Optimizing Cox Models with Stochastic Gradient Descent: Theoretical Foundations and Practical Guidances

Optimizing Cox regression and its neural network variants poses substantial computational challenges in large-scale studies. Stochastic gradient descent (SGD), known for its scalability in model optimization, has recently been adapted to optimize Cox models. Unlike its conventional application, which typically targets a sum of independent individual loss, SGD for Cox models updates parameters based on the partial likelihood of a subset of data. Despite its empirical success, the theoretical foundation for optimizing Cox partial likelihood with SGD is largely underexplored. In this work, we demonstrate that the SGD estimator targets an objective function that is batch-size-dependent. We establish that the SGD estimator for the Cox neural network (Cox-NN) is consistent and achieves the optimal minimax convergence rate up to a polylogarithmic factor. For Cox regression, we further prove the $\sqrt{n}$-consistency and asymptotic normality of the SGD estimator, with variance depending on the batch size. Furthermore, we quantify the impact of batch size on Cox-NN training and its effect on the SGD estimator's asymptotic efficiency in Cox regression. These findings are validated by extensive numerical experiments and provide guidance for selecting batch sizes in SGD applications. Finally, we demonstrate the effectiveness of SGD in a real-world application where GD is unfeasible due to the large scale of data.

SDoH-GPT: Using Large Language Models to Extract Social Determinants of Health (SDoH)

Extracting social determinants of health (SDoH) from unstructured medical notes depends heavily on labor-intensive annotations, which are typically task-specific, hampering reusability and limiting sharing. In this study we introduced SDoH-GPT, a simple and effective few-shot Large Language Model (LLM) method leveraging contrastive examples and concise instructions to extract SDoH without relying on extensive medical annotations or costly human intervention. It achieved tenfold and twentyfold reductions in time and cost respectively, and superior consistency with human annotators measured by Cohen's kappa of up to 0.92. The innovative combination of SDoH-GPT and XGBoost leverages the strengths of both, ensuring high accuracy and computational efficiency while consistently maintaining 0.90+ AUROC scores. Testing across three distinct datasets has confirmed its robustness and accuracy. This study highlights the potential of leveraging LLMs to revolutionize medical note classification, demonstrating their capability to achieve highly accurate classifications with significantly reduced time and cost.

All Against Some: Efficient Integration of Large Language Models for Message Passing in Graph Neural Networks

Graph Neural Networks (GNNs) have attracted immense attention in the past decade due to their numerous real-world applications built around graph-structured data. On the other hand, Large Language Models (LLMs) with extensive pretrained knowledge and powerful semantic comprehension abilities have recently shown a remarkable ability to benefit applications using vision and text data. In this paper, we investigate how LLMs can be leveraged in a computationally efficient fashion to benefit rich graph-structured data, a modality relatively unexplored in LLM literature. Prior works in this area exploit LLMs to augment every node features in an ad-hoc fashion (not scalable for large graphs), use natural language to describe the complex structural information of graphs, or perform computationally expensive finetuning of LLMs in conjunction with GNNs. We propose E-LLaGNN (Efficient LLMs augmented GNNs), a framework with an on-demand LLM service that enriches message passing procedure of graph learning by enhancing a limited fraction of nodes from the graph. More specifically, E-LLaGNN relies on sampling high-quality neighborhoods using LLMs, followed by on-demand neighborhood feature enhancement using diverse prompts from our prompt catalog, and finally information aggregation using message passing from conventional GNN architectures. We explore several heuristics-based active node selection strategies to limit the computational and memory footprint of LLMs when handling millions of nodes. Through extensive experiments & ablation on popular graph benchmarks of varying scales (Cora, PubMed, ArXiv, & Products), we illustrate the effectiveness of our E-LLaGNN framework and reveal many interesting capabilities such as improved gradient flow in deep GNNs, LLM-free inference ability etc.

DALK: Dynamic Co-Augmentation of LLMs and KG to answer Alzheimer's Disease Questions with Scientific Literature

Recent advancements in large language models (LLMs) have achieved promising performances across various applications. Nonetheless, the ongoing challenge of integrating long-tail knowledge continues to impede the seamless adoption of LLMs in specialized domains. In this work, we introduce DALK, a.k.a. Dynamic Co-Augmentation of LLMs and KG, to address this limitation and demonstrate its ability on studying Alzheimer's Disease (AD), a specialized sub-field in biomedicine and a global health priority. With a synergized framework of LLM and KG mutually enhancing each other, we first leverage LLM to construct an evolving AD-specific knowledge graph (KG) sourced from AD-related scientific literature, and then we utilize a coarse-to-fine sampling method with a novel self-aware knowledge retrieval approach to select appropriate knowledge from the KG to augment LLM inference capabilities. The experimental results, conducted on our constructed AD question answering (ADQA) benchmark, underscore the efficacy of DALK. Additionally, we perform a series of detailed analyses that can offer valuable insights and guidelines for the emerging topic of mutually enhancing KG and LLM. We will release the code and data at https://github.com/David-Li0406/DALK.

Uncovering Misattributed Suicide Causes through Annotation Inconsistency Detection in Death Investigation Notes

Data accuracy is essential for scientific research and policy development. The National Violent Death Reporting System (NVDRS) data is widely used for discovering the patterns and causes of death. Recent studies suggested the annotation inconsistencies within the NVDRS and the potential impact on erroneous suicide-cause attributions. We present an empirical Natural Language Processing (NLP) approach to detect annotation inconsistencies and adopt a cross-validation-like paradigm to identify problematic instances. We analyzed 267,804 suicide death incidents between 2003 and 2020 from the NVDRS. Our results showed that incorporating the target state's data into training the suicide-crisis classifier brought an increase of 5.4% to the F-1 score on the target state's test set and a decrease of 1.1% on other states' test set. To conclude, we demonstrated the annotation inconsistencies in NVDRS's death investigation notes, identified problematic instances, evaluated the effectiveness of correcting problematic instances, and eventually proposed an NLP improvement solution.

Thought Graph: Generating Thought Process for Biological Reasoning

We present the Thought Graph as a novel framework to support complex reasoning and use gene set analysis as an example to uncover semantic relationships between biological processes. Our framework stands out for its ability to provide a deeper understanding of gene sets, significantly surpassing GSEA by 40.28% and LLM baselines by 5.38% based on cosine similarity to human annotations. Our analysis further provides insights into future directions of biological processes naming, and implications for bioinformatics and precision medicine.

Improving Fairness of Automated Chest X-ray Diagnosis by Contrastive Learning

Purpose: Limited studies exploring concrete methods or approaches to tackle and enhance model fairness in the radiology domain. Our proposed AI model utilizes supervised contrastive learning to minimize bias in CXR diagnosis. Materials and Methods: In this retrospective study, we evaluated our proposed method on two datasets: the Medical Imaging and Data Resource Center (MIDRC) dataset with 77,887 CXR images from 27,796 patients collected as of April 20, 2023 for COVID-19 diagnosis, and the NIH Chest X-ray (NIH-CXR) dataset with 112,120 CXR images from 30,805 patients collected between 1992 and 2015. In the NIH-CXR dataset, thoracic abnormalities include atelectasis, cardiomegaly, effusion, infiltration, mass, nodule, pneumonia, pneumothorax, consolidation, edema, emphysema, fibrosis, pleural thickening, or hernia. Our proposed method utilizes supervised contrastive learning with carefully selected positive and negative samples to generate fair image embeddings, which are fine-tuned for subsequent tasks to reduce bias in chest X-ray (CXR) diagnosis. We evaluated the methods using the marginal AUC difference ($\delta$ mAUC). Results: The proposed model showed a significant decrease in bias across all subgroups when compared to the baseline models, as evidenced by a paired T-test (p<0.0001). The $\delta$ mAUC obtained by our method were 0.0116 (95\% CI, 0.0110-0.0123), 0.2102 (95% CI, 0.2087-0.2118), and 0.1000 (95\% CI, 0.0988-0.1011) for sex, race, and age on MIDRC, and 0.0090 (95\% CI, 0.0082-0.0097) for sex and 0.0512 (95% CI, 0.0512-0.0532) for age on NIH-CXR, respectively. Conclusion: Employing supervised contrastive learning can mitigate bias in CXR diagnosis, addressing concerns of fairness and reliability in deep learning-based diagnostic methods.

How Does Pruning Impact Long-Tailed Multi-Label Medical Image Classifiers?

Pruning has emerged as a powerful technique for compressing deep neural networks, reducing memory usage and inference time without significantly affecting overall performance. However, the nuanced ways in which pruning impacts model behavior are not well understood, particularly for long-tailed, multi-label datasets commonly found in clinical settings. This knowledge gap could have dangerous implications when deploying a pruned model for diagnosis, where unexpected model behavior could impact patient well-being. To fill this gap, we perform the first analysis of pruning's effect on neural networks trained to diagnose thorax diseases from chest X-rays (CXRs). On two large CXR datasets, we examine which diseases are most affected by pruning and characterize class "forgettability" based on disease frequency and co-occurrence behavior. Further, we identify individual CXRs where uncompressed and heavily pruned models disagree, known as pruning-identified exemplars (PIEs), and conduct a human reader study to evaluate their unifying qualities. We find that radiologists perceive PIEs as having more label noise, lower image quality, and higher diagnosis difficulty. This work represents a first step toward understanding the impact of pruning on model behavior in deep long-tailed, multi-label medical image classification. All code, model weights, and data access instructions can be found at https://github.com/VITA-Group/PruneCXR.

Dynamic Prediction using Time-Dependent Cox Survival Neural Network

The target of dynamic prediction is to provide individualized risk predictions over time which can be updated as new data become available. Motivated by establishing a dynamic prediction model for the progressive eye disease, age-related macular degeneration (AMD), we proposed a time-dependent Cox model-based survival neural network (tdCoxSNN) to predict its progression on a continuous time scale using longitudinal fundus images. tdCoxSNN extends the time-dependent Cox model by utilizing a neural network to model the non-linear effect of the time-dependent covariates on the survival outcome. Additionally, by incorporating the convolutional neural network (CNN), tdCoxSNN can take the longitudinal raw images as input. We evaluate and compare our proposed method with joint modeling and landmarking approaches through comprehensive simulations using two time-dependent accuracy metrics, the Brier Score and dynamic AUC. We applied the proposed approach to two real datasets. One is a large AMD study, the Age-Related Eye Disease Study (AREDS), in which more than 50,000 fundus images were captured over a period of 12 years for more than 4,000 participants. Another is a public dataset of the primary biliary cirrhosis (PBC) disease, in which multiple lab tests were longitudinally collected to predict the time-to-liver transplant. Our approach achieves satisfactory prediction performance in both simulation studies and the two real data analyses. tdCoxSNN was implemented in PyTorch, Tensorflow, and R-Tensorflow.

Has China caught up to the US in AI research? An exploration of mimetic isomorphism as a model for late industrializers

Artificial Intelligence (AI), a cornerstone of 21st-century technology, has seen remarkable growth in China. In this paper, we examine China's AI development process, demonstrating that it is characterized by rapid learning and differentiation, surpassing the export-oriented growth propelled by Foreign Direct Investment seen in earlier Asian industrializers. Our data indicates that China currently leads the USA in the volume of AI-related research papers. However, when we delve into the quality of these papers based on specific metrics, the USA retains a slight edge. Nevertheless, the pace and scale of China's AI development remain noteworthy. We attribute China's accelerated AI progress to several factors, including global trends favoring open access to algorithms and research papers, contributions from China's broad diaspora and returnees, and relatively lax data protection policies. In the vein of our research, we have developed a novel measure for gauging China's imitation of US research. Our analysis shows that by 2018, the time lag between China and the USA in addressing AI research topics had evaporated. This finding suggests that China has effectively bridged a significant knowledge gap and could potentially be setting out on an independent research trajectory. While this study compares China and the USA exclusively, it's important to note that research collaborations between these two nations have resulted in more highly cited work than those produced by either country independently. This underscores the power of international cooperation in driving scientific progress in AI.