Interpretable Machine Learning Models for the Digital Clock Drawing Test

The Clock Drawing Test (CDT) is a rapid, inexpensive, and popular neuropsychological screening tool for cognitive conditions. The Digital Clock Drawing Test (dCDT) uses novel software to analyze data from a digitizing ballpoint pen that reports its position with considerable spatial and temporal precision, making possible the analysis of both the drawing process and final product. We developed methodology to analyze pen stroke data from these drawings, and computed a large collection of features which were then analyzed with a variety of machine learning techniques. The resulting scoring systems were designed to be more accurate than the systems currently used by clinicians, but just as interpretable and easy to use. The systems also allow us to quantify the tradeoff between accuracy and interpretability. We created automated versions of the CDT scoring systems currently used by clinicians, allowing us to benchmark our models, which indicated that our machine learning models substantially outperformed the existing scoring systems.

Balancing Appearance and Context in Sketch Interpretation

We describe a sketch interpretation system that detects and classifies clock numerals created by subjects taking the Clock Drawing Test, a clinical tool widely used to screen for cognitive impairments (e.g., dementia). We describe how it balances appearance and context, and document its performance on some 2,000 drawings (about 24K clock numerals) produced by a wide spectrum of patients. We calibrate the utility of different forms of context, describing experiments with Conditional Random Fields trained and tested using a variety of features. We identify context that contributes to interpreting otherwise ambiguous or incomprehensible strokes. We describe ST-slices, a novel representation that enables "unpeeling" the layers of ink that result when people overwrite, which often produces ink impossible to analyze if only the final drawing is examined. We characterize when ST-slices work, calibrate their impact on performance, and consider their breadth of applicability.