minus chronological age) and mortality risk.

METHODS : A total of 80 169 fundus images taken from 46 969 participants in the UK Biobank with reasonable quality were included in this study. Of these, 19 200 fundus images from 11 052 participants without prior medical history at the baseline examination were used to train and validate the DL model for age prediction using fivefold cross-validation. A total of 35 913 of the remaining 35 917 participants had available mortality data and were used to investigate the association between retinal age gap and mortality.

RESULTS : The DL model achieved a strong correlation of 0.81 (p<0·001) between retinal age and chronological age, and an overall mean absolute error of 3.55 years. Cox regression models showed that each 1 year increase in the retinal age gap was associated with a 2% increase in risk of all-cause mortality (hazard ratio (HR)=1.02, 95% CI 1.00 to 1.03, p=0.020) and a 3% increase in risk of cause-specific mortality attributable to non-cardiovascular and non-cancer disease (HR=1.03, 95% CI 1.00 to 1.05, p=0.041) after multivariable adjustments. No significant association was identified between retinal age gap and cardiovascular- or cancer-related mortality.

CONCLUSIONS : Our findings indicate that retinal age gap might be a potential biomarker of ageing that is closely related to risk of mortality, implying the potential of retinal image as a screening tool for risk stratification and delivery of tailored interventions.

Zhu Zhuoting, Shi Danli, Guankai Peng, Tan Zachary, Shang Xianwen, Hu Wenyi, Liao Huan, Zhang Xueli, Huang Yu, Yu Honghua, Meng Wei, Wang Wei, Ge Zongyuan, Yang Xiaohong, He Mingguang



General General

External Validation of Postpartum Hemorrhage Prediction Models Using Electronic Health Record Data.

In American journal of perinatology ; h5-index 32.0

OBJECTIVE : A recent study leveraging machine learning methods found that postpartum hemorrhage (PPH) can be predicted accurately at the time of labor admission in the U.S. Consortium for Safe Labor (CSL) dataset, with a C-statistic as high as 0.93. These CSL models were developed in older data (2002-2008) and used an estimated blood loss (EBL) of ≥1000 mL to define PPH. We sought to externally validate these models using a more recent cohort of births where blood loss was measured using quantitative blood loss (QBL) methods.

STUDY DESIGN : Using data from 5,261 deliveries between February 1, 2019 to May 11, 2020 at a single tertiary hospital, we mapped our electronic health record (EHR) data to the 55 predictors described in previously published CSL models. PPH was defined as QBL ≥1000 mL within 24 hours after delivery. Model discrimination and calibration of the four CSL models were measured using our cohort. In a secondary analysis, we fit new models in our study cohort using the same predictors and algorithms as the original CSL models.

RESULTS : The original study cohort had a substantially lower rate of PPH, 4.8% (7,279/228,438) vs. 25% (1,321/5,261), possibly due to differences in measurement. The CSL models had lower discrimination in our study cohort, with a C-statistic as high as 0.57 (logistic regression). Models refit in our study cohort achieved better discrimination, with a C-statistic as high as 0.64 (random forrest). Calibration improved in the refit models as compared to the original models.

CONCLUSION : The CSL models' accuracy was lower in a contemporary EHR where PPH is assessed using QBL. As institutions continue to adopt QBL methods, further data are needed to understand the differences between EBL and QBL to enable accurate prediction of PPH.

Meyer Sean R, Carver Alissa, Joo Hyeon, Venkatesh Kartik Kailas, Jelovsek J Eric, Klumpner Thomas T, Singh Karandeep


Pathology Pathology

Evolved explainable classifications for lymph node metastases.

In Neural networks : the official journal of the International Neural Network Society

A novel evolutionary approach for Explainable Artificial Intelligence is presented: the "Evolved Explanations" model (EvEx). This methodology combines Local Interpretable Model Agnostic Explanations (LIME) with Multi-Objective Genetic Algorithms to allow for automated segmentation parameter tuning in image classification tasks. In this case, the dataset studied is Patch-Camelyon, comprised of patches from pathology whole slide images. A publicly available Convolutional Neural Network (CNN) was trained on this dataset to provide a binary classification for presence/absence of lymph node metastatic tissue. In turn, the classifications are explained by means of evolving segmentations, seeking to optimize three evaluation goals simultaneously. The final explanation is computed as the mean of all explanations generated by Pareto front individuals, evolved by the developed genetic algorithm. To enhance reproducibility and traceability of the explanations, each of them was generated from several different seeds, randomly chosen. The observed results show remarkable agreement between different seeds. Despite the stochastic nature of LIME explanations, regions of high explanation weights proved to have good agreement in the heat maps, as computed by pixel-wise relative standard deviations. The found heat maps coincide with expert medical segmentations, which demonstrates that this methodology can find high quality explanations (according to the evaluation metrics), with the novel advantage of automated parameter fine tuning. These results give additional insight into the inner workings of neural network black box decision making for medical data.

Palatnik de Sousa Iam, Vellasco Marley M B R, Costa da Silva Eduardo


Artificial intelligence, Convolutional Neural Networks, Explainable AI, Multi-objective genetic algorithms

Radiology Radiology

Detection of metallic objects on digital radiographs with convolutional neural networks: A MRI screening tool.

In Radiography (London, England : 1995)

INTRODUCTION : Screening for metallic implants and foreign bodies before magnetic resonance imaging (MRI) examinations, are crucial for patient safety. History of health are supplied by the patient, a family member, screening of electronic health records or the picture and archive systems (PACS). PACS securely store and transmits digital radiographs (DR) and related reports with patient information. Convolutional neural networks (CNN) can be used to detect metallic objects in DRs stored in PACS. This study evaluates the accuracy of CNNs in the detection of metallic objects on DRs as an MRI screening tool.

METHODS : The musculoskeletal radiographs (MURA) dataset consisting of 14.863 upper extremity studies were stratified into datasets with and without metal. For each anatomical region: Elbow, finger, hand, humerus, forearm, shoulder and wrist we trained and validated CNN algorithms to classify radiographs with and without metal. Algorithm performance was evaluated with area under the receiver-operating curve (AUC), sensitivity, specificity, predictive values and accuracies compared with a reference standard of manually labelling.

RESULTS : Sensitivities, specificities and area under the ROC-curves (AUC) for the six anatomic regions ranged from 85.33% (95% CI: 78.64%-90.57%) to 100.00% (95% CI: 98.16%-100.00%), 75.44% (95% CI: 62.24%-85.87%) to 93.57% (95% CI: 88.78%-96.75%) and 0.95 to 0.99, respectively.

CONCLUSION : CNN algorithms classify DRs with metallic objects for six different anatomic regions with near-perfect accuracy. The rapid and iterative capability of the algorithms allows for scalable expansion and as a substitute MRI screening tool for metallic objects.

IMPLICATIONS FOR PRACTICE : All CNNs would be able to assist in metal detection of digital radiographs prior to MRI, an substantially decrease screening time.

Lie S O, Lysdahlgaard S


Deep learning, Digital radiography, Magnetic resonance imaging, Metallic objects, Patient safety