An Improved Machine-Learning Approach for COVID-19 Prediction Using Harris Hawks Optimization and Feature Analysis Using SHAP

Prediction of Post-Treatment Visual Acuity in Age-Related Macular Degeneration Patients With an Interpretable Machine Learning Method

Purpose

We evaluated the features predicting visual acuity (VA) after one year in neovascular age-related macular degeneration (nAMD) patients.

Methods

A total of 527 eyes of 506 patients were included. Machine learning (ML) models were trained to predict VA deterioration beyond a logarithm of the minimum angle of resolution of 1.0 after 1 year based on the sequential addition of multimodal data. BaseM models used clinical data (age, sex, treatment regimen, and VA), SegM models included fluid volumes from optical coherence tomography (OCT) images, and RawM models used probabilities of visual deterioration (hereafter probability) from deep learning classifiers trained on baseline OCT (OCT0) and OCT after three loading doses (OCT3), fluorescein angiography, and indocyanine green angiography. We applied SHapley Additive exPlanations (SHAP) for machine learning model interpretation.

Results

The RawM model based on the probability of OCT0 outperformed the SegM model (area under the receiver operating characteristic curve of 0.95 vs. 0.91). Adding probabilities from OCT3, fluorescein angiography, and indocyanine green angiography to RawM showed minimal performance improvement, highlighting the practicality of using raw OCT0 data for predicting visual outcomes. Applied SHapley Additive exPlanations analysis identified VA after 3 months and OCT3 probability values as the most influential features over quantified fluid segments.

Conclusions

Integrating multimodal data to create a visual predictive model yielded accurate, interpretable predictions. This approach allowed the identification of crucial factors for predicting VA in patients with nAMD.

Translational Relevance

Interpreting a predictive model for 1-year VA in patients with nAMD from multimodal data allowed us to identify crucial factors for predicting VA.

A brief review and scientometric analysis on ensemble learning methods for handling COVID-19

Numerous efforts and research have been conducted worldwide to combat the coronavirus disease 2019 (COVID-19) pandemic. In this regard, some researchers have focused on deep and machine-learning approaches to discover more about this disease. There have been many articles on using ensemble learning methods for COVID-19 detection. Still, there seems to be no scientometric analysis or a brief review of these researches. Hence, a combined method of scientometric analysis and brief review was used to study the published articles that employed an ensemble learning approach to detect COVID-19. This research used both methods to overcome their limitations, leading to enhanced and reliable outcomes. The related articles were retrieved from the Scopus database. Then a two-step procedure was employed. A concise review of the collected articles was conducted. Then they underwent scientometric and bibliometric analyses. The findings revealed that convolutional neural network (CNN) is the mostly employed algorithm, while support vector machine (SVM), random forest, Resnet, DenseNet, and visual geometry group (VGG) were also frequently used. Additionally, China has had a significant presence in the numerous top-ranking categories of this field of research. Both study phases yielded valuable results and rankings.

FCMCPS-COVID: AI propelled fog-cloud inspired scalable medical cyber-physical system, specific to coronavirus disease

Medical cyber-physical systems (MCPS) firmly integrate a network of medical objects. These systems are highly efficacious and have been progressively used in the Healthcare 4.0 to achieve continuous high-quality services. Healthcare 4.0 encompasses numerous emerging technologies and their applications have been realized in the monitoring of a variety of virus outbreaks. As a growing healthcare trend, coronavirus disease (COVID-19) can be cured and its spread can be prevented using MCPS. This virus spreads from human to human and can have devastating consequences. Moreover, with the alarmingly rising death rate and new cases across the world, there is an urgent need for continuous identification and screening of infected patients to mitigate their spread. Motivated by the facts, we propose a framework for early detection, prevention, and control of the COVID-19 outbreak by using novel Industry 5.0 technologies. The proposed framework uses a dimensionality reduction technique in the fog layer, allowing high-quality data to be used for classification purposes. The fog layer also uses the ensemble learning-based data classification technique for the detection of COVID-19 patients based on the symptomatic dataset. In addition, in the cloud layer, social network analysis (SNA) has been performed to control the spread of COVID-19. The experimental results reveal that compared with state-of-the-art methods, the proposed framework achieves better results in terms of accuracy (82.28 %), specificity (91.42 %), sensitivity (90 %) and stability with effective response time. Furthermore, the utilization of CVI-based alert generation at the fog layer improves the novelty aspects of the proposed system.

Clinical Validation of Explainable Deep Learning Model for Predicting the Mortality of In-Hospital Cardiac Arrest Using Diagnosis Codes of Electronic Health Records

Background

Using deep learning for disease outcome prediction is an approach that has made large advances in recent years. Notwithstanding its excellent performance, clinicians are also interested in learning how input affects prediction. Clinical validation of explainable deep learning models is also as yet unexplored. This study aims to evaluate the performance of Deep SHapley Additive exPlanations (D-SHAP) model in accurately identifying the diagnosis code associated with the highest mortality risk.

Methods

Incidences of at least one in-hospital cardiac arrest (IHCA) for 168,693 patients as well as 1,569,478 clinical records were extracted from Taiwan's National Health Insurance Research Database. We propose a D-SHAP model to provide insights into deep learning model predictions. We trained a deep learning model to predict the 30-day mortality likelihoods of IHCA patients and used D-SHAP to see how the diagnosis codes affected the model's predictions. Physicians were asked to annotate a cardiac arrest dataset and provide expert opinions, which we used to validate our proposed method. A 1-to-4-point annotation of each record (current decision) along with four previous records (historical decision) was used to validate the current and historical D-SHAP values.

Results

A subset consisting of 402 patients with at least one cardiac arrest record was randomly selected from the IHCA cohort. The median age was 72 years, with mean and standard deviation of 69 ± 17 years. Results indicated that D-SHAP can identify the cause of mortality based on the diagnosis codes. The top five most important diagnosis codes, namely respiratory failure, sepsis, pneumonia, shock, and acute kidney injury were consistent with the physician's opinion. Some diagnoses, such as urinary tract infection, showed a discrepancy between D-SHAP and clinical judgment due to the lower frequency of the disease and its occurrence in combination with other comorbidities.

Conclusions

The D-SHAP framework was found to be an effective tool to explain deep neural networks and identify most of the important diagnoses for predicting patients' 30-day mortality. However, physicians should always carefully consider the structure of the original database and underlying pathophysiology.

Combating Covid-19 using machine learning and deep learning: Applications, challenges, and future perspectives

COVID-19, a worldwide pandemic that has affected many people and thousands of individuals have died due to COVID-19, during the last two years. Due to the benefits of Artificial Intelligence (AI) in X-ray image interpretation, sound analysis, diagnosis, patient monitoring, and CT image identification, it has been further researched in the area of medical science during the period of COVID-19. This study has assessed the performance and investigated different machine learning (ML), deep learning (DL), and combinations of various ML, DL, and AI approaches that have been employed in recent studies with diverse data formats to combat the problems that have arisen due to the COVID-19 pandemic. Finally, this study shows the comparison among the stand-alone ML and DL-based research works regarding the COVID-19 issues with the combinations of ML, DL, and AI-based research works. After in-depth analysis and comparison, this study responds to the proposed research questions and presents the future research directions in this context. This review work will guide different research groups to develop viable applications based on ML, DL, and AI models, and will also guide healthcare institutes, researchers, and governments by showing them how these techniques can ease the process of tackling the COVID-19.

Smart ECG Biosensor Design with an Improved ANN Performance Based on the Taguchi Optimizer

This paper aims to design a smart biosensor to predict electrocardiogram (ECG) signals in a specific auscultation site from other ECG signals measured from other measurement sites. The proposed design is based on a hybrid architecture using the Artificial Neural Networks (ANNs) model and Taguchi optimizer to avoid the ANN issues related to hyperparameters and to improve its accuracy. The proposed approach aims to optimize the number and type of inputs to be considered for the ANN model. Indeed, different combinations are considered in order to find the optimal input combination for the best prediction quality. By identifying the factors that influence a model’s prediction and their degree of importance via the modified Taguchi optimizer, the developed biosensor improves the prediction accuracy of ECG signals collected from different auscultation sites compared to the ANN-based biosensor. Based on an actual database, the simulation results show that this improvement is significant; it can reach more than 94% accuracy.

Development of a Smartphone-Based Expert System for COVID-19 Risk Prediction at Early Stage

COVID-19 has imposed many challenges and barriers on traditional healthcare systems due to the high risk of being infected by the coronavirus. Modern electronic devices like smartphones with information technology can play an essential role in handling the current pandemic by contributing to different telemedical services. This study has focused on determining the presence of this virus by employing smartphone technology, as it is available to a large number of people. A publicly available COVID-19 dataset consisting of 33 features has been utilized to develop the aimed model, which can be collected from an in-house facility. The chosen dataset has 2.82% positive and 97.18% negative samples, demonstrating a high imbalance of class populations. The Adaptive Synthetic (ADASYN) has been applied to overcome the class imbalance problem with imbalanced data. Ten optimal features are chosen from the given 33 features, employing two different feature selection algorithms, such as K Best and recursive feature elimination methods. Mainly, three classification schemes, Random Forest (RF), eXtreme Gradient Boosting (XGB), and Support Vector Machine (SVM), have been applied for the ablation studies, where the accuracy from the XGB, RF, and SVM classifiers achieved 97.91%, 97.81%, and 73.37%, respectively. As the XGB algorithm confers the best results, it has been implemented in designing the Android operating system base and web applications. By analyzing 10 users’ questionnaires, the developed expert system can predict the presence of COVID-19 in the human body of the primary suspect. The preprocessed data and codes are available on the GitHub repository.