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Register a new userExplainable AI For COVID-19 CT Classifiers: An Initial Comparison Study
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Guang Yang A
Publication date
2021
fields
Informatics Engineering
and research's language is
English
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Artificial Intelligence (AI) has made leapfrogs in development across all the industrial sectors especially when deep learning has been introduced. Deep learning helps to learn the behaviour of an entity through methods of recognising and interpreting patterns. Despite its limitless potential, the mystery is how deep learning algorithms make a decision in the first place. Explainable AI (XAI) is the key to unlocking AI and the black-box for deep learning. XAI is an AI model that is programmed to explain its goals, logic, and decision making so that the end users can understand. The end users can be domain experts, regulatory agencies, managers and executive board members, data scientists, users that use AI, with or without awareness, or someone who is affected by the decisions of an AI model. Chest CT has emerged as a valuable tool for the clinical diagnostic and treatment management of the lung diseases associated with COVID-19. AI can support rapid evaluation of CT scans to differentiate COVID-19 findings from other lung diseases. However, how these AI tools or deep learning algorithms reach such a decision and which are the most influential features derived from these neural networks with typically deep layers are not clear. The aim of this study is to propose and develop XAI strategies for COVID-19 classification models with an investigation of comparison. The results demonstrate promising quantification and qualitative visualisations that can further enhance the clinicians understanding and decision making with more granular information from the results given by the learned XAI models.
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Our motivating application is a real-world problem: COVID-19 classification from CT imaging, for which we present an explainable Deep Learning approach based on a semi-supervised classification pipeline that employs variational autoencoders to extract efficient feature embedding. We have optimized the architecture of two different networks for CT images: (i) a novel conditional variational autoencoder (CVAE) with a specific architecture that integrates the class labels inside the encoder layers and uses side information with shared attention layers for the encoder, which make the most of the contextual clues for representation learning, and (ii) a downstream convolutional neural network for supervised classification using the encoder structure of the CVAE. With the explainable classification results, the proposed diagnosis system is very effective for COVID-19 classification. Based on the promising results obtained qualitatively and quantitatively, we envisage a wide deployment of our developed technique in large-scale clinical studies.Code is available at https://git.etrovub.be/AVSP/ct-based-covid-19-diagnostic-tool.git.
Machine learning methods offer great promise for fast and accurate detection and prognostication of COVID-19 from standard-of-care chest radiographs (CXR) and computed tomography (CT) images. Many articles have been published in 2020 describing new machine learning-based models for both of these tasks, but it is unclear which are of potential clinical utility. In this systematic review, we search EMBASE via OVID, MEDLINE via PubMed, bioRxiv, medRxiv and arXiv for published papers and preprints uploaded from January 1, 2020 to October 3, 2020 which describe new machine learning models for the diagnosis or prognosis of COVID-19 from CXR or CT images. Our search identified 2,212 studies, of which 415 were included after initial screening and, after quality screening, 61 studies were included in this systematic review. Our review finds that none of the models identified are of potential clinical use due to methodological flaws and/or underlying biases. This is a major weakness, given the urgency with which validated COVID-19 models are needed. To address this, we give many recommendations which, if followed, will solve these issues and lead to higher quality model development and well documented manuscripts.
Since COVID-19 was first identified in December 2019, various public health interventions have been implemented across the world. As different measures are implemented at different countries at different times, we conduct an assessment of the relative effectiveness of the measures implemented in 18 countries and regions using data from 22/01/2020 to 02/04/2020. We compute the top one and two measures that are most effective for the countries and regions studied during the period. Two Explainable AI techniques, SHAP and ECPI, are used in our study; such that we construct (machine learning) models for predicting the instantaneous reproduction number ($R_t$) and use the models as surrogates to the real world and inputs that the greatest influence to our models are seen as measures that are most effective. Across-the-board, city lockdown and contact tracing are the two most effective measures. For ensuring $R_t<1$, public wearing face masks is also important. Mass testing alone is not the most effective measure although when paired with other measures, it can be effective. Warm temperature helps for reducing the transmission.
During the coronavirus disease 2019 (COVID-19) pandemic, rapid and accurate triage of patients at the emergency department is critical to inform decision-making. We propose a data-driven approach for automatic prediction of deterioration risk using a deep neural network that learns from chest X-ray images and a gradient boosting model that learns from routine clinical variables. Our AI prognosis system, trained using data from 3,661 patients, achieves an area under the receiver operating characteristic curve (AUC) of 0.786 (95% CI: 0.745-0.830) when predicting deterioration within 96 hours. The deep neural network extracts informative areas of chest X-ray images to assist clinicians in interpreting the predictions and performs comparably to two radiologists in a reader study. In order to verify performance in a real clinical setting, we silently deployed a preliminary version of the deep neural network at New York University Langone Health during the first wave of the pandemic, which produced accurate predictions in real-time. In summary, our findings demonstrate the potential of the proposed system for assisting front-line physicians in the triage of COVID-19 patients.
The unprecedented global crisis brought about by the COVID-19 pandemic has sparked numerous efforts to create predictive models for the detection and prognostication of SARS-CoV-2 infections with the goal of helping health systems allocate resources. Machine learning models, in particular, hold promise for their ability to leverage patient clinical information and medical images for prediction. However, most of the published COVID-19 prediction models thus far have little clinical utility due to methodological flaws and lack of appropriate validation. In this paper, we describe our methodology to develop and validate multi-modal models for COVID-19 mortality prediction using multi-center patient data. The models for COVID-19 mortality prediction were developed using retrospective data from Madrid, Spain (N=2547) and were externally validated in patient cohorts from a community hospital in New Jersey, USA (N=242) and an academic center in Seoul, Republic of Korea (N=336). The models we developed performed differently across various clinical settings, underscoring the need for a guided strategy when employing machine learning for clinical decision-making. We demonstrated that using features from both the structured electronic health records and chest X-ray imaging data resulted in better 30-day-mortality prediction performance across all three datasets (areas under the receiver operating characteristic curves: 0.85 (95% confidence interval: 0.83-0.87), 0.76 (0.70-0.82), and 0.95 (0.92-0.98)). We discuss the rationale for the decisions made at every step in developing the models and have made our code available to the research community. We employed the best machine learning practices for clinical model development. Our goal is to create a toolkit that would assist investigators and organizations in building multi-modal models for prediction, classification and/or optimization.
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