Supriya Nagesh, Nina Mishra, Yonatan Naamad, James M. Rehg, M. A. Shah, Alexei Wagner
{"title":"Explaining a machine learning decision to physicians via counterfactuals","authors":"Supriya Nagesh, Nina Mishra, Yonatan Naamad, James M. Rehg, M. A. Shah, Alexei Wagner","doi":"10.48550/arXiv.2306.06325","DOIUrl":"https://doi.org/10.48550/arXiv.2306.06325","url":null,"abstract":"Machine learning models perform well on several healthcare tasks and can help reduce the burden on the healthcare system. However, the lack of explainability is a major roadblock to their adoption in hospitals. textit{How can the decision of an ML model be explained to a physician?} The explanations considered in this paper are counterfactuals (CFs), hypothetical scenarios that would have resulted in the opposite outcome. Specifically, time-series CFs are investigated, inspired by the way physicians converse and reason out decisions `I would have given the patient a vasopressor if their blood pressure was lower and falling'. Key properties of CFs that are particularly meaningful in clinical settings are outlined: physiological plausibility, relevance to the task and sparse perturbations. Past work on CF generation does not satisfy these properties, specifically plausibility in that realistic time-series CFs are not generated. A variational autoencoder (VAE)-based approach is proposed that captures these desired properties. The method produces CFs that improve on prior approaches quantitatively (more plausible CFs as evaluated by their likelihood w.r.t original data distribution, and 100$times$ faster at generating CFs) and qualitatively (2$times$ more plausible and relevant) as evaluated by three physicians.","PeriodicalId":87342,"journal":{"name":"Proceedings of the ACM Conference on Health, Inference, and Learning","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73175490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Rare Life Event Detection via Mobile Sensing Using Multi-Task Learning","authors":"Arvind Pillai, Subigya Nepal, Andrew T. Campbell","doi":"10.48550/arXiv.2305.20056","DOIUrl":"https://doi.org/10.48550/arXiv.2305.20056","url":null,"abstract":"Rare life events significantly impact mental health, and their detection in behavioral studies is a crucial step towards health-based interventions. We envision that mobile sensing data can be used to detect these anomalies. However, the human-centered nature of the problem, combined with the infrequency and uniqueness of these events makes it challenging for unsupervised machine learning methods. In this paper, we first investigate granger-causality between life events and human behavior using sensing data. Next, we propose a multi-task framework with an unsupervised autoencoder to capture irregular behavior, and an auxiliary sequence predictor that identifies transitions in workplace performance to contextualize events. We perform experiments using data from a mobile sensing study comprising N=126 information workers from multiple industries, spanning 10106 days with 198 rare events (<2%). Through personalized inference, we detect the exact day of a rare event with an F1 of 0.34, demonstrating that our method outperforms several baselines. Finally, we discuss the implications of our work from the context of real-world deployment.","PeriodicalId":87342,"journal":{"name":"Proceedings of the ACM Conference on Health, Inference, and Learning","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72784227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"PTGB: Pre-Train Graph Neural Networks for Brain Network Analysis","authors":"Yi Yang, Hejie Cui, Carl Yang","doi":"10.48550/arXiv.2305.14376","DOIUrl":"https://doi.org/10.48550/arXiv.2305.14376","url":null,"abstract":"The human brain is the central hub of the neurobiological system, controlling behavior and cognition in complex ways. Recent advances in neuroscience and neuroimaging analysis have shown a growing interest in the interactions between brain regions of interest (ROIs) and their impact on neural development and disorder diagnosis. As a powerful deep model for analyzing graph-structured data, Graph Neural Networks (GNNs) have been applied for brain network analysis. However, training deep models requires large amounts of labeled data, which is often scarce in brain network datasets due to the complexities of data acquisition and sharing restrictions. To make the most out of available training data, we propose PTGB, a GNN pre-training framework that captures intrinsic brain network structures, regardless of clinical outcomes, and is easily adaptable to various downstream tasks. PTGB comprises two key components: (1) an unsupervised pre-training technique designed specifically for brain networks, which enables learning from large-scale datasets without task-specific labels; (2) a data-driven parcellation atlas mapping pipeline that facilitates knowledge transfer across datasets with different ROI systems. Extensive evaluations using various GNN models have demonstrated the robust and superior performance of PTGB compared to baseline methods.","PeriodicalId":87342,"journal":{"name":"Proceedings of the ACM Conference on Health, Inference, and Learning","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78915420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Large-Scale Study of Temporal Shift in Health Insurance Claims","authors":"Christina X. Ji, A. Alaa, D. Sontag","doi":"10.48550/arXiv.2305.05087","DOIUrl":"https://doi.org/10.48550/arXiv.2305.05087","url":null,"abstract":"Most machine learning models for predicting clinical outcomes are developed using historical data. Yet, even if these models are deployed in the near future, dataset shift over time may result in less than ideal performance. To capture this phenomenon, we consider a task--that is, an outcome to be predicted at a particular time point--to be non-stationary if a historical model is no longer optimal for predicting that outcome. We build an algorithm to test for temporal shift either at the population level or within a discovered sub-population. Then, we construct a meta-algorithm to perform a retrospective scan for temporal shift on a large collection of tasks. Our algorithms enable us to perform the first comprehensive evaluation of temporal shift in healthcare to our knowledge. We create 1,010 tasks by evaluating 242 healthcare outcomes for temporal shift from 2015 to 2020 on a health insurance claims dataset. 9.7% of the tasks show temporal shifts at the population level, and 93.0% have some sub-population affected by shifts. We dive into case studies to understand the clinical implications. Our analysis highlights the widespread prevalence of temporal shifts in healthcare.","PeriodicalId":87342,"journal":{"name":"Proceedings of the ACM Conference on Health, Inference, and Learning","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85985750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Token Imbalance Adaptation for Radiology Report Generation","authors":"Yuexin Wu, I. Huang, Xiaolei Huang","doi":"10.48550/arXiv.2304.09185","DOIUrl":"https://doi.org/10.48550/arXiv.2304.09185","url":null,"abstract":"Imbalanced token distributions naturally exist in text documents, leading neural language models to overfit on frequent tokens. The token imbalance may dampen the robustness of radiology report generators, as complex medical terms appear less frequently but reflect more medical information. In this study, we demonstrate how current state-of-the-art models fail to generate infrequent tokens on two standard benchmark datasets (IU X-RAY and MIMIC-CXR) of radiology report generation. % However, no prior study has proposed methods to adapt infrequent tokens for text generators feeding with medical images. To solve the challenge, we propose the textbf{T}oken textbf{Im}balance Adapttextbf{er} (textit{TIMER}), aiming to improve generation robustness on infrequent tokens. The model automatically leverages token imbalance by an unlikelihood loss and dynamically optimizes generation processes to augment infrequent tokens. We compare our approach with multiple state-of-the-art methods on the two benchmarks. Experiments demonstrate the effectiveness of our approach in enhancing model robustness overall and infrequent tokens. Our ablation analysis shows that our reinforcement learning method has a major effect in adapting token imbalance for radiology report generation.","PeriodicalId":87342,"journal":{"name":"Proceedings of the ACM Conference on Health, Inference, and Learning","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82799029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eunbyeol Cho, Min Jae Lee, Kyunghoon Hur, Jiyoun Kim, Jinsung Yoon, E. Choi
{"title":"Rediscovery of CNN's Versatility for Text-based Encoding of Raw Electronic Health Records","authors":"Eunbyeol Cho, Min Jae Lee, Kyunghoon Hur, Jiyoun Kim, Jinsung Yoon, E. Choi","doi":"10.48550/arXiv.2303.08290","DOIUrl":"https://doi.org/10.48550/arXiv.2303.08290","url":null,"abstract":"Making the most use of abundant information in electronic health records (EHR) is rapidly becoming an important topic in the medical domain. Recent work presented a promising framework that embeds entire features in raw EHR data regardless of its form and medical code standards. The framework, however, only focuses on encoding EHR with minimal preprocessing and fails to consider how to learn efficient EHR representation in terms of computation and memory usage. In this paper, we search for a versatile encoder not only reducing the large data into a manageable size but also well preserving the core information of patients to perform diverse clinical tasks. We found that hierarchically structured Convolutional Neural Network (CNN) often outperforms the state-of-the-art model on diverse tasks such as reconstruction, prediction, and generation, even with fewer parameters and less training time. Moreover, it turns out that making use of the inherent hierarchy of EHR data can boost the performance of any kind of backbone models and clinical tasks performed. Through extensive experiments, we present concrete evidence to generalize our research findings into real-world practice. We give a clear guideline on building the encoder based on the research findings captured while exploring numerous settings.","PeriodicalId":87342,"journal":{"name":"Proceedings of the ACM Conference on Health, Inference, and Learning","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90384831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Ciná, Tabea E. Rober, R. Goedhart, cS. .Ilker Birbil
{"title":"Semantic match: Debugging feature attribution methods in XAI for healthcare","authors":"G. Ciná, Tabea E. Rober, R. Goedhart, cS. .Ilker Birbil","doi":"10.48550/arXiv.2301.02080","DOIUrl":"https://doi.org/10.48550/arXiv.2301.02080","url":null,"abstract":"The recent spike in certified Artificial Intelligence (AI) tools for healthcare has renewed the debate around adoption of this technology. One thread of such debate concerns Explainable AI (XAI) and its promise to render AI devices more transparent and trustworthy. A few voices active in the medical AI space have expressed concerns on the reliability of Explainable AI techniques and especially feature attribution methods, questioning their use and inclusion in guidelines and standards. Despite valid concerns, we argue that existing criticism on the viability of post-hoc local explainability methods throws away the baby with the bathwater by generalizing a problem that is specific to image data. We begin by characterizing the problem as a lack of semantic match between explanations and human understanding. To understand when feature importance can be used reliably, we introduce a distinction between feature importance of low- and high-level features. We argue that for data types where low-level features come endowed with a clear semantics, such as tabular data like Electronic Health Records (EHRs), semantic match can be obtained, and thus feature attribution methods can still be employed in a meaningful and useful way. Finally, we sketch a procedure to test whether semantic match has been achieved.","PeriodicalId":87342,"journal":{"name":"Proceedings of the ACM Conference on Health, Inference, and Learning","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86590799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seongjun Yang, Hyeonji Hwang, Daeyoung Kim, Radhika Dua, Jong-Yeup Kim, Eunho Yang, E. Choi
{"title":"Towards the Practical Utility of Federated Learning in the Medical Domain","authors":"Seongjun Yang, Hyeonji Hwang, Daeyoung Kim, Radhika Dua, Jong-Yeup Kim, Eunho Yang, E. Choi","doi":"10.48550/arXiv.2207.03075","DOIUrl":"https://doi.org/10.48550/arXiv.2207.03075","url":null,"abstract":"Federated learning (FL) is an active area of research. One of the most suitable areas for adopting FL is the medical domain, where patient privacy must be respected. Previous research, however, does not provide a practical guide to applying FL in the medical domain. We propose empirical benchmarks and experimental settings for three representative medical datasets with different modalities: longitudinal electronic health records, skin cancer images, and electrocardiogram signals. The likely users of FL such as medical institutions and IT companies can take these benchmarks as guides for adopting FL and minimize their trial and error. For each dataset, each client data is from a different source to preserve real-world heterogeneity. We evaluate six FL algorithms designed for addressing data heterogeneity among clients, and a hybrid algorithm combining the strengths of two representative FL algorithms. Based on experiment results from three modalities, we discover that simple FL algorithms tend to outperform more sophisticated ones, while the hybrid algorithm consistently shows good, if not the best performance. We also find that a frequent global model update leads to better performance under a fixed training iteration budget. As the number of participating clients increases, higher cost is incurred due to increased IT administrators and GPUs, but the performance consistently increases. We expect future users will refer to these empirical benchmarks to design the FL experiments in the medical domain considering their clinical tasks and obtain stronger performance with lower costs.","PeriodicalId":87342,"journal":{"name":"Proceedings of the ACM Conference on Health, Inference, and Learning","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77056542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Self-supervised Pretraining and Transfer Learning Enable Flu and COVID-19 Predictions in Small Mobile Sensing Datasets","authors":"Michael Merrill, Tim Althoff","doi":"10.48550/arXiv.2205.13607","DOIUrl":"https://doi.org/10.48550/arXiv.2205.13607","url":null,"abstract":"Detailed mobile sensing data from phones, watches, and fitness trackers offer an unparalleled opportunity to quantify and act upon previously unmeasurable behavioral changes in order to improve individual health and accelerate responses to emerging diseases. Unlike in natural language processing and computer vision, deep representation learning has yet to broadly impact this domain, in which the vast majority of research and clinical applications still rely on manually defined features and boosted tree models or even forgo predictive modeling altogether due to insufficient accuracy. This is due to unique challenges in the behavioral health domain, including very small datasets (~10^1 participants), which frequently contain missing data, consist of long time series with critical long-range dependencies (length>10^4), and extreme class imbalances (>10^3:1). Here, we introduce a neural architecture for multivariate time series classification designed to address these unique domain challenges. Our proposed behavioral representation learning approach combines novel tasks for self-supervised pretraining and transfer learning to address data scarcity, and captures long-range dependencies across long-history time series through transformer self-attention following convolutional neural network-based dimensionality reduction. We propose an evaluation framework aimed at reflecting expected real-world performance in plausible deployment scenarios. Concretely, we demonstrate (1) performance improvements over baselines of up to 0.15 ROC AUC across five prediction tasks, (2) transfer learning-induced performance improvements of 16% PR AUC in small data scenarios, and (3) the potential of transfer learning in novel disease scenarios through an exploratory case study of zero-shot COVID-19 prediction in an independent data set. Finally, we discuss potential implications for medical surveillance testing.","PeriodicalId":87342,"journal":{"name":"Proceedings of the ACM Conference on Health, Inference, and Learning","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73080509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Subhrajit Roy, Diana Mincu, Lev Proleev, Negar Rostamzadeh, Chintan Ghate, Natalie Harris, Christina Chen, J. Schrouff, Nenad Tomašev, F. Hartsell, K. Heller
{"title":"Disability prediction in multiple sclerosis using performance outcome measures and demographic data","authors":"Subhrajit Roy, Diana Mincu, Lev Proleev, Negar Rostamzadeh, Chintan Ghate, Natalie Harris, Christina Chen, J. Schrouff, Nenad Tomašev, F. Hartsell, K. Heller","doi":"10.48550/arXiv.2204.03969","DOIUrl":"https://doi.org/10.48550/arXiv.2204.03969","url":null,"abstract":"Literature on machine learning for multiple sclerosis has primarily focused on the use of neuroimaging data such as magnetic resonance imaging and clinical laboratory tests for disease identification. However, studies have shown that these modalities are not consistent with disease activity such as symptoms or disease progression. Furthermore, the cost of collecting data from these modalities is high, leading to scarce evaluations. In this work, we used multi-dimensional, affordable, physical and smartphone-based performance outcome measures (POM) in conjunction with demographic data to predict multiple sclerosis disease progression. We performed a rigorous benchmarking exercise on two datasets and present results across 13 clinically actionable prediction endpoints and 6 machine learning models. To the best of our knowledge, our results are the first to show that it is possible to predict disease progression using POMs and demographic data in the context of both clinical trials and smartphone-base studies by using two datasets. Moreover, we investigate our models to understand the impact of different POMs and demographics on model performance through feature ablation studies. We also show that model performance is similar across different demographic subgroups (based on age and sex). To enable this work, we developed an end-to-end reusable pre-processing and machine learning framework which allows quicker experimentation over disparate MS datasets.","PeriodicalId":87342,"journal":{"name":"Proceedings of the ACM Conference on Health, Inference, and Learning","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90675061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}