Taming the Tail: Leveraging Asymmetric Loss and Pade Approximation to Overcome Medical Image Long-Tailed Class Imbalance

Long-tailed problems in healthcare emerge from data imbalance due to variability in the prevalence and representation of different medical conditions, warranting the requirement of precise and dependable classification methods. Traditional loss functions such as cross-entropy and binary cross-entropy are often inadequate due to their inability to address the imbalances between the classes with high representation and the classes with low representation found in medical image datasets. We introduce a novel polynomial loss function based on Pade approximation, designed specifically to overcome the challenges associated with long-tailed classification. This approach incorporates asymmetric sampling techniques to better classify under-represented classes. We conducted extensive evaluations on three publicly available medical datasets and a proprietary medical dataset. Our implementation of the proposed loss function is open-sourced in the public repository:https://github.com/ipankhi/ALPA.

MedSAGa: Few-shot Memory Efficient Medical Image Segmentation using Gradient Low-Rank Projection in SAM

The application of large-scale models in medical image segmentation demands substantial quantities of meticulously annotated data curated by experts along with high computational resources, both of which are challenges in resource-poor settings. In this study, we present the Medical Segment Anything Model with Galore MedSAGa where we adopt the Segment Anything Model (SAM) to achieve memory-efficient, few-shot medical image segmentation by applying Gradient Low-Rank Projection GaLore to the parameters of the image encoder of SAM. Meanwhile, the weights of the prompt encoder and mask decoder undergo full parameter fine-tuning using standard optimizers. We further assess MedSAGa's few-shot learning capabilities, reporting on its memory efficiency and segmentation performance across multiple standard medical image segmentation datasets. We compare it with several baseline models, including LoRA fine-tuned SAM (SAMed) and DAE-Former. Experiments across multiple datasets and these baseline models with different number of images for fine tuning demonstrated that the GPU memory consumption of MedSAGa is significantly less than that of the baseline models, achieving an average memory efficiency of 66% more than current state-of-the-art (SOTA) models for medical image segmentation. The combination of substantially lower memory requirements and comparable to SOTA results in few-shot learning for medical image segmentation positions MedSAGa as an optimal solution for deployment in resource-constrained settings.

Few shot chain-of-thought driven reasoning to prompt LLMs for open ended medical question answering

Large Language models (LLMs) have demonstrated significant potential in transforming healthcare by automating tasks such as clinical documentation, information retrieval, and decision support. In this aspect, carefully engineered prompts have emerged as a powerful tool for using LLMs for medical scenarios, e.g., patient clinical scenarios. In this paper, we propose a modified version of the MedQA-USMLE dataset, which is subjective, to mimic real-life clinical scenarios. We explore the Chain of Thought (CoT) reasoning based on subjective response generation for the modified MedQA-USMLE dataset with appropriate LM-driven forward reasoning for correct responses to the medical questions. Keeping in mind the importance of response verification in the medical setting, we utilize a reward training mechanism whereby the language model also provides an appropriate verified response for a particular response to a clinical question. In this regard, we also include human-in-the-loop for different evaluation aspects. We develop better in-contrast learning strategies by modifying the 5-shot-codex-CoT-prompt from arXiv:2207.08143 for the subjective MedQA dataset and developing our incremental-reasoning prompt. Our evaluations show that the incremental reasoning prompt performs better than the modified codex prompt in certain scenarios. We also show that greedy decoding with the incremental reasoning method performs better than other strategies, such as prompt chaining and eliminative reasoning.

FESS Loss: Feature-Enhanced Spatial Segmentation Loss for Optimizing Medical Image Analysis

Medical image segmentation is a critical process in the field of medical imaging, playing a pivotal role in diagnosis, treatment, and research. It involves partitioning of an image into multiple regions, representing distinct anatomical or pathological structures. Conventional methods often grapple with the challenge of balancing spatial precision and comprehensive feature representation due to their reliance on traditional loss functions. To overcome this, we propose Feature-Enhanced Spatial Segmentation Loss (FESS Loss), that integrates the benefits of contrastive learning (which extracts intricate features, particularly in the nuanced domain of medical imaging) with the spatial accuracy inherent in the Dice loss. The objective is to augment both spatial precision and feature-based representation in the segmentation of medical images. FESS Loss signifies a notable advancement, offering a more accurate and refined segmentation process, ultimately contributing to heightened precision in the analysis of medical images. Further, FESS loss demonstrates superior performance in limited annotated data availability scenarios often present in the medical domain.