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Machine Learning with Electronic Health Records is vulnerable to Backdoor Trigger Attacks

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 Added by Byunggill Joe
 Publication date 2021
and research's language is English




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Electronic Health Records (EHRs) provide a wealth of information for machine learning algorithms to predict the patient outcome from the data including diagnostic information, vital signals, lab tests, drug administration, and demographic information. Machine learning models can be built, for example, to evaluate patients based on their predicted mortality or morbidity and to predict required resources for efficient resource management in hospitals. In this paper, we demonstrate that an attacker can manipulate the machine learning predictions with EHRs easily and selectively at test time by backdoor attacks with the poisoned training data. Furthermore, the poison we create has statistically similar features to the original data making it hard to detect, and can also attack multiple machine learning models without any knowledge of the models. With less than 5% of the raw EHR data poisoned, we achieve average attack success rates of 97% on mortality prediction tasks with MIMIC-III database against Logistic Regression, Multilayer Perceptron, and Long Short-term Memory models simultaneously.



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An estimated 180 papers focusing on deep learning and EHR were published between 2010 and 2018. Despite the common workflow structure appearing in these publications, no trusted and verified software framework exists, forcing researchers to arduously repeat previous work. In this paper, we propose Cardea, an extensible open-source automated machine learning framework encapsulating common prediction problems in the health domain and allows users to build predictive models with their own data. This system relies on two components: Fast Healthcare Interoperability Resources (FHIR) -- a standardized data structure for electronic health systems -- and several AUTOML frameworks for automated feature engineering, model selection, and tuning. We augment these components with an adaptive data assembler and comprehensive data- and model- auditing capabilities. We demonstrate our framework via 5 prediction tasks on MIMIC-III and Kaggle datasets, which highlight Cardeas human competitiveness, flexibility in problem definition, extensive feature generation capability, adaptable automatic data assembler, and its usability.
As machine learning systems grow in scale, so do their training data requirements, forcing practitioners to automate and outsource the curation of training data in order to achieve state-of-the-art performance. The absence of trustworthy human supervision over the data collection process exposes organizations to security vulnerabilities; training data can be manipulated to control and degrade the downstream behaviors of learned models. The goal of this work is to systematically categorize and discuss a wide range of dataset vulnerabilities and exploits, approaches for defending against these threats, and an array of open problems in this space. In addition to describing various poisoning and backdoor threat models and the relationships among them, we develop their unified taxonomy.
One important challenge of applying deep learning to electronic health records (EHR) is the complexity of their multimodal structure. EHR usually contains a mixture of structured (codes) and unstructured (free-text) data with sparse and irregular longitudinal features -- all of which doctors utilize when making decisions. In the deep learning regime, determining how different modality representations should be fused together is a difficult problem, which is often addressed by handcrafted modeling and intuition. In this work, we extend state-of-the-art neural architecture search (NAS) methods and propose MUltimodal Fusion Architecture SeArch (MUFASA) to simultaneously search across multimodal fusion strategies and modality-specific architectures for the first time. We demonstrate empirically that our MUFASA method outperforms established unimodal NAS on public EHR data with comparable computation costs. In addition, MUFASA produces architectures that outperform Transformer and Evolved Transformer. Compared with these baselines on CCS diagnosis code prediction, our discovered models improve top-5 recall from 0.88 to 0.91 and demonstrate the ability to generalize to other EHR tasks. Studying our top architecture in depth, we provide empirical evidence that MUFASAs improvements are derived from its ability to both customize modeling for each data modality and find effective fusion strategies.
Increasing volume of Electronic Health Records (EHR) in recent years provides great opportunities for data scientists to collaborate on different aspects of healthcare research by applying advanced analytics to these EHR clinical data. A key requirement however is obtaining meaningful insights from high dimensional, sparse and complex clinical data. Data science approaches typically address this challenge by performing feature learning in order to build more reliable and informative feature representations from clinical data followed by supervised learning. In this paper, we propose a predictive modeling approach based on deep learning based feature representations and word embedding techniques. Our method uses different deep architectures (stacked sparse autoencoders, deep belief network, adversarial autoencoders and variational autoencoders) for feature representation in higher-level abstraction to obtain effective and robust features from EHRs, and then build prediction models on top of them. Our approach is particularly useful when the unlabeled data is abundant whereas labeled data is scarce. We investigate the performance of representation learning through a supervised learning approach. Our focus is to present a comparative study to evaluate the performance of different deep architectures through supervised learning and provide insights in the choice of deep feature representation techniques. Our experiments demonstrate that for small data sets, stacked sparse autoencoder demonstrates a superior generality performance in prediction due to sparsity regularization whereas variational autoencoders outperform the competing approaches for large data sets due to its capability of learning the representation distribution
Increasing volume of Electronic Health Records (EHR) in recent years provides great opportunities for data scientists to collaborate on different aspects of healthcare research by applying advanced analytics to these EHR clinical data. A key requirement however is obtaining meaningful insights from high dimensional, sparse and complex clinical data. Data science approaches typically address this challenge by performing feature learning in order to build more reliable and informative feature representations from clinical data followed by supervised learning. In this paper, we propose a predictive modeling approach based on deep learning based feature representations and word embedding techniques. Our method uses different deep architectures (stacked sparse autoencoders, deep belief network, adversarial autoencoders and variational autoencoders) for feature representation in higher-level abstraction to obtain effective and robust features from EHRs, and then build prediction models on top of them. Our approach is particularly useful when the unlabeled data is abundant whereas labeled data is scarce. We investigate the performance of representation learning through a supervised learning approach. Our focus is to present a comparative study to evaluate the performance of different deep architectures through supervised learning and provide insights in the choice of deep feature representation techniques. Our experiments demonstrate that for small data sets, stacked sparse autoencoder demonstrates a superior generality performance in prediction due to sparsity regularization whereas variational autoencoders outperform the competing approaches for large data sets due to its capability of learning the representation distribution.

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