Exploring the Versatility of Zero-Shot CLIP for Interstitial Lung Disease Classification

Interstitial lung diseases (ILD) present diagnostic challenges due to their varied manifestations and overlapping imaging features. To address this, we propose a machine learning approach that utilizes CLIP, a multimodal (image and text) self-supervised model, for ILD classification. We extensively integrate zero-shot CLIP throughout our workflow, starting from the initial extraction of image patches from volumetric CT scans and proceeding to ILD classification using "patch montages". Furthermore, we investigate how domain adaptive pretraining (DAPT) CLIP with task-specific images (CT "patch montages" extracted with ILD-specific prompts for CLIP) and/or text (lung-specific sections of radiology reports) affects downstream ILD classification performance. By leveraging CLIP-extracted "patch montages" and DAPT, we achieve strong zero-shot ILD classification results, including an AUROC of 0.893, without the need for any labeled training data. This work highlights the versatility and potential of multimodal models like CLIP for medical image classification tasks where labeled data is scarce.

Predicting Treatment Adherence of Tuberculosis Patients at Scale

Tuberculosis (TB), an infectious bacterial disease, is a significant cause of death, especially in low-income countries, with an estimated ten million new cases reported globally in $2020$. While TB is treatable, non-adherence to the medication regimen is a significant cause of morbidity and mortality. Thus, proactively identifying patients at risk of dropping off their medication regimen enables corrective measures to mitigate adverse outcomes. Using a proxy measure of extreme non-adherence and a dataset of nearly $700,000$ patients from four states in India, we formulate and solve the machine learning (ML) problem of early prediction of non-adherence based on a custom rank-based metric. We train ML models and evaluate against baselines, achieving a $\sim 100\%$ lift over rule-based baselines and $\sim 214\%$ over a random classifier, taking into account country-wide large-scale future deployment. We deal with various issues in the process, including data quality, high-cardinality categorical data, low target prevalence, distribution shift, variation across cohorts, algorithmic fairness, and the need for robustness and explainability. Our findings indicate that risk stratification of non-adherent patients is a viable, deployable-at-scale ML solution. As the official AI partner of India's Central TB Division, we are working on multiple city and state-level pilots with the goal of pan-India deployment.