Abstract:Early detection of neurocognitive disorders (NCDs) is crucial for timely intervention and disease management. Speech analysis offers a non-intrusive and scalable screening method, particularly through narrative tasks in neuropsychological assessment tools. Traditional narrative analysis often focuses on local indicators in microstructure, such as word usage and syntax. While these features provide insights into language production abilities, they often fail to capture global narrative patterns, or microstructures. Macrostructures include coherence, thematic organization, and logical progressions, reflecting essential cognitive skills potentially critical for recognizing NCDs. Addressing this gap, we propose to investigate specific cognitive and linguistic challenges by analyzing topical shifts, temporal dynamics, and the coherence of narratives over time, aiming to reveal cognitive deficits by identifying narrative impairments, and exploring their impact on communication and cognition. The investigation is based on the CU-MARVEL Rabbit Story corpus, which comprises recordings of a story-telling task from 758 older adults. We developed two approaches: the Dynamic Topic Models (DTM)-based temporal analysis to examine the evolution of topics over time, and the Text-Image Temporal Alignment Network (TITAN) to evaluate the coherence between spoken narratives and visual stimuli. DTM-based approach validated the effectiveness of dynamic topic consistency as a macrostructural metric (F1=0.61, AUC=0.78). The TITAN approach achieved the highest performance (F1=0.72, AUC=0.81), surpassing established microstructural and macrostructural feature sets. Cross-comparison and regression tasks further demonstrated the effectiveness of proposed dynamic macrostructural modeling approaches for NCD detection.
Abstract:Alzheimer's Disease (AD) and related dementia are a growing global health challenge due to the aging population. In this paper, we present ADMarker, the first end-to-end system that integrates multi-modal sensors and new federated learning algorithms for detecting multidimensional AD digital biomarkers in natural living environments. ADMarker features a novel three-stage multi-modal federated learning architecture that can accurately detect digital biomarkers in a privacy-preserving manner. Our approach collectively addresses several major real-world challenges, such as limited data labels, data heterogeneity, and limited computing resources. We built a compact multi-modality hardware system and deployed it in a four-week clinical trial involving 91 elderly participants. The results indicate that ADMarker can accurately detect a comprehensive set of digital biomarkers with up to 93.8% accuracy and identify early AD with an average of 88.9% accuracy. ADMarker offers a new platform that can allow AD clinicians to characterize and track the complex correlation between multidimensional interpretable digital biomarkers, demographic factors of patients, and AD diagnosis in a longitudinal manner.
Abstract:Many patients with chronic diseases resort to multiple medications to relieve various symptoms, which raises concerns about the safety of multiple medication use, as severe drug-drug antagonism can lead to serious adverse effects or even death. This paper presents a Decision Support System, called DSSDDI, based on drug-drug interactions to support doctors prescribing decisions. DSSDDI contains three modules, Drug-Drug Interaction (DDI) module, Medical Decision (MD) module and Medical Support (MS) module. The DDI module learns safer and more effective drug representations from the drug-drug interactions. To capture the potential causal relationship between DDI and medication use, the MD module considers the representations of patients and drugs as context, DDI and patients' similarity as treatment, and medication use as outcome to construct counterfactual links for the representation learning. Furthermore, the MS module provides drug candidates to doctors with explanations. Experiments on the chronic data collected from the Hong Kong Chronic Disease Study Project and a public diagnostic data MIMIC-III demonstrate that DSSDDI can be a reliable reference for doctors in terms of safety and efficiency of clinical diagnosis, with significant improvements compared to baseline methods.