A Survey of Few-Shot Learning for Biomedical Time Series

Advancements in wearable sensor technologies and the digitization of medical records have contributed to the unprecedented ubiquity of biomedical time series data. Data-driven models have tremendous potential to assist clinical diagnosis and improve patient care by improving long-term monitoring capabilities, facilitating early disease detection and intervention, as well as promoting personalized healthcare delivery. However, accessing extensively labeled datasets to train data-hungry deep learning models encounters many barriers, such as long-tail distribution of rare diseases, cost of annotation, privacy and security concerns, data-sharing regulations, and ethical considerations. An emerging approach to overcome the scarcity of labeled data is to augment AI methods with human-like capabilities to leverage past experiences to learn new tasks with limited examples, called few-shot learning. This survey provides a comprehensive review and comparison of few-shot learning methods for biomedical time series applications. The clinical benefits and limitations of such methods are discussed in relation to traditional data-driven approaches. This paper aims to provide insights into the current landscape of few-shot learning for biomedical time series and its implications for future research and applications.

MorpheusNet: Resource efficient sleep stage classifier for embedded on-line systems

Sleep Stage Classification (SSC) is a labor-intensive task, requiring experts to examine hours of electrophysiological recordings for manual classification. This is a limiting factor when it comes to leveraging sleep stages for therapeutic purposes. With increasing affordability and expansion of wearable devices, automating SSC may enable deployment of sleep-based therapies at scale. Deep Learning has gained increasing attention as a potential method to automate this process. Previous research has shown accuracy comparable to manual expert scores. However, previous approaches require sizable amount of memory and computational resources. This constrains the ability to classify in real time and deploy models on the edge. To address this gap, we aim to provide a model capable of predicting sleep stages in real-time, without requiring access to external computational sources (e.g., mobile phone, cloud). The algorithm is power efficient to enable use on embedded battery powered systems. Our compact sleep stage classifier can be deployed on most off-the-shelf microcontrollers (MCU) with constrained hardware settings. This is due to the memory footprint of our approach requiring significantly fewer operations. The model was tested on three publicly available data bases and achieved performance comparable to the state of the art, whilst reducing model complexity by orders of magnitude (up to 280 times smaller compared to state of the art). We further optimized the model with quantization of parameters to 8 bits with only an average drop of 0.95% in accuracy. When implemented in firmware, the quantized model achieves a latency of 1.6 seconds on an Arm CortexM4 processor, allowing its use for on-line SSC-based therapies.

Computationally efficient neural network classifiers for next generation closed loop neuromodulation therapy, a case study in epilepsy

This work explores the potential utility of neural network classifiers for real-time classification of field-potential based biomarkers in next-generation responsive neuromodulation systems. Compared to classical filter-based classifiers, neural networks offer an ease of patient-specific parameter tuning, promising to reduce the burden of programming on clinicians. The paper explores a compact, feed-forward neural network architecture of only dozens of units for seizure-state classification in refractory epilepsy. The proposed classifier offers comparable accuracy to filter classifiers on clinician-labelled data, while reducing detection latency. As a trade-off to classical methods, the paper focuses on keeping the complexity of the architecture minimal, to accommodate the on-board computational constraints of implantable pulse generator systems.

Embedding digital chronotherapy into medical devices -- A canine case study in controlling status epilepticus through multi-scale rhythmic brain stimulation

Circadian and other physiological rhythms play a key role in both normal homeostasis and disease processes. Such is the case of circadian and infradian seizure patterns observed in epilepsy. However, these rhythms are not fully exploited in the design of active implantable medical devices. In this paper we explore a new implantable stimulator that implements chronotherapy as a feedforward input to supplement both open-loop and closed-loop methods. This integrated algorithm allows for stimulation to be adjusted to the ultradian, circadian, and infradian patterns observed in patients through slowly-varying temporal adjustments of stimulation and algorithm sub-components, while also enabling adaption of stimulation based on immediate physiological needs such as a breakthrough seizure or change of posture. Embedded physiological sensors in the stimulator can be used to refine the baseline stimulation circadian pattern as a "digital zeitgeber". This algorithmic approach is tested on a canine with severe drug-resistant idiopathic generalized epilepsy exhibiting a characteristic diurnal pattern correlated with sleep-wake cycles. Prior to implantation, the canine's cluster seizures evolved to status epilepticus (SE) and required emergency pharmacological intervention. The cranially-mounted system was fully-implanted bilaterally into the centromedian nucleus of the thalamus. Using combinations of time-based modulation, thalamocortical rhythm-specific tuning of frequency parameters, and fast-adaptive modes based on activity, the canine has experienced no further SE events post-implant at the time of writing (7 months), and no significant clusters are observed any longer. The use of digitally-enabled chronotherapy as a feedforward signal to augment adaptive neurostimulators could prove a useful algorithmic method where sensitivity to temporal patterns are characteristics of the disease state.