Reducing False Arrhythmia Alarms Using Different Methods of Probability and Class Assignment in Random Forest Learning Methods

Clinician Preimplementation Perspectives of a Decision-Support Tool for the Prediction of Cardiac Arrhythmia Based on Machine Learning: Near-Live Feasibility and Qualitative Study

BACKGROUND

Artificial intelligence (AI), such as machine learning (ML), shows great promise for improving clinical decision-making in cardiac diseases by outperforming statistical-based models. However, few AI-based tools have been implemented in cardiology clinics because of the sociotechnical challenges during transitioning from algorithm development to real-world implementation.

OBJECTIVE

This study explored how an ML-based tool for predicting ventricular tachycardia and ventricular fibrillation (VT/VF) could support clinical decision-making in the remote monitoring of patients with an implantable cardioverter defibrillator (ICD).

METHODS

Seven experienced electrophysiologists participated in a near-live feasibility and qualitative study, which included walkthroughs of 5 blinded retrospective patient cases, use of the prediction tool, and questionnaires and interview questions. All sessions were video recorded, and sessions evaluating the prediction tool were transcribed verbatim. Data were analyzed through an inductive qualitative approach based on grounded theory.

RESULTS

The prediction tool was found to have potential for supporting decision-making in ICD remote monitoring by providing reassurance, increasing confidence, acting as a second opinion, reducing information search time, and enabling delegation of decisions to nurses and technicians. However, the prediction tool did not lead to changes in clinical action and was found less useful in cases where the quality of data was poor or when VT/VF predictions were found to be irrelevant for evaluating the patient.

CONCLUSIONS

When transitioning from AI development to testing its feasibility for clinical implementation, we need to consider the following: expectations must be aligned with the intended use of AI; trust in the prediction tool is likely to emerge from real-world use; and AI accuracy is relational and dependent on available information and local workflows. Addressing the sociotechnical gap between the development and implementation of clinical decision-support tools based on ML in cardiac care is essential for succeeding with adoption. It is suggested to include clinical end-users, clinical contexts, and workflows throughout the overall iterative approach to design, development, and implementation.

A Hybrid Approach: Dynamic Diagnostic Rules for Sensor Systems in Industry 4.0 Generated by Online Hyperparameter Tuned Random Forest

In this work, a hybrid component Fault Detection and Diagnosis (FDD) approach for industrial sensor systems is established and analyzed, to provide a hybrid schema that combines the advantages and eliminates the drawbacks of both model-based and data-driven methods of diagnosis. Moreover, it shines light on a new utilization of Random Forest (RF) together with model-based diagnosis, beyond its ordinary data-driven application. RF is trained and hyperparameter tuned using three-fold cross validation over a random grid of parameters using random search, to finally generate diagnostic graphs as the dynamic, data-driven part of this system. This is followed by translating those graphs into model-based rules in the form of if-else statements, SQL queries or semantic queries such as SPARQL, in order to feed the dynamic rules into a structured model essential for further diagnosis. The RF hyperparameters are consistently updated online using the newly generated sensor data to maintain the dynamicity and accuracy of the generated graphs and rules thereafter. The architecture of the proposed method is demonstrated in a comprehensive manner, and the dynamic rules extraction phase is applied using a case study on condition monitoring of a hydraulic test rig using time-series multivariate sensor readings.

A Hybrid Approach: Dynamic Diagnostic Rules for Sensor Systems in Industry 4.0 Generated by Online Hyperparameter Tuned Random Forest

In this work, a hybrid component Fault Detection and Diagnosis (FDD) approach for industrial sensor systems is established and analyzed, to provide a hybrid schema that combines the advantages and eliminates the drawbacks of both model-based and data-driven methods of diagnosis. Moreover, it shines the light on a new utilization of Random Forest (RF) together with model-based diagnosis, beyond its ordinary data-driven application. RF is trained and hyperparameter tuned using three-fold cross validation over a random grid of parameters using random search, to finally generate diagnostic graphs as the dynamic, data-driven part of this system. This is followed by translating those graphs into model-based rules in the form of if-else statements, SQL queries or semantic queries such as SPARQL, in order to feed the dynamic rules into a structured model essential for further diagnosis. The RF hyperparameters are consistently updated online using the newly generated sensor data to maintain the dynamicity and accuracy of the generated graphs and rules thereafter. The architecture of the proposed method is demonstrated in a comprehensive manner, and the dynamic rules extraction phase is applied using a case study on condition monitoring of a hydraulic test rig using time-series multivariate sensor readings.

A Hybrid Approach: Dynamic Diagnostic Rules for Sensor Systems in Industry 4.0 Generated by Online Hyperparameter Tuned Random Forest

In this work, a hybrid component Fault Detection and Diagnosis (FDD) approach for industrial sensor systems is established and analyzed, to provide a hybrid schema that combines the advantages and eliminates the drawbacks of both model-based and data-driven methods of diagnosis. Moreover, it shines the light on a new utilization of Random Forest (RF) together with model-based diagnosis, beyond its ordinary data-driven application. RF is trained and hyperparameter tuned using three-fold cross validation over a random grid of parameters using random search, to finally generate diagnostic graphs as the dynamic, data-driven part of this system. This is followed by translating those graphs into model-based rules in the form of if-else statements, SQL queries or semantic queries such as SPARQL, in order to feed the dynamic rules into a structured model essential for further diagnosis. The RF hyperparameters are consistently updated online using the newly generated sensor data to maintain the dynamicity and accuracy of the generated graphs and rules thereafter. The architecture of the proposed method is demonstrated in a comprehensive manner, and the dynamic rules extraction phase is applied using a case study on condition monitoring of a hydraulic test rig using time-series multivariate sensor readings.

Single-modal and multi-modal false arrhythmia alarm reduction using attention-based convolutional and recurrent neural networks

This study proposes a deep learning model that effectively suppresses the false alarms in the intensive care units (ICUs) without ignoring the true alarms using single- and multi- modal biosignals. Most of the current work in the literature are either rule-based methods, requiring prior knowledge of arrhythmia analysis to build rules, or classical machine learning approaches, depending on hand-engineered features. In this work, we apply convolutional neural networks to automatically extract time-invariant features, an attention mechanism to put more emphasis on the important regions of the segmented input signal(s) that are more likely to contribute to an alarm, and long short-term memory units to capture the temporal information presented in the signal segments. We trained our method efficiently using a two-step training algorithm (i.e., pre-training and fine-tuning the proposed network) on the dataset provided by the PhysioNet computing in cardiology challenge 2015. The evaluation results demonstrate that the proposed method obtains better results compared to other existing algorithms for the false alarm reduction task in ICUs. The proposed method achieves a sensitivity of 93.88% and a specificity of 92.05% for the alarm classification, considering three different signals. In addition, our experiments for 5 separate alarm types leads significant results, where we just consider a single-lead ECG (e.g., a sensitivity of 90.71%, a specificity of 88.30%, an AUC of 89.51 for alarm type of Ventricular Tachycardia arrhythmia).

Weighted Random Forests to Improve Arrhythmia Classification

Construction of an ensemble model is a process of combining many diverse base predictive learners. It arises questions of how to weight each model and how to tune the parameters of the weighting process. The most straightforward approach is simply to average the base models. However, numerous studies have shown that a weighted ensemble can provide superior prediction results to a simple average of models. The main goals of this article are to propose a new weighting algorithm applicable for each tree in the Random Forest model and the comprehensive examination of the optimal parameter tuning. Importantly, the approach is motivated by its flexibility, good performance, stability, and resistance to overfitting. The proposed scheme is examined and evaluated on the Physionet/Computing in Cardiology Challenge 2015 data set. It consists of signals (electrocardiograms and pulsatory waveforms) from intensive care patients which triggered an alarm for five cardiac arrhythmia types (Asystole, Bradycardia, Tachycardia, Ventricular Tachycardia, and Ventricular Fultter/Fibrillation). The classification problem regards whether the alarm should or should not have been generated. It was proved that the proposed weighting approach improved classification accuracy for the three most challenging out of the five investigated arrhythmias comparing to the standard Random Forest model.