Explainable Tensor Multi-Task Ensemble Learning Based on Brain Structure Variation for Alzheimer's Disease Dynamic Prediction

Machine learning approaches for predicting Alzheimer's disease (AD) progression can substantially assist researchers and clinicians in developing effective AD preventive and treatment strategies. This study proposes a novel machine learning algorithm to predict the AD progression utilising a multi-task ensemble learning approach. Specifically, we present a novel tensor multi-task learning (MTL) algorithm based on similarity measurement of spatio-temporal variability of brain biomarkers to model AD progression. In this model, the prediction of each patient sample in the tensor is set as one task, where all tasks share a set of latent factors obtained through tensor decomposition. Furthermore, as subjects have continuous records of brain biomarker testing, the model is extended to ensemble the subjects' temporally continuous prediction results utilising a gradient boosting kernel to find more accurate predictions. We have conducted extensive experiments utilising data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) to evaluate the performance of the proposed algorithm and model. Results demonstrate that the proposed model have superior accuracy and stability in predicting AD progression compared to benchmarks and state-of-the-art multi-task regression methods in terms of the Mini Mental State Examination (MMSE) questionnaire and The Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) cognitive scores. Brain biomarker correlation information can be utilised to identify variations in individual brain structures and the model can be utilised to effectively predict the progression of AD with magnetic resonance imaging (MRI) data and cognitive scores of AD patients at different stages.

Keeping patient and public partnership at the heart of medical technology development during Covid-19: examples of adaptive practice

NIHR (National Institute for Health Research) Devices for Dignity MedTech Cooperative (D4D) and NIHR Children and Young People MedTech Cooperative (CYPMedTech) have established track records in keeping patient and public involvement (PPI) at the core of medical technology development, evaluation and implementation. The 2020 global COVID-19 pandemic presented significant challenges to maintaining this crucial focus. In this paper we describe prior successful methodologies and share examples of the adaptations made in order to continue to engage with patients and the public throughout the pandemic and beyond. We reflect on learning gained from these experiences, and new areas of scope and focus relating to broadening the reach of engagement and representation, along with associated resource requirements and impact metrics.

Spatio-temporal Tensor Multi-Task Learning for Predicting Alzheimer's Disease in a Longitudinal study

The utilisation of machine learning techniques to predict Alzheimer's Disease (AD) progression will substantially assist researchers and clinicians in establishing effective AD prevention and treatment strategies. In this research, we present a novel Multi-Task Learning (MTL) model for modelling AD progression based on tensor formation from spatio-temporal similarity measures of brain biomarkers. In this model, each patient sample's prediction in the tensor is assigned to a task, with each task sharing a set of latent factors acquired via tensor decomposition. To further improve the performance of the model, we present a novel regularisation term which utilises the convex combination of disease progression to modify longitudinal stability and ensure that two regression models have a minimal variation at successive time points. The model can be utilised to effectively predict AD progression with magnetic resonance imaging (MRI) data and cognitive scores of AD patients at various stages. We conducted extensive experiments to evaluate the performance for the proposed model and algorithm utilising data from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Compared to single-task and state-of-the-art multi-task regression techniques, our proposed method has greater accuracy and stability for predicting AD progress in terms of root mean square error, with an average reduction of 2.60 compared to single-task regression methods and 1.17 compared to multi-task regression methods in the Mini-Mental State Examination (MMSE) questionnaire; with an average reduction of 5.08 compared to single-task regression methods and 2.71 compared to multi-task regression methods in the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog).

User attitudes towards virtual home assessment technologies

Telehealth has long been highlighted as a way to solve issues of efficiency and effectiveness in healthcare and to improve patients' care and has become fundamental to address patients' needs during the COVID-19 pandemic; however previous studies have shown mixed results in the user acceptance of such technologies. Whilst many previous studies have focussed on clinical application of telehealth, we focus on the adoption of telehealth for virtual assessments visits aimed to evaluate the suitability of a property where a patient is discharged, and eventual adaptations needed. We present a study of stakeholders' attitudes towards such virtual assessment visits. The study has been carried out with healthcare professionals and patients and allowed us to identify user attitudes, barriers and facilitators for the success of virtual assessment visits from the point of view of healthcare professionals and patients. Finally, we discuss implications for designers of telehealth services and guidelines that can be derived from our study.

Technical validation of real-world monitoring of gait: a multicentric observational study

INTRODUCTION

Existing mobility endpoints based on functional performance, physical assessments and patient self-reporting are often affected by lack of sensitivity, limiting their utility in clinical practice. Wearable devices including inertial measurement units (IMUs) can overcome these limitations by quantifying digital mobility outcomes (DMOs) both during supervised structured assessments and in real-world conditions. The validity of IMU-based methods in the real-world, however, is still limited in patient populations. Rigorous validation procedures should cover the device metrological verification, the validation of the algorithms for the DMOs computation specifically for the population of interest and in daily life situations, and the users' perspective on the device.

METHODS AND ANALYSIS

This protocol was designed to establish the technical validity and patient acceptability of the approach used to quantify digital mobility in the real world by Mobilise-D, a consortium funded by the European Union (EU) as part of the Innovative Medicine Initiative, aiming at fostering regulatory approval and clinical adoption of DMOs.After defining the procedures for the metrological verification of an IMU-based device, the experimental procedures for the validation of algorithms used to calculate the DMOs are presented. These include laboratory and real-world assessment in 120 participants from five groups: healthy older adults; chronic obstructive pulmonary disease, Parkinson's disease, multiple sclerosis, proximal femoral fracture and congestive heart failure. DMOs extracted from the monitoring device will be compared with those from different reference systems, chosen according to the contexts of observation. Questionnaires and interviews will evaluate the users' perspective on the deployed technology and relevance of the mobility assessment.

ETHICS AND DISSEMINATION

The study has been granted ethics approval by the centre's committees (London-Bloomsbury Research Ethics committee; Helsinki Committee, Tel Aviv Sourasky Medical Centre; Medical Faculties of The University of Tübingen and of the University of Kiel). Data and algorithms will be made publicly available.

TRIAL REGISTRATION NUMBER

ISRCTN (12246987).

Fit for purpose? A cross-sectional study to evaluate the acceptability and usability of HeadUp, a novel neck support collar for neurological neck weakness

The HeadUp collar (previously known as the Sheffield Support Snood) provides support for neck weakness caused by amyotrophic lateral sclerosis (ALS) and has shown to be superior to alternative options in a small cohort of patients from one single center. Here we report the assessment of the HeadUp collar in a larger cohort of patients, exploring the use in other neurological conditions and expanding to other centers across the UK and Ireland. An interventional cross-sectional study design was implemented to investigate the usability and acceptability of the HeadUp collar. A total of 139 patients were recruited for the study, 117 patients had a diagnosis of ALS and 22 patients presented with neck weakness due to other neurological conditions. Participants were assessed at baseline, fitted a HeadUp collar and followed-up one month later. The performance of the HeadUp collar was rated favorably compared to previously worn collars in terms of the ability to eat, drink and swallow. Findings suggest that the collar also permitted a more acceptable range of head movements whilst maintaining a good level of support. We conclude that the HeadUp collar is a suitable option for patients with neck weakness due to ALS and other neurological conditions.

Cloud-Based Automated Clinical Decision Support System for Detection and Diagnosis of Lung Cancer in Chest CT

Lung cancer is a major cause for cancer-related deaths. The detection of pulmonary cancer in the early stages can highly increase survival rate. Manual delineation of lung nodules by radiologists is a tedious task. We developed a novel computer-aided decision support system for lung nodule detection based on a 3D Deep Convolutional Neural Network (3DDCNN) for assisting the radiologists. Our decision support system provides a second opinion to the radiologists in lung cancer diagnostic decision making. In order to leverage 3-dimensional information from Computed Tomography (CT) scans, we applied median intensity projection and multi-Region Proposal Network (mRPN) for automatic selection of potential region-of-interests. Our Computer Aided Diagnosis (CAD) system has been trained and validated using LUNA16, ANODE09, and LIDC-IDR datasets; the experiments demonstrate the superior performance of our system, attaining sensitivity, specificity, AUROC, accuracy, of 98.4%, 92%, 96% and 98.51% with 2.1 FPs per scan. We integrated cloud computing, trained and validated our Cloud-Based 3DDCNN on the datasets provided by Shanghai Sixth People's Hospital, as well as LUNA16, ANODE09, and LIDC-IDR. Our system outperformed the state-of-the-art systems and obtained an impressive 98.7% sensitivity at 1.97 FPs per scan. This shows the potentials of deep learning, in combination with cloud computing, for accurate and efficient lung nodule detection via CT imaging, which could help doctors and radiologists in treating lung cancer patients.

Mediating between AI and highly specialized users

We report part of the design experience gained in X-Media, a system for knowledge management and sharing. Consolidated techniques of interaction design (scenario-based design) had to be revisited to capture the richness and complexity of intelligent interactive systems. We show that the design of intelligent systems requires methodologies (faceted scenarios) that support the investigation of intelligent features and usability factors simultaneously. Interaction designers become mediators between intelligent technology and users, and have to facilitate reciprocal understanding.

Remote Web usability testing

Recently, various techniques for and approaches to extending usability testing beyond the traditional laboratories and technologies have emerged. Remote usability testing allows researchers to evaluate the usability of websites by gathering information from remote users. Several different approaches have been proposed, but they often require that the user perform particular installations or configurations. We introduce OpenWebSurvey, a software system for remote usability testing that can remotely record users' behavior while they surf the Internet and that requires no program installation or configuration.