Identification of head impact locations, speeds, and force based on head kinematics

Objective: Head impact information including impact directions, speeds and force are important to study traumatic brain injury, design and evaluate protective gears. This study presents a deep learning model developed to accurately predict head impact information, including location, speed, orientation, and force, based on head kinematics during helmeted impacts. Methods: Leveraging a dataset of 16,000 simulated helmeted head impacts using the Riddell helmet finite element model, we implemented a Long Short-Term Memory (LSTM) network to process the head kinematics: tri-axial linear accelerations and angular velocities. Results: The models accurately predict the impact parameters describing impact location, direction, speed, and the impact force profile with R2 exceeding 70% for all tasks. Further validation was conducted using an on-field dataset recorded by instrumented mouthguards and videos, consisting of 79 head impacts in which the impact location can be clearly identified. The deep learning model significantly outperformed existing methods, achieving a 79.7% accuracy in identifying impact locations, compared to lower accuracies with traditional methods (the highest accuracy of existing methods is 49.4%). Conclusion: The precision underscores the model's potential in enhancing helmet design and safety in sports by providing more accurate impact data. Future studies should test the models across various helmets and sports on large in vivo datasets to validate the accuracy of the models, employing techniques like transfer learning to broaden its effectiveness.

Unraveling Radiomics Complexity: Strategies for Optimal Simplicity in Predictive Modeling

Background: The high dimensionality of radiomic feature sets, the variability in radiomic feature types and potentially high computational requirements all underscore the need for an effective method to identify the smallest set of predictive features for a given clinical problem. Purpose: Develop a methodology and tools to identify and explain the smallest set of predictive radiomic features. Materials and Methods: 89,714 radiomic features were extracted from five cancer datasets: low-grade glioma, meningioma, non-small cell lung cancer (NSCLC), and two renal cell carcinoma cohorts (n=2104). Features were categorized by computational complexity into morphological, intensity, texture, linear filters, and nonlinear filters. Models were trained and evaluated on each complexity level using the area under the curve (AUC). The most informative features were identified, and their importance was explained. The optimal complexity level and associated most informative features were identified using systematic statistical significance analyses and a false discovery avoidance procedure, respectively. Their predictive importance was explained using a novel tree-based method. Results: MEDimage, a new open-source tool, was developed to facilitate radiomic studies. Morphological features were optimal for MRI-based meningioma (AUC: 0.65) and low-grade glioma (AUC: 0.68). Intensity features were optimal for CECT-based renal cell carcinoma (AUC: 0.82) and CT-based NSCLC (AUC: 0.76). Texture features were optimal for MRI-based renal cell carcinoma (AUC: 0.72). Tuning the Hounsfield unit range improved results for CECT-based renal cell carcinoma (AUC: 0.86). Conclusion: Our proposed methodology and software can estimate the optimal radiomics complexity level for specific medical outcomes, potentially simplifying the use of radiomics in predictive modeling across various contexts.

Towards a more inductive world for drug repurposing approaches

Drug-target interaction (DTI) prediction is a challenging, albeit essential task in drug repurposing. Learning on graph models have drawn special attention as they can significantly reduce drug repurposing costs and time commitment. However, many current approaches require high-demanding additional information besides DTIs that complicates their evaluation process and usability. Additionally, structural differences in the learning architecture of current models hinder their fair benchmarking. In this work, we first perform an in-depth evaluation of current DTI datasets and prediction models through a robust benchmarking process, and show that DTI prediction methods based on transductive models lack generalization and lead to inflated performance when evaluated as previously done in the literature, hence not being suited for drug repurposing approaches. We then propose a novel biologically-driven strategy for negative edge subsampling and show through in vitro validation that newly discovered interactions are indeed true. We envision this work as the underpinning for future fair benchmarking and robust model design. All generated resources and tools are publicly available as a python package.

Multimodal Machine Learning in Image-Based and Clinical Biomedicine: Survey and Prospects

Machine learning (ML) applications in medical artificial intelligence (AI) systems have shifted from traditional and statistical methods to increasing application of deep learning models. This survey navigates the current landscape of multimodal ML, focusing on its profound impact on medical image analysis and clinical decision support systems. Emphasizing challenges and innovations in addressing multimodal representation, fusion, translation, alignment, and co-learning, the paper explores the transformative potential of multimodal models for clinical predictions. It also questions practical implementation of such models, bringing attention to the dynamics between decision support systems and healthcare providers. Despite advancements, challenges such as data biases and the scarcity of "big data" in many biomedical domains persist. We conclude with a discussion on effective innovation and collaborative efforts to further the miss

Foundation Metrics: Quantifying Effectiveness of Healthcare Conversations powered by Generative AI

Generative Artificial Intelligence is set to revolutionize healthcare delivery by transforming traditional patient care into a more personalized, efficient, and proactive process. Chatbots, serving as interactive conversational models, will probably drive this patient-centered transformation in healthcare. Through the provision of various services, including diagnosis, personalized lifestyle recommendations, and mental health support, the objective is to substantially augment patient health outcomes, all the while mitigating the workload burden on healthcare providers. The life-critical nature of healthcare applications necessitates establishing a unified and comprehensive set of evaluation metrics for conversational models. Existing evaluation metrics proposed for various generic large language models (LLMs) demonstrate a lack of comprehension regarding medical and health concepts and their significance in promoting patients' well-being. Moreover, these metrics neglect pivotal user-centered aspects, including trust-building, ethics, personalization, empathy, user comprehension, and emotional support. The purpose of this paper is to explore state-of-the-art LLM-based evaluation metrics that are specifically applicable to the assessment of interactive conversational models in healthcare. Subsequently, we present an comprehensive set of evaluation metrics designed to thoroughly assess the performance of healthcare chatbots from an end-user perspective. These metrics encompass an evaluation of language processing abilities, impact on real-world clinical tasks, and effectiveness in user-interactive conversations. Finally, we engage in a discussion concerning the challenges associated with defining and implementing these metrics, with particular emphasis on confounding factors such as the target audience, evaluation methods, and prompt techniques involved in the evaluation process.

Reliability-based cleaning of noisy training labels with inductive conformal prediction in multi-modal biomedical data mining

Accurately labeling biomedical data presents a challenge. Traditional semi-supervised learning methods often under-utilize available unlabeled data. To address this, we propose a novel reliability-based training data cleaning method employing inductive conformal prediction (ICP). This method capitalizes on a small set of accurately labeled training data and leverages ICP-calculated reliability metrics to rectify mislabeled data and outliers within vast quantities of noisy training data. The efficacy of the method is validated across three classification tasks within distinct modalities: filtering drug-induced-liver-injury (DILI) literature with title and abstract, predicting ICU admission of COVID-19 patients through CT radiomics and electronic health records, and subtyping breast cancer using RNA-sequencing data. Varying levels of noise to the training labels were introduced through label permutation. Results show significant enhancements in classification performance: accuracy enhancement in 86 out of 96 DILI experiments (up to 11.4%), AUROC and AUPRC enhancements in all 48 COVID-19 experiments (up to 23.8% and 69.8%), and accuracy and macro-average F1 score improvements in 47 out of 48 RNA-sequencing experiments (up to 74.6% and 89.0%). Our method offers the potential to substantially boost classification performance in multi-modal biomedical machine learning tasks. Importantly, it accomplishes this without necessitating an excessive volume of meticulously curated training data.

Toward more accurate and generalizable brain deformation estimators for traumatic brain injury detection with unsupervised domain adaptation

Machine learning head models (MLHMs) are developed to estimate brain deformation for early detection of traumatic brain injury (TBI). However, the overfitting to simulated impacts and the lack of generalizability caused by distributional shift of different head impact datasets hinders the broad clinical applications of current MLHMs. We propose brain deformation estimators that integrates unsupervised domain adaptation with a deep neural network to predict whole-brain maximum principal strain (MPS) and MPS rate (MPSR). With 12,780 simulated head impacts, we performed unsupervised domain adaptation on on-field head impacts from 302 college football (CF) impacts and 457 mixed martial arts (MMA) impacts using domain regularized component analysis (DRCA) and cycle-GAN-based methods. The new model improved the MPS/MPSR estimation accuracy, with the DRCA method significantly outperforming other domain adaptation methods in prediction accuracy (p<0.001): MPS RMSE: 0.027 (CF) and 0.037 (MMA); MPSR RMSE: 7.159 (CF) and 13.022 (MMA). On another two hold-out test sets with 195 college football impacts and 260 boxing impacts, the DRCA model significantly outperformed the baseline model without domain adaptation in MPS and MPSR estimation accuracy (p<0.001). The DRCA domain adaptation reduces the MPS/MPSR estimation error to be well below TBI thresholds, enabling accurate brain deformation estimation to detect TBI in future clinical applications.

Denoising instrumented mouthguard measurements of head impact kinematics with a convolutional neural network

Wearable sensors for measuring head kinematics can be noisy due to imperfect interfaces with the body. Mouthguards are used to measure head kinematics during impacts in traumatic brain injury (TBI) studies, but deviations from reference kinematics can still occur due to potential looseness. In this study, deep learning is used to compensate for the imperfect interface and improve measurement accuracy. A set of one-dimensional convolutional neural network (1D-CNN) models was developed to denoise mouthguard kinematics measurements along three spatial axes of linear acceleration and angular velocity. The denoised kinematics had significantly reduced errors compared to reference kinematics, and reduced errors in brain injury criteria and tissue strain and strain rate calculated via finite element modeling. The 1D-CNN models were also tested on an on-field dataset of college football impacts and a post-mortem human subject dataset, with similar denoising effects observed. The models can be used to improve detection of head impacts and TBI risk evaluation, and potentially extended to other sensors measuring kinematics.

Disparities in Dermatology AI Performance on a Diverse, Curated Clinical Image Set

Access to dermatological care is a major issue, with an estimated 3 billion people lacking access to care globally. Artificial intelligence (AI) may aid in triaging skin diseases. However, most AI models have not been rigorously assessed on images of diverse skin tones or uncommon diseases. To ascertain potential biases in algorithm performance in this context, we curated the Diverse Dermatology Images (DDI) dataset-the first publicly available, expertly curated, and pathologically confirmed image dataset with diverse skin tones. Using this dataset of 656 images, we show that state-of-the-art dermatology AI models perform substantially worse on DDI, with receiver operator curve area under the curve (ROC-AUC) dropping by 27-36 percent compared to the models' original test results. All the models performed worse on dark skin tones and uncommon diseases, which are represented in the DDI dataset. Additionally, we find that dermatologists, who typically provide visual labels for AI training and test datasets, also perform worse on images of dark skin tones and uncommon diseases compared to ground truth biopsy annotations. Finally, fine-tuning AI models on the well-characterized and diverse DDI images closed the performance gap between light and dark skin tones. Moreover, algorithms fine-tuned on diverse skin tones outperformed dermatologists on identifying malignancy on images of dark skin tones. Our findings identify important weaknesses and biases in dermatology AI that need to be addressed to ensure reliable application to diverse patients and diseases.

Filter Drug-induced Liver Injury Literature with Natural Language Processing and Ensemble Learning

Drug-induced liver injury (DILI) describes the adverse effects of drugs that damage liver. Life-threatening results including liver failure or death were also reported in severe DILI cases. Therefore, DILI-related events are strictly monitored for all approved drugs and the liver toxicity became important assessments for new drug candidates. These DILI-related reports are documented in hospital records, in clinical trial results, and also in research papers that contain preliminary in vitro and in vivo experiments. Conventionally, data extraction from previous publications relies heavily on resource-demanding manual labelling, which considerably decreased the efficiency of the information extraction process. The recent development of artificial intelligence, particularly, the rise of natural language processing (NLP) techniques, enabled the automatic processing of biomedical texts. In this study, based on around 28,000 papers (titles and abstracts) provided by the Critical Assessment of Massive Data Analysis (CAMDA) challenge, we benchmarked model performances on filtering out DILI literature. Among four word vectorization techniques, the model using term frequency-inverse document frequency (TF-IDF) and logistic regression outperformed others with an accuracy of 0.957 with our in-house test set. Furthermore, an ensemble model with similar overall performances was implemented and was fine-tuned to lower the false-negative cases to avoid neglecting potential DILI reports. The ensemble model achieved a high accuracy of 0.954 and an F1 score of 0.955 in the hold-out validation data provided by the CAMDA committee. Moreover, important words in positive/negative predictions were identified via model interpretation. Overall, the ensemble model reached satisfactory classification results, which can be further used by researchers to rapidly filter DILI-related literature.