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Register a new userImprovement of a Prediction Model for Heart Failure Survival through Explainable Artificial Intelligence
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Added by
Pedro A. Moreno-Sanchez PhD
Publication date
2021
fields
Informatics Engineering
and research's language is
English
Authors
Pedro A. Moreno-Sanchez
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Cardiovascular diseases and their associated disorder of heart failure are one of the major death causes globally, being a priority for doctors to detect and predict its onset and medical consequences. Artificial Intelligence (AI) allows doctors to discover clinical indicators and enhance their diagnosis and treatments. Specifically, explainable AI offers tools to improve the clinical prediction models that experience poor interpretability of their results. This work presents an explainability analysis and evaluation of a prediction model for heart failure survival by using a dataset that comprises 299 patients who suffered heart failure. The model employs a data workflow pipeline able to select the best ensemble tree algorithm as well as the best feature selection technique. Moreover, different post-hoc techniques have been used for the explainability analysis of the model. The papers main contribution is an explainability-driven approach to select the best prediction model for HF survival based on an accuracy-explainability balance. Therefore, the most balanced explainable prediction model implements an Extra Trees classifier over 5 selected features (follow-up time, serum creatinine, ejection fraction, age and diabetes) out of 12, achieving a balanced-accuracy of 85.1% and 79.5% with cross-validation and new unseen data respectively. The follow-up time is the most influencing feature followed by serum-creatinine and ejection-fraction. The explainable prediction model for HF survival presented in this paper would improve a further adoption of clinical prediction models by providing doctors with intuitions to better understand the reasoning of, usually, black-box AI clinical solutions, and make more reasonable and data-driven decisions.
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Cardiovascular disease, especially heart failure is one of the major health hazard issues of our time and is a leading cause of death worldwide. Advancement in data mining techniques using machine learning (ML) models is paving promising prediction approaches. Data mining is the process of converting massive volumes of raw data created by the healthcare institutions into meaningful information that can aid in making predictions and crucial decisions. Collecting various follow-up data from patients who have had heart failures, analyzing those data, and utilizing several ML models to predict the survival possibility of cardiovascular patients is the key aim of this study. Due to the imbalance of the classes in the dataset, Synthetic Minority Oversampling Technique (SMOTE) has been implemented. Two unsupervised models (K-Means and Fuzzy C-Means clustering) and three supervised classifiers (Random Forest, XGBoost and Decision Tree) have been used in our study. After thorough investigation, our results demonstrate a superior performance of the supervised ML algorithms over unsupervised models. Moreover, we designed and propose a supervised stacked ensemble learning model that can achieve an accuracy, precision, recall and F1 score of 99.98%. Our study shows that only certain attributes collected from the patients are imperative to successfully predict the surviving possibility post heart failure, using supervised ML algorithms.
Predicting the incidence of complex chronic conditions such as heart failure is challenging. Deep learning models applied to rich electronic health records may improve prediction but remain unexplainable hampering their wider use in medical practice. We developed a novel Transformer deep-learning model for more accurate and yet explainable prediction of incident heart failure involving 100,071 patients from longitudinal linked electronic health records across the UK. On internal 5-fold cross validation and held-out external validation, our model achieved 0.93 and 0.93 area under the receiver operator curve and 0.69 and 0.70 area under the precision-recall curve, respectively and outperformed existing deep learning models. Predictor groups included all community and hospital diagnoses and medications contextualised within the age and calendar year for each patients clinical encounter. The importance of contextualised medical information was revealed in a number of sensitivity analyses, and our perturbation method provided a way of identifying factors contributing to risk. Many of the identified risk factors were consistent with existing knowledge from clinical and epidemiological research but several new associations were revealed which had not been considered in expert-driven risk prediction models.
EXplainable AI (XAI) methods have been proposed to interpret how a deep neural network predicts inputs through model saliency explanations that highlight the parts of the inputs deemed important to arrive a decision at a specific target. However, it remains challenging to quantify correctness of their interpretability as current evaluation approaches either require subjective input from humans or incur high computation cost with automated evaluation. In this paper, we propose backdoor trigger patterns--hidden malicious functionalities that cause misclassification--to automate the evaluation of saliency explanations. Our key observation is that triggers provide ground truth for inputs to evaluate whether the regions identified by an XAI method are truly relevant to its output. Since backdoor triggers are the most important features that cause deliberate misclassification, a robust XAI method should reveal their presence at inference time. We introduce three complementary metrics for systematic evaluation of explanations that an XAI method generates and evaluate seven state-of-the-art model-free and model-specific posthoc methods through 36 models trojaned with specifically crafted triggers using color, shape, texture, location, and size. We discovered six methods that use local explanation and feature relevance fail to completely highlight trigger regions, and only a model-free approach can uncover the entire trigger region.
We introduce MAgent, a platform to support research and development of many-agent reinforcement learning. Unlike previous research platforms on single or multi-agent reinforcement learning, MAgent focuses on supporting the tasks and the applications that require hundreds to millions of agents. Within the interactions among a population of agents, it enables not only the study of learning algorithms for agents optimal polices, but more importantly, the observation and understanding of individual agents behaviors and social phenomena emerging from the AI society, including communication languages, leaderships, altruism. MAgent is highly scalable and can host up to one million agents on a single GPU server. MAgent also provides flexible configurations for AI researchers to design their customized environments and agents. In this demo, we present three environments designed on MAgent and show emerged collective intelligence by learning from scratch.
Dry eye disease (DED) has a prevalence of between 5 and 50%, depending on the diagnostic criteria used and population under study. However, it remains one of the most underdiagnosed and undertreated conditions in ophthalmology. Many tests used in the diagnosis of DED rely on an experienced observer for image interpretation, which may be considered subjective and result in variation in diagnosis. Since artificial intelligence (AI) systems are capable of advanced problem solving, use of such techniques could lead to more objective diagnosis. Although the term `AI is commonly used, recent success in its applications to medicine is mainly due to advancements in the sub-field of machine learning, which has been used to automatically classify images and predict medical outcomes. Powerful machine learning techniques have been harnessed to understand nuances in patient data and medical images, aiming for consistent diagnosis and stratification of disease severity. This is the first literature review on the use of AI in DED. We provide a brief introduction to AI, report its current use in DED research and its potential for application in the clinic. Our review found that AI has been employed in a wide range of DED clinical tests and research applications, primarily for interpretation of interferometry, slit-lamp and meibography images. While initial results are promising, much work is still needed on model development, clinical testing and standardisation.
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