A Novel Ensemble Method for Imbalanced Data Learning: Bagging of Extrapolation-SMOTE SVM

Class imbalance should not throw you off balance: Choosing the right classifiers and performance metrics for brain decoding with imbalanced data

Machine learning (ML) is increasingly used in cognitive, computational and clinical neuroscience. The reliable and efficient application of ML requires a sound understanding of its subtleties and limitations. Training ML models on datasets with imbalanced classes is a particularly common problem, and it can have severe consequences if not adequately addressed. With the neuroscience ML user in mind, this paper provides a didactic assessment of the class imbalance problem and illustrates its impact through systematic manipulation of data imbalance ratios in (i) simulated data and (ii) brain data recorded with electroencephalography (EEG), magnetoencephalography (MEG) and functional magnetic resonance imaging (fMRI). Our results illustrate how the widely-used Accuracy (Acc) metric, which measures the overall proportion of successful predictions, yields misleadingly high performances, as class imbalance increases. Because Acc weights the per-class ratios of correct predictions proportionally to class size, it largely disregards the performance on the minority class. A binary classification model that learns to systematically vote for the majority class will yield an artificially high decoding accuracy that directly reflects the imbalance between the two classes, rather than any genuine generalizable ability to discriminate between them. We show that other evaluation metrics such as the Area Under the Curve (AUC) of the Receiver Operating Characteristic (ROC), and the less common Balanced Accuracy (BAcc) metric - defined as the arithmetic mean between sensitivity and specificity, provide more reliable performance evaluations for imbalanced data. Our findings also highlight the robustness of Random Forest (RF), and the benefits of using stratified cross-validation and hyperprameter optimization to tackle data imbalance. Critically, for neuroscience ML applications that seek to minimize overall classification error, we recommend the routine use of BAcc, which in the specific case of balanced data is equivalent to using standard Acc, and readily extends to multi-class settings. Importantly, we present a list of recommendations for dealing with imbalanced data, as well as open-source code to allow the neuroscience community to replicate and extend our observations and explore alternative approaches to coping with imbalanced data.

Adaptive Subspace Optimization Ensemble Method for High-Dimensional Imbalanced Data Classification

It is hard to construct an optimal classifier for high-dimensional imbalanced data, on which the performance of classifiers is seriously affected and becomes poor. Although many approaches, such as resampling, cost-sensitive, and ensemble learning methods, have been proposed to deal with the skewed data, they are constrained by high-dimensional data with noise and redundancy. In this study, we propose an adaptive subspace optimization ensemble method (ASOEM) for high-dimensional imbalanced data classification to overcome the above limitations. To construct accurate and diverse base classifiers, a novel adaptive subspace optimization (ASO) method based on adaptive subspace generation (ASG) process and rotated subspace optimization (RSO) process is designed to generate multiple robust and discriminative subspaces. Then a resampling scheme is applied on the optimized subspace to build a class-balanced data for each base classifier. To verify the effectiveness, our ASOEM is implemented based on different resampling strategies on 24 real-world high-dimensional imbalanced datasets. Experimental results demonstrate that our proposed methods outperform other mainstream imbalance learning approaches and classifier ensemble methods.

Machine learning for prediction of postoperative nausea and vomiting in patients with intravenous patient-controlled analgesia

BACKGROUND

Postoperative nausea and vomiting (PONV) is a still highly relevant problem and is known to be a distressing side effect in patients. The aim of this study was to develop a machine learning model to predict PONV up to 24 h with fentanyl-based intravenous patient-controlled analgesia (IV-PCA).

METHODS

From July 2019 and July 2020, data from 2,149 patients who received fentanyl-based IV-PCA for analgesia after non-cardiac surgery under general anesthesia were applied to develop predictive models. The rates of PONV at 1 day after surgery were measured according to patient characteristics as well as anesthetic, surgical, or PCA-related factors. All statistical analyses and computations were performed using the R software.

RESULTS

A total of 2,149 patients were enrolled in this study, 337 of whom (15.7%) experienced PONV. After applying the machine-learning algorithm and Apfel model to the test dataset to predict PONV, we found that the area under the receiver operating characteristic curve using logistic regression was 0.576 (95% confidence interval [CI], 0.520-0.633), k-nearest neighbor was 0.597 (95% CI, 0.537-0.656), decision tree was 0.561 (95% CI, 0.498-0.625), random forest was 0.610 (95% CI, 0.552-0.668), gradient boosting machine was 0.580 (95% CI, 0.520-0.639), support vector machine was 0.649 (95% CI, 0.592-0.707), artificial neural network was 0.686 (95% CI, 0.630-0.742), and Apfel model was 0.643 (95% CI, 0.596-0.690).

CONCLUSIONS

We developed and validated machine learning models for predicting PONV in the first 24 h. The machine learning model showed better performance than the Apfel model in predicting PONV.

Classification of COVID-19 from tuberculosis and pneumonia using deep learning techniques

Deep learning provides the healthcare industry with the ability to analyse data at exceptional speeds without compromising on accuracy. These techniques are applicable to healthcare domain for accurate and timely prediction. Convolutional neural network is a class of deep learning methods which has become dominant in various computer vision tasks and is attracting interest across a variety of domains, including radiology. Lung diseases such as tuberculosis (TB), bacterial and viral pneumonias, and COVID-19 are not predicted accurately due to availability of very few samples for either of the lung diseases. The disease could be easily diagnosed using X-ray or CT scan images. But the number of images available for each of the disease is not as equally as other resulting in imbalance nature of input data. Conventional supervised machine learning methods do not achieve higher accuracy when trained using a lesser amount of COVID-19 data samples. Image data augmentation is a technique that can be used to artificially expand the size of a training dataset by creating modified versions of images in the dataset. Data augmentation helped reduce overfitting when training a deep neural network. The SMOTE (Synthetic Minority Oversampling Technique) algorithm is used for the purpose of balancing the classes. The novelty in this research work is to apply combined data augmentation and class balance techniques before classification of tuberculosis, pneumonia, and COVID-19. The classification accuracy obtained with the proposed multi-level classification after training the model is recorded as 97.4% for TB and pneumonia and 88% for bacterial, viral, and COVID-19 classifications. The proposed multi-level classification method produced is ~8 to ~10% improvement in classification accuracy when compared with the existing methods in this area of research. The results reveal the fact that the proposed system is scalable to growing medical data and classifies lung diseases and its sub-types in less time with higher accuracy.

Imbalanced Data Classification via Cooperative Interaction Between Classifier and Generator

Learning classifiers with imbalanced data can be strongly biased toward the majority class. To address this issue, several methods have been proposed using generative adversarial networks (GANs). Existing GAN-based methods, however, do not effectively utilize the relationship between a classifier and a generator. This article proposes a novel three-player structure consisting of a discriminator, a generator, and a classifier, along with decision boundary regularization. Our method is distinctive in which the generator is trained in cooperation with the classifier to provide minority samples that gradually expand the minority decision region, improving performance for imbalanced data classification. The proposed method outperforms the existing methods on real data sets as well as synthetic imbalanced data sets.

A survey on computational taste predictors

Taste is a sensory modality crucial for nutrition and survival, since it allows the discrimination between healthy foods and toxic substances thanks to five tastes, i.e., sweet, bitter, umami, salty, and sour, associated with distinct nutritional or physiological needs. Today, taste prediction plays a key role in several fields, e.g., medical, industrial, or pharmaceutical, but the complexity of the taste perception process, its multidisciplinary nature, and the high number of potentially relevant players and features at the basis of the taste sensation make taste prediction a very complex task. In this context, the emerging capabilities of machine learning have provided fruitful insights in this field of research, allowing to consider and integrate a very large number of variables and identifying hidden correlations underlying the perception of a particular taste. This review aims at summarizing the latest advances in taste prediction, analyzing available food-related databases and taste prediction tools developed in recent years.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00217-022-04044-5.

BurnoutEnsemble: Augmented Intelligence to Detect Indications for Burnout in Clinical Psychology

Burnout, a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress, is a growing concern. It is known to occur when an individual feels overwhelmed, emotionally exhausted, and unable to meet the constant demands imposed upon them. Detecting burnout is not an easy task, in large part because symptoms can overlap with those of other illnesses or syndromes. The use of natural language processing (NLP) methods has the potential to mitigate the limitations of typical burnout detection via inventories. In this article, the performance of NLP methods on anonymized free text data samples collected from the online forum/social media platform Reddit was analyzed. A dataset consisting of 13,568 samples describing first-hand experiences, of which 352 are related to burnout and 979 to depression, was compiled. This work demonstrates the effectiveness of NLP and machine learning methods in detecting indicators for burnout. Finally, it improves upon standard baseline classifiers by building and training an ensemble classifier using two methods (subreddit and random batching). The best ensemble models attain a balanced accuracy of 0.93, test F1 score of 0.43, and test recall of 0.93. Both the subreddit and random batching ensembles outperform the single classifier baselines in the experimental setup.

Radiomic and Artificial Intelligence Analysis with Textural Metrics Extracted by Contrast-Enhanced Mammography and Dynamic Contrast Magnetic Resonance Imaging to Detect Breast Malignant Lesions

Purpose:The purpose of this study was to discriminate between benign and malignant breast lesions through several classifiers using, as predictors, radiomic metrics extracted from CEM and DCE-MRI images. In order to optimize the analysis, balancing and feature selection procedures were performed. Methods: Fifty-four patients with 79 histo-pathologically proven breast lesions (48 malignant lesions and 31 benign lesions) underwent both CEM and DCE-MRI. The lesions were retrospectively analyzed with radiomic and artificial intelligence approaches. Forty-eight textural metrics were extracted, and univariate and multivariate analyses were performed: non-parametric statistical test, receiver operating characteristic (ROC) and machine learning classifiers. Results: Considering the single metrics extracted from CEM, the best predictors were KURTOSIS (area under ROC curve (AUC) = 0.71) and SKEWNESS (AUC = 0.71) calculated on late MLO view. Considering the features calculated from DCE-MRI, the best predictors were RANGE (AUC = 0.72), ENERGY (AUC = 0.72), ENTROPY (AUC = 0.70) and GLN (gray-level nonuniformity) of the gray-level run-length matrix (AUC = 0.72). Considering the analysis with classifiers and an unbalanced dataset, no significant results were obtained. After the balancing and feature selection procedures, higher values of accuracy, specificity and AUC were reached. The best performance was obtained considering 18 robust features among all metrics derived from CEM and DCE-MRI, using a linear discriminant analysis (accuracy of 0.84 and AUC = 0.88). Conclusions: Classifiers, adjusted with adaptive synthetic sampling and feature selection, allowed for increased diagnostic performance of CEM and DCE-MRI in the differentiation between benign and malignant lesions.

A Boundary-Information-Based Oversampling Approach to Improve Learning Performance for Imbalanced Datasets

Oversampling is the most popular data preprocessing technique. It makes traditional classifiers available for learning from imbalanced data. Through an overall review of oversampling techniques (oversamplers), we find that some of them can be regarded as danger-information-based oversamplers (DIBOs) that create samples near danger areas to make it possible for these positive examples to be correctly classified, and others are safe-information-based oversamplers (SIBOs) that create samples near safe areas to increase the correct rate of predicted positive values. However, DIBOs cause misclassification of too many negative examples in the overlapped areas, and SIBOs cause incorrect classification of too many borderline positive examples. Based on their advantages and disadvantages, a boundary-information-based oversampler (BIBO) is proposed. First, a concept of boundary information that considers safe information and dangerous information at the same time is proposed that makes created samples near decision boundaries. The experimental results show that DIBOs and BIBO perform better than SIBOs on the basic metrics of recall and negative class precision; SIBOs and BIBO perform better than DIBOs on the basic metrics for specificity and positive class precision, and BIBO is better than both of DIBOs and SIBOs in terms of integrated metrics.

Machine Learning Approaches to Predict Chronic Lower Back Pain in People Aged over 50 Years

Background and Objectives: Chronic lower back pain (LBP) is a common clinical disorder. The early identification of patients who will develop chronic LBP would help develop preventive measures and treatment. We aimed to develop machine learning models that can accurately predict the risk of chronic LBP. Materials and Methods: Data from the Sixth Korea National Health and Nutrition Examination Survey conducted in 2014 and 2015 (KNHANES VI-2, 3) were screened for selecting patients with chronic LBP. LBP lasting >30 days in the past 3 months was defined as chronic LBP in the survey. The following classification models with machine learning algorithms were developed and validated to predict chronic LBP: logistic regression (LR), k-nearest neighbors (KNN), naïve Bayes (NB), decision tree (DT), random forest (RF), gradient boosting machine (GBM), support vector machine (SVM), and artificial neural network (ANN). The performance of these models was compared with respect to the area under the receiver operating characteristic curve (AUROC). Results: A total of 6119 patients were analyzed in this study, of which 1394 had LBP. The feature selected data consisted of 13 variables. The LR, KNN, NB, DT, RF, GBM, SVM, and ANN models showed performances (in terms of AUROCs) of 0.656, 0.656, 0.712, 0.671, 0.699, 0.660, 0.707, and 0.716, respectively, with ten-fold cross-validation. Conclusions: In this study, the ANN model was identified as the best machine learning classification model for predicting the occurrence of chronic LBP. Therefore, machine learning could be effectively applied in the identification of populations at high risk of chronic LBP.

CLASS-IMBALANCED CLASSIFIERS USING ENSEMBLES OF GAUSSIAN PROCESSES AND GAUSSIAN PROCESS LATENT VARIABLE MODELS

Classification with imbalanced data is a common and challenging problem in many practical machine learning problems. Ensemble learning is a popular solution where the results from multiple base classifiers are synthesized to reduce the effect of a possibly skewed distribution of the training set. In this paper, binary classifiers based on Gaussian processes are chosen as bases for inferring the predictive distributions of test latent variables. We apply a Gaussian process latent variable model where the outputs of the Gaussian processes are used for making the final decision. The tests of the new method in both synthetic and real data sets show improved performance over standard approaches.

Evolving scenario of big data and Artificial Intelligence (AI) in drug discovery

The accumulation of massive data in the plethora of Cheminformatics databases has made the role of big data and artificial intelligence (AI) indispensable in drug design. This has necessitated the development of newer algorithms and architectures to mine these databases and fulfil the specific needs of various drug discovery processes such as virtual drug screening, de novo molecule design and discovery in this big data era. The development of deep learning neural networks and their variants with the corresponding increase in chemical data has resulted in a paradigm shift in information mining pertaining to the chemical space. The present review summarizes the role of big data and AI techniques currently being implemented to satisfy the ever-increasing research demands in drug discovery pipelines.

Radiomics and Artificial Intelligence Analysis with Textural Metrics Extracted by Contrast-Enhanced Mammography in the Breast Lesions Classification

The aim of the study was to estimate the diagnostic accuracy of textural features extracted by dual-energy contrast-enhanced mammography (CEM) images, by carrying out univariate and multivariate statistical analyses including artificial intelligence approaches. In total, 80 patients with known breast lesion were enrolled in this prospective study according to regulations issued by the local Institutional Review Board. All patients underwent dual-energy CEM examination in both craniocaudally (CC) and double acquisition of mediolateral oblique (MLO) projections (early and late). The reference standard was pathology from a surgical specimen for malignant lesions and pathology from a surgical specimen or fine needle aspiration cytology, core or Tru-Cut needle biopsy, and vacuum assisted breast biopsy for benign lesions. In total, 104 samples of 80 patients were analyzed. Furthermore, 48 textural parameters were extracted by manually segmenting regions of interest. Univariate and multivariate approaches were performed: non-parametric Wilcoxon–Mann–Whitney test; receiver operating characteristic (ROC), linear classifier (LDA), decision tree (DT), k-nearest neighbors (KNN), artificial neural network (NNET), and support vector machine (SVM) were utilized. A balancing approach and feature selection methods were used. The univariate analysis showed low accuracy and area under the curve (AUC) for all considered features. Instead, in the multivariate textural analysis, the best performance considering the CC view (accuracy (ACC) = 0.75; AUC = 0.82) was reached with a DT trained with leave-one-out cross-variation (LOOCV) and balanced data (with adaptive synthetic (ADASYN) function) and a subset of three robust textural features (MAD, VARIANCE, and LRLGE). The best performance (ACC = 0.77; AUC = 0.83) considering the early-MLO view was reached with a NNET trained with LOOCV and balanced data (with ADASYN function) and a subset of ten robust features (MEAN, MAD, RANGE, IQR, VARIANCE, CORRELATION, RLV, COARSNESS, BUSYNESS, and STRENGTH). The best performance (ACC = 0.73; AUC = 0.82) considering the late-MLO view was reached with a NNET trained with LOOCV and balanced data (with ADASYN function) and a subset of eleven robust features (MODE, MEDIAN, RANGE, RLN, LRLGE, RLV, LZLGE, GLV_GLSZM, ZSV, COARSNESS, and BUSYNESS). Multivariate analyses using pattern recognition approaches, considering 144 textural features extracted from all three mammographic projections (CC, early MLO, and late MLO), optimized by adaptive synthetic sampling and feature selection operations obtained the best results (ACC = 0.87; AUC = 0.90) and showed the best performance in the discrimination of benign and malignant lesions.

SEMI-SUPERVISED SPARSE REPRESENTATION CLASSIFICATION FOR SLEEP EEG RECOGNITION WITH IMBALANCED SAMPLE SETS

Sleep staging with supervised learning requires a large amount of labeled data that are time-consuming and expensive to collect. Semi-supervised learning is widely used to improve classification performance by combining a small amount of labeled data with a large amount of unlabeled data. The accuracy of pseudo-labels in semi-supervised learning may influence the performance of classifier. Based on semi-supervised sparse representation classification, this study proposed an improved sparse concentration index to estimate the confidence of pseudo-labels data for sleep EEG recognition considering both interclass differences and intraclass concentration. In view of class imbalance in sleep EEG data, the synthetic minority oversampling technique was also improved to remove mixed samples at the boundary between minority and majority classes. The results showed that the proposed method achieved better classification performance, in which the classification accuracy after class balancing was obviously higher than that before class balancing. The findings of this study will be beneficial for application in sleep monitoring devices and sleep-related diseases.

Measuring Activities of Daily Living in Stroke Patients with Motion Machine Learning Algorithms: A Pilot Study

Measuring activities of daily living (ADLs) using wearable technologies may offer higher precision and granularity than the current clinical assessments for patients after stroke. This study aimed to develop and determine the accuracy of detecting different ADLs using machine-learning (ML) algorithms and wearable sensors. Eleven post-stroke patients participated in this pilot study at an ADL Simulation Lab across two study visits. We collected blocks of repeated activity (“atomic” activity) performance data to train our ML algorithms during one visit. We evaluated our ML algorithms using independent semi-naturalistic activity data collected at a separate session. We tested Decision Tree, Random Forest, Support Vector Machine (SVM), and eXtreme Gradient Boosting (XGBoost) for model development. XGBoost was the best classification model. We achieved 82% accuracy based on ten ADL tasks. With a model including seven tasks, accuracy improved to 90%. ADL tasks included chopping food, vacuuming, sweeping, spreading jam or butter, folding laundry, eating, brushing teeth, taking off/putting on a shirt, wiping a cupboard, and buttoning a shirt. Results provide preliminary evidence that ADL functioning can be predicted with adequate accuracy using wearable sensors and ML. The use of external validation (independent training and testing data sets) and semi-naturalistic testing data is a major strength of the study and a step closer to the long-term goal of ADL monitoring in real-world settings. Further investigation is needed to improve the ADL prediction accuracy, increase the number of tasks monitored, and test the model outside of a laboratory setting.

Outlier-SMOTE: A refined oversampling technique for improved detection of COVID-19

Almost every dataset these days continually faces the predicament of class imbalance. It is difficult to train classifiers on these types of data as they become biased towards a set of classes, hence leading to reduction in classifier performance. This setback is often tackled by the use of various over-sampling or under-sampling algorithms. But, the method which stood out of all the numerous algorithms was the Synthetic Minority Oversampling Technique (SMOTE). SMOTE generates synthetic samples of the minority class by oversampling each data-point by considering linear combinations of existing minority class neighbors. Each minority data sample generates an equal number of synthetic data. As the world is suffering from the plight of COVID-19 pandemic, the authors applied the idea to help boost the classifying performance whilst detecting this deadly virus. This paper presents a modified version of SMOTE known as Outlier-SMOTE wherein each data-point is oversampled with respect to its distance from other data-points. The data-point which is farther than the other data-points is given greater importance and is oversampled more than its counterparts. Outlier-SMOTE reduces the chances of overlapping of minority data samples which often occurs in the traditional SMOTE algorithm. This method is tested on five benchmark datasets and is eventually tested on a COVID-19 dataset. F-measure, Recall and Precision are used as principle metrics to evaluate the performance of the classifier as is the case for any class imbalanced data set. The proposed algorithm performs considerably better than the traditional SMOTE algorithm for the considered datasets.

Entropy and Confidence-Based Undersampling Boosting Random Forests for Imbalanced Problems

In this article, we propose a novel entropy and confidence-based undersampling boosting (ECUBoost) framework to solve imbalanced problems. The boosting-based ensemble is combined with a new undersampling method to improve the generalization performance. To avoid losing informative samples during the data preprocessing of the boosting-based ensemble, both confidence and entropy are used in ECUBoost as benchmarks to ensure the validity and structural distribution of the majority samples during the undersampling. Furthermore, different from other iterative dynamic resampling methods, ECUBoost based on confidence can be applied to algorithms without iterations such as decision trees. Meanwhile, random forests are used as base classifiers in ECUBoost. Furthermore, experimental results on both artificial data sets and KEEL data sets prove the effectiveness of the proposed method.

Semi-Supervised Classification of Noisy, Gigapixel Histology Images

One of the greatest obstacles in the adoption of deep neural networks for new medical applications is that training these models typically require a large amount of manually labeled training samples. In this body of work, we investigate the semi-supervised scenario where one has access to large amounts of unlabeled data and only a few labeled samples. We study the performance of MixMatch and FixMatch-two popular semi-supervised learning methods-on a histology dataset. More specifically, we study these models' impact under a highly noisy and imbalanced setting. The findings here motivate the development of semi-supervised methods to ameliorate problems commonly encountered in medical data applications.

Classification of Dermoscopy Skin Lesion Color-Images Using Fractal-Deep Learning Features

The detection of skin diseases is becoming one of the priority tasks worldwide due to the increasing amount of skin cancer. Computer-aided diagnosis is a helpful tool to help dermatologists in the detection of these kinds of illnesses. This work proposes a computer-aided diagnosis based on 1D fractal signatures of texture-based features combining with deep-learning features using transferred learning based in Densenet-201. This proposal works with three 1D fractal signatures built per color-image. The energy, variance, and entropy of the fractal signatures are used combined with 100 features extracted from Densenet-201 to construct the features vector. Because commonly, the classes in the dataset of skin lesion images are imbalanced, we use the technique of ensemble of classifiers: K-nearest neighbors and two types of support vector machines. The computer-aided diagnosis output was determined based on the linear plurality vote. In this work, we obtained an average accuracy of 97.35%, an average precision of 91.61%, an average sensitivity of 66.45%, and an average specificity of 97.85% in the eight classes’ classification in the International Skin Imaging Collaboration (ISIC) archive-2019.

Designing a Streaming Algorithm for Outlier Detection in Data Mining-An Incrementa Approach

To design an algorithm for detecting outliers over streaming data has become an important task in many common applications, arising in areas such as fraud detections, network analysis, environment monitoring and so forth. Due to the fact that real-time data may arrive in the form of streams rather than batches, properties such as concept drift, temporal context, transiency, and uncertainty need to be considered. In addition, data processing needs to be incremental with limited memory resource, and scalable. These facts create big challenges for existing outlier detection algorithms in terms of their accuracies when they are implemented in an incremental fashion, especially in the streaming environment. To address these problems, we first propose C_KDE_WR, which uses sliding window and kernel function to process the streaming data online, and reports its results demonstrating high throughput on handling real-time streaming data, implemented in a CUDA framework on Graphics Processing Unit (GPU). We also present another algorithm, C_LOF, based on a very popular and effective outlier detection algorithm called Local Outlier Factor (LOF) which unfortunately works only on batched data. Using a novel incremental approach that compensates the drawback of high complexity in LOF, we show how to implement it in a streaming context and to obtain results in a timely manner. Like C_KDE_WR, C_LOF also employs sliding-window and statistical-summary to help making decision based on the data in the current window. It also addresses all those challenges of streaming data as addressed in C_KDE_WR. In addition, we report the comparative evaluation on the accuracy of C_KDE_WR with the state-of-the-art SOD_GPU using Precision, Recall and F-score metrics. Furthermore, a t-test is also performed to demonstrate the significance of the improvement. We further report the testing results of C_LOF on different parameter settings and drew ROC and PR curve with their area under the curve (AUC) and Average Precision (AP) values calculated respectively. Experimental results show that C_LOF can overcome the masquerading problem, which often exists in outlier detection on streaming data. We provide complexity analysis and report experiment results on the accuracy of both C_KDE_WR and C_LOF algorithms in order to evaluate their effectiveness as well as their efficiencies.

Explainable Machine Learning Approach as a Tool to Understand Factors Used to Select the Refractive Surgery Technique on the Expert Level

Purpose

Recently, laser refractive surgery options, including laser epithelial keratomileusis, laser in situ keratomileusis, and small incision lenticule extraction, successfully improved patients' quality of life. Evidence-based recommendation for an optimal surgery technique is valuable in increasing patient satisfaction. We developed an interpretable multiclass machine learning model that selects the laser surgery option on the expert level.

Methods

A multiclass XGBoost model was constructed to classify patients into four categories including laser epithelial keratomileusis, laser in situ keratomileusis, small incision lenticule extraction, and contraindication groups. The analysis included 18,480 subjects who intended to undergo refractive surgery at the B&VIIT Eye center. Training (n = 10,561) and internal validation (n = 2640) were performed using subjects who visited between 2016 and 2017. The model was trained based on clinical decisions of highly experienced experts and ophthalmic measurements. External validation (n = 5279) was conducted using subjects who visited in 2018. The SHapley Additive ex-Planations technique was adopted to explain the output of the XGBoost model.

Results

The multiclass XGBoost model exhibited an accuracy of 81.0% and 78.9% when tested on the internal and external validation datasets, respectively. The SHapley Additive ex-Planations explanations for the results were consistent with prior knowledge from ophthalmologists. The explanation from one-versus-one and one-versus-rest XGBoost classifiers was effective for easily understanding users in the multicategorical classification problem.

Conclusions

This study suggests an expert-level multiclass machine learning model for selecting the refractive surgery for patients. It also provided a clinical understanding in a multiclass problem based on an explainable artificial intelligence technique.

Translational Relevance

Explainable machine learning exhibits a promising future for increasing the practical use of artificial intelligence in ophthalmic clinics.

Standard Decision Boundary in a Support-Domain of Fuzzy Classifier Prediction for the Task of Imbalanced Data Classification

Many real classification problems are characterized by a strong disturbance in a prior probability, which for the most of classification algorithms leads to favoring majority classes. The action most often used to deal with this problem is oversampling of the minority class by the smote algorithm. Following work proposes to employ a modification of an individual binary classifier support-domain decision boundary, similar to the fusion of classifier ensembles done by the Fuzzy Templates method to deal with imbalanced data classification without introducing any repeated or artificial patterns into the training set. The proposed solution has been tested in computer experiments, which results shows its potential in the imbalanced data classification.

Integrating Growth and Environmental Parameters to Discriminate Powdery Mildew and Aphid of Winter Wheat Using Bi-Temporal Landsat-8 Imagery

Monitoring and discriminating co-epidemic diseases and pests at regional scales are of practical importance in guiding differential treatment. A combination of vegetation and environmental parameters could improve the accuracy for discriminating crop diseases and pests. Different diseases and pests could cause similar stresses and symptoms during the same crop growth period, so combining growth period information can be useful for discerning different changes in crop diseases and pests. Additionally, problems associated with imbalanced data often have detrimental effects on the performance of image classification. In this study, we developed an approach for discriminating crop diseases and pests based on bi-temporal Landsat-8 satellite imagery integrating both crop growth and environmental parameters. As a case study, the approach was applied to data during a period of typical co-epidemic outbreak of winter wheat powdery mildew and aphids in the Shijiazhuang area of Hebei Province, China. Firstly, bi-temporal remotely sensed features characterizing growth indices and environmental factors were calculated based on two Landsat-8 images. The synthetic minority oversampling technique (SMOTE) algorithm was used to resample the imbalanced training data set before model construction. Then, a back propagation neural network (BPNN) based on a new training data set balanced by the SMOTE approach (SMOTE-BPNN) was developed to generate the regional wheat disease and pest distribution maps. The original training data set-based BPNN and support vector machine (SVM) methods were used for comparison and testing of the initial results. Our findings suggest that the proposed approach incorporating both growth and environmental parameters of different crop periods could distinguish wheat powdery mildew and aphids at the regional scale. The bi-temporal growth indices and environmental factors-based SMOTE-BPNN, BPNN, and SVM models all had an overall accuracy high than 80%. Meanwhile, the SMOTE-BPNN method had the highest G-means among the three methods. These results revealed that the combination of bi-temporal crop growth and environmental parameters is essential for improving the accuracy of the crop disease and pest discriminating models. The combination of SMOTE and BPNN could effectively improve the discrimination accuracy of the minor disease or pest.

Predicting Surgical Complications in Patients Undergoing Elective Adult Spinal Deformity Procedures Using Machine Learning

STUDY DESIGN

Cross-sectional database study.

OBJECTIVE

To train and validate machine learning models to identify risk factors for complications following surgery for adult spinal deformity (ASD).

SUMMARY OF BACKGROUND DATA

Machine learning models such as logistic regression (LR) and artificial neural networks (ANNs) are valuable tools for analyzing and interpreting large and complex data sets. ANNs have yet to be used for risk factor analysis in orthopedic surgery.

METHODS

The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for patients who underwent surgery for ASD. This query returned 4,073 patients, which data were used to train and evaluate our models. The predictive variables used included sex, age, ethnicity, diabetes, smoking, steroid use, coagulopathy, functional status, American Society of Anesthesiologists (ASA) class >3, body mass index (BMI), pulmonary comorbidities, and cardiac comorbidities. The models were used to predict cardiac complications, wound complications, venous thromboembolism (VTE), and mortality. Using ASA class as a benchmark for prediction, area under receiver operating characteristic curves (AUC) was used to determine the accuracy of our machine learning models.

RESULTS

The mean age of patients was 59.5 years. Forty-one percent of patients were male whereas 59.0% of patients were female. ANN and LR outperformed ASA scoring in predicting every complication (p<.05). The ANN outperformed LR in predicting cardiac complication, wound complication, and mortality (p<.05).

CONCLUSIONS

Machine learning algorithms outperform ASA scoring for predicting individual risk prognosis. These algorithms also outperform LR in predicting individual risk for all complications except VTE. With the growing size of medical data, the training of machine learning on these large data sets promises to improve risk prognostication, with the ability of continuously learning making them excellent tools in complex clinical scenarios.

LEVEL OF EVIDENCE

Level III.

Predicting Surgical Complications in Adult Patients Undergoing Anterior Cervical Discectomy and Fusion Using Machine Learning

Objective

Machine learning algorithms excel at leveraging big data to identify complex patterns that can be used to aid in clinical decision-making. The objective of this study is to demonstrate the performance of machine learning models in predicting postoperative complications following anterior cervical discectomy and fusion (ACDF).

Methods

Artificial neural network (ANN), logistic regression (LR), support vector machine (SVM), and random forest decision tree (RF) models were trained on a multicenter data set of patients undergoing ACDF to predict surgical complications based on readily available patient data. Following training, these models were compared to the predictive capability of American Society of Anesthesiologists (ASA) physical status classification.

Results

A total of 20,879 patients were identified as having undergone ACDF. Following exclusion criteria, patients were divided into 14,615 patients for training and 6,264 for testing data sets. ANN and LR consistently outperformed ASA physical status classification in predicting every complication (p < 0.05). The ANN outperformed LR in predicting venous thromboembolism, wound complication, and mortality (p < 0.05). The SVM and RF models were no better than random chance at predicting any of the postoperative complications (p < 0.05).

Conclusion

ANN and LR algorithms outperform ASA physical status classification for predicting individual postoperative complications. Additionally, neural networks have greater sensitivity than LR when predicting mortality and wound complications. With the growing size of medical data, the training of machine learning on these large datasets promises to improve risk prognostication, with the ability of continuously learning making them excellent tools in complex clinical scenarios.

Examining the Ability of Artificial Neural Networks Machine Learning Models to Accurately Predict Complications Following Posterior Lumbar Spine Fusion

STUDY DESIGN

A cross-sectional database study.

OBJECTIVE

The aim of this study was to train and validate machine learning models to identify risk factors for complications following posterior lumbar spine fusion.

SUMMARY OF BACKGROUND DATA

Machine learning models such as artificial neural networks (ANNs) are valuable tools for analyzing and interpreting large and complex datasets. ANNs have yet to be used for risk factor analysis in orthopedic surgery.

METHODS

The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for patients who underwent posterior lumbar spine fusion. This query returned 22,629 patients, 70% of whom were used to train our models, and 30% were used to evaluate the models. The predictive variables used included sex, age, ethnicity, diabetes, smoking, steroid use, coagulopathy, functional status, American Society for Anesthesiology (ASA) class ≥3, body mass index (BMI), pulmonary comorbidities, and cardiac comorbidities. The models were used to predict cardiac complications, wound complications, venous thromboembolism (VTE), and mortality. Using ASA class as a benchmark for prediction, area under receiver operating curves (AUC) was used to determine the accuracy of our machine learning models.

RESULTS

On the basis of AUC values, ANN and LR both outperformed ASA class for predicting all four types of complications. ANN was the most accurate for predicting cardiac complications, and LR was most accurate for predicting wound complications, VTE, and mortality, though ANN and LR had comparable AUC values for predicting all types of complications. ANN had greater sensitivity than LR for detecting wound complications and mortality.

CONCLUSION

Machine learning in the form of logistic regression and ANNs were more accurate than benchmark ASA scores for identifying risk factors of developing complications following posterior lumbar spine fusion, suggesting they are potentially great tools for risk factor analysis in spine surgery.

LEVEL OF EVIDENCE

3.