Pulmonologists-Level lung cancer detection based on standard blood test results and smoking status using an explainable machine learning approach

Lung cancer (LC) remains the primary cause of cancer-related mortality, largely due to late-stage diagnoses. Effective strategies for early detection are therefore of paramount importance. In recent years, machine learning (ML) has demonstrated considerable potential in healthcare by facilitating the detection of various diseases. In this retrospective development and validation study, we developed an ML model based on dynamic ensemble selection (DES) for LC detection. The model leverages standard blood sample analysis and smoking history data from a large population at risk in Denmark. The study includes all patients examined on suspicion of LC in the Region of Southern Denmark from 2009 to 2018. We validated and compared the predictions by the DES model with diagnoses provided by five pulmonologists. Among the 38,944 patients, 9,940 had complete data of which 2,505 (25\%) had LC. The DES model achieved an area under the roc curve of 0.77$\pm$0.01, sensitivity of 76.2\%$\pm$2.4\%, specificity of 63.8\%$\pm$2.3\%, positive predictive value of 41.6\%$\pm$1.2\%, and F\textsubscript{1}-score of 53.8\%$\pm$1.1\%. The DES model outperformed all five pulmonologists, achieving a sensitivity 9\% higher than their average. The model identified smoking status, age, total calcium levels, neutrophil count, and lactate dehydrogenase as the most important factors for the detection of LC. The results highlight the successful application of the ML approach in detecting LC, surpassing pulmonologists' performance. Incorporating clinical and laboratory data in future risk assessment models can improve decision-making and facilitate timely referrals.

DENS-ECG: A Deep Learning Approach for ECG Signal Delineation

Objectives: With the technological advancements in the field of tele-health monitoring, it is now possible to gather huge amounts of electro-physiological signals such as electrocardiogram (ECG). It is therefore necessary to develop models/algorithms that are capable of analysing these massive amounts of data in real-time. This paper proposes a deep learning model for real-time segmentation of heartbeats. Methods: The proposed algorithm, named as the DENS-ECG algorithm, combines convolutional neural network (CNN) and long short-term memory (LSTM) model to detect onset, peak, and offset of different heartbeat waveforms such as the P-wave, QRS complex, T-wave, and No wave (NW). Using ECG as the inputs, the model learns to extract high level features through the training process, which, unlike other classical machine learning based methods, eliminates the feature engineering step. Results: The proposed DENS-ECG model was trained and validated on a dataset with 105 ECGs of length 15 minutes each and achieved an average sensitivity and precision of 97.95% and 95.68%, respectively, using a 5-fold cross validation. Additionally, the model was evaluated on an unseen dataset to examine its robustness in QRS detection, which resulted in a sensitivity of 99.61% and precision of 99.52%. Conclusion: The empirical results show the flexibility and accuracy of the combined CNN-LSTM model for ECG signal delineation. Significance: This paper proposes an efficient and easy to use approach using deep learning for heartbeat segmentation, which could potentially be used in real-time tele-health monitoring systems.