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Exploring disparities of teleconsultation readiness: A comparative analysis of healthcare facilities in Indonesia

DIGITAL health 2024年 10卷

作者： Daniel Chriswinanto Adityo Nugroho Katherina Adisaputro Mitra Andini Sigilipoe Ida Ayu Triastuti Suryani Hutomo Ardhinta Bellano Septarda Aryososepti Yuwono Caraka Randi Yusuf Dedik Sulistiawan Balqis Gusbela Jason C Hsu Emily Chia-Yu Su Faculty of Medicine Universitas Kristen Duta Wacana Yogyakarta IndonesiaGraduate Institute of Biomedical Informatics College of Medical Science and Technology Taipei Medical University Taipei Faculty of Medicine Universitas Kristen Duta Wacana Yogyakarta Indonesia Faculty of Public Health Universitas Ahmad Dahlan Yogyakarta IndonesiaSchool of Public Health Taipei Medical University Taipei International PhD Program in Biotech and Healthcare Management College of Management Taipei Medical University Taipei International PhD Program in Biotech and Healthcare Management College of Management Taipei Medical University TaipeiClinical Data Center Office of Data Science Taipei Medical University TaipeiClinical Big Data Research Center Taipei Medical University Hospital TaipeiResearch Center of Health Care Industry Data Science College of Management Taipei Medical University Taipei Graduate Institute of Biomedical Informatics College of Medical Science and Technology Taipei Medical University TaipeiClinical Big Data Research Center Taipei Medical University Hospital TaipeiInstitute of Biomedical Informatics College of Medicine National Yang Ming Chiao Tung University Taipei

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An artificial intelligence method for vessel detection in images of cardiac catheterization

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informatics in Medicine Unlocked 2023年 39卷

作者： Chien, Ting-Ying Ting, Hsien-Wei Li, Hao-Wei Chang, Hsiao-Huang Department of Computer Science and Engineering Yuan Ze University 320 Taoyuan City Taiwan Graduate Program in Biomedical Informatics Yuan Ze University 320 Taoyuan City Taiwan Innovation Center for Big Data and Digital Convergence Yuan Ze University 320 Taoyuan City Taiwan Department of Neurosurgery Taipei Hospital Ministry of Health and Welfare 242 New Taipei City Taiwan Division of Cardiovascular Surgery Department of Surgery Taipei Veterans General Hospital Taipei 11217 Taiwan Department of Surgery School of Medicine College of Medicine Taipei Medical University Taipei 11031 Taiwan

Coronary artery disease (CAD) is one of the top ten leading causes of death in countries worldwide. There are several methods used by physicians to diagnose CAD. One common method is the use of X-ray angiogram (XRA) images. When employing a computer-aided automatic analysis method to locate blood vessels in XRA images, problems such as complex background noise, low contrast, and difficulty in separating blood vessels from the background are encountered, especially for blood vessels with a low contrast to the background noise. In this study, we used various image preprocessing methods to highlight blood vessels from complex backgrounds and different types of blood vessel, followed by the employment of four superpixel segmentation methods to partition an image into multiple segments, and finally the utilization of Weighted Voting to determine the best superpixel algorithm. A genetic algorithm was used to identify the best weights by which to determine the locations of blood vessels in images of cardiac catheterization. Our proposed method achieved an average F1-score of 73.4% in the analysis of five patients, which was better than the other superpixel algorithms tested. The results of this research will be helpful for future SYNTAX score analysis. © 2023

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Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

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The Lancet 2020年第10258期396卷 1204-1222页

作者： Abbafati, Cristiana Abbas, Kaja M. Abbasi, Mohammad Abbasifard, Mitra Abbasi-Kangevari, Mohsen Abbastabar, Hedayat Abd-Allah, Foad Abdelalim, Ahmed Abdollahi, Mohammad Abdollahpour, Ibrahim Abedi, Aidin Abedi, Parisa Abegaz, Kedir Hussein Abolhassani, Hassan Abosetugn, Akine Eshete Aboyans, Victor Abrams, Elissa M. Abreu, Lucas Guimarães Abrigo, Michael R.M. Abu Haimed, Abdulaziz Khalid Abualhasan, Ahmed Abu-Gharbieh, Eman Abu-Raddad, Laith Jamal Abushouk, Abdelrahman I. Acebedo, Alyssa Ackerman, Ilana N. Adabi, Maryam Adair, Tim Adamu, Abdu A. Adebayo, Oladimeji M. Adedeji, Isaac Akinkunmi Adekanmbi, Victor Adelson, Jaimie D. Adeoye, Abiodun Moshood Adetokunboh, Olatunji O. Adham, Davoud Advani, Shailesh M. Afarideh, Mohsen Afshari, Mahdi Afshin, Ashkan Agardh, Emilie E. Agarwal, Gina Agasthi, Pradyumna Agesa, Kareha M. Aghaali, Mohammad Aghamir, Seyed Mohammad Kazem Agrawal, Anurag Ahmad, Tauseef Ahmadi, Alireza Ahmadi, Keivan Ahmadi, Mehdi Ahmadieh, Hamid Ahmadpour, Ehsan Ahmed, Muktar Beshir Aji, Budi Akalu, Temesgen Yihunie Akinyemi, Rufus Olusola Akinyemiju, Tomi Akombi, Blessing Akunna, Chisom Joyqueenet Alahdab, Fares Al-Aly, Ziyad Alam, Khurshid Alam, Noore Alam, Samiah Alam, Tahiya Alanezi, Fahad Mashhour Alanzi, Turki M. Albertson, Samuel B. Alcalde-Rabanal, Jacqueline Elizabeth Alema, Niguse Meles Alemu, Biresaw Wassihun Alemu, Yihun Mulugeta Alhabib, Khalid F. Alhassan, Robert Kaba Ali, Muhammad Ali, Saqib Alicandro, Gianfranco Alijanzadeh, Mehran Alinia, Cyrus Alipour, Vahid Alizade, Hesam Aljunid, Syed Mohamed Alla, François Allebeck, Peter Almadi, Majid Abdulrahman Hamad Almasi, Ali Almasi-Hashiani, Amir Almasri, Nihad A. Al-Mekhlafi, Hesham M. Almulhim, Abdulaziz M. Alonso, Jordi Al-Raddadi, Rajaa M. Altirkawi, Khalid A. Alumran, Arwa Khalid Alvis-Guzman, Nelson Alvis-Zakzuk, Nelson J. Amare, Azmeraw T. Amare, Bekalu Amini, Saeed Amini-Rarani, Mostafa Aminorroaya, Arya Amiri, Fatemeh Amit, Arianna Maever L. Amugsi, Dickson A. Amul, Gianna Gayle Herrera Anbesu, Etsay Woldu Ancuceanu, Robert Anderl Department of Juridical and Economic Studies La Sapienza University Rome Italy Department of Infectious Disease Epidemiology London School of Hygiene and Tropical Medicine London United Kingdom Social Determinants of Health Research Center Tehran Iran Department of Neurology Cairo University Cairo Egypt School of Pharmacy Tehran Iran The Institute of Pharmaceutical Sciences (TIPS) Tehran Iran Neuroscience Research Center Isfahan University of Medical Sciences Isfahan Iran Biostatistics Department Near East University Nicosia Cyprus Biostatistics and Health Informatics Madda Walabu University Bale Robe Ethiopia Research Center for Immunodeficiencies Tehran Iran Karolinska University Hospital Huddinge Sweden Department of Cardiology Dupuytren University Hospital Limoges France University of Limoges Limoges France Department of Pediatric Dentistry Federal University of Minas Gerais Belo Horizonte Brazil Department of Research Philippine Institute for Development Studies Quezon City Philippines Department of Healthcare Policy and Research Weill Cornell Medical College in Qatar Doha Qatar Harvard Medical School Boston MA United States Department of Medicine Ain Shams University Cairo Egypt Hamadan University of Medical Sciences Hamadan Iran School of Medicine Cardiff University Cardiff United Kingdom School of Laboratory Medicine and Science University College Hospital Ibadan Ibadan Nigeria Institute of Cardiovascular Diseases University of Ibadan Ibadan Nigeria Centre of Excellence for Epidemiological Modelling and Analysis Stellenbosch University Cape Town South Africa Department of Global Health Stellenbosch University Cape Town South Africa School of Health Ardabil University of Medical Science Ardabil Iran Social Behavioral Research Branch National Institute of Health Bethesda MD United States Department of Oncology Georgetown University Washington DC DC United States Department of Health Metrics Sciences School of Medicine Seattle WA

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw value

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Hybrid Intelligent-Annotation Organ Segmentation on Medical datasets

Hybrid Intelligent-Annotation Organ Segmentation on Medical ...

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IEEE International Conference on Systems, Man and Cybernetics

作者： Tao Peng Jing Zhao Yidong Gu Gongye Di Lei Zhang Jing Cai School of Future Science and Engineering Soochow University Suzhou China Department of Radiation Oncology UT Southwestern Medical Center Dallas TX USA Department of Ultrasound Tsinghua University Affiliated Beijing Tsinghua Changgung Hospital Beijing China Department of Medical Ultrasound Suzhou Municipal Hospital The Affiliated Suzhou Hospital of Nanjing Medical University Suzhou Jiangsu China Department of Ultrasonic The Affiliated Taizhou People's Hospital of Nanjing Medical University Taizhou China Graduate Program of Medical Physics and Data Science Research Center Duke Kunshan University Kunshan Jiangsu China Department of Health Technology and Informatics The Hong Kong Polytechnic University Hong Kong China

Ultrasound image segmentation is crucial for early disease detection and treatment planning but remains a challenging task due to the low contrast of organ boundaries and varying image quality. Current methods often require manual intervention or have limited accuracy. In this paper, we propose a novel hybrid framework that combines an automatic option polygon segment (AOPS) algorithm and a distributed- and memory-based evolution (DME) algorithm for precise ultrasound organ segmentation. Our pipeline consists of two cascaded stages: (1) a coarse segmentation step using the AOPS algorithm, which determines the number of vertices/clusters without human intervention, and (2) a refinement step using the DME algorithm to hunt for the optimal neural network, which is then used to represent a smooth, explainable mathematical expression of the organ boundary. We employ the fractional backpropagation learning network with L2 regularization (FBLN) for training and use the scaled exponential linear unit (SELU) activation function to address the vanishing gradient problem. This is a new attempt such a hybrid framework is applied to ultrasound organ segmentation tasks, and it demonstrates significant contributions in terms of accuracy, smoothness, and computational efficiency.

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Contour Detection from Ultrasound Kidney Images with A Coarse-to-Fine Approach

Contour Detection from Ultrasound Kidney Images with A Coars...

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IEEE International Conference on Systems, Man and Cybernetics

作者： Tao Peng Yidong Gu Yanqing Xu Caishan Wang Lei Zhang Jing Cai School of Future Science and Engineering Soochow University Suzhou China Department of Radiation Oncology UT Southwestern Medical Center Dallas TX USA Department of Medical Ultrasound the Affiliated Suzhou Hospital of Nanjing Medical University Suzhou Municipal Hospital Suzhou Jiangsu China McDermott Center for Human Growth and Development University of Texas Southwestern Medical Center Dallas Texas USA Department of Ultrasound the Second Affiliated Hospital of Soochow University Suzhou China Graduate Program of Medical Physics and Data Science Research Center Duke Kunshan University Kunshan Jiangsu China Department of Health Technology and Informatics The Hong Kong Polytechnic University Hong Kong China

Ultrasound kidney image segmentation presents significant challenges due to missing or ambiguous boundaries. In this study, we introduce a coarse-to-refinement approach incorporating four novel aspects. Firstly, we leverage the properties of a principal curve (PC) to automatically fine-tune the curve shape and employ a neural network's learning ability to reduce model error. Secondly, a deep fusion learning network is utilized for the coarse segmentation step, incorporating a parallel architecture to enhance deep-learning performance. Thirdly, addressing the limitation of standard PC-based methods in determining the number of vertices automatically, we propose an automatic searching polygon tracking method using a mean shift clustering-based approach to replace the projection and vertex extension step in standard PC-based methods. Lastly, we develop an explainable mathematical map function for the kidney contour, as denoted by the neural network output (i.e., optimized vertices), which aligns well with the ground truth contour. We conducted various experiments to evaluate our method's performance, demonstrating its effectiveness in ultrasound kidney image segmentation.

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AI-based Anomaly Detection for Clinical-Grade Histopathological Diagnostics

arXiv

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arXiv 2024年

作者： Dippel, Jonas Prenißl, Niklas Hense, Julius Liznerski, Philipp Winterhoff, Tobias Schallenberg, Simon Kloft, Marius Buchstab, Oliver Horst, David Alber, Maximilian Ruff, Lukas Müller, Klaus-Robert Klauschen, Frederick Machine Learning Group Technische Universität Berlin Berlin Germany BIFOLD – Berlin Institute for the Foundations of Learning and Data Berlin Germany Institute of Pathology Charité – Universitätsmedizin Berlin Berlin Germany Berlin Institute of Health Charité – Universitätsmedizin Berlin BIH Biomedical Innovation Academy BIH Charité Junior Digital Clinician Scientist Program Charitéplatz 1 Berlin10117 Germany RPTU Kaiserslautern Germany Aignostics GmbH Berlin Germany Institute of Pathology Ludwig-Maximilians-Universität Munich Germany Munich Partner Site Germany Department of Artificial Intelligence Korea University Seoul Korea Republic of Max-Planck Institute for Informatics Saarbrücken Germany

While previous studies have demonstrated the potential of AI to diagnose diseases in imaging data, clinical implementation is still lagging behind. This is partly because AI models require training with large numbers of examples only available for common diseases. In clinical reality, however, only few diseases are common, whereas the majority of diseases are less frequent (long-tail distribution). Current AI models overlook or misclassify these diseases. We propose a deep anomaly detection approach that only requires training data from common diseases to detect also all less frequent diseases. We collected two large real-world datasets of gastrointestinal biopsies, which are prototypical of the problem. Herein, the ten most common findings account for approximately 90% of cases, whereas the remaining 10% contained 56 disease entities, including many cancers. 17 million histological images from 5,423 cases were used for training and evaluation. Without any specific training for the diseases, our best-performing model reliably detected a broad spectrum of infrequent ("anomalous") pathologies with 95.0% (stomach) and 91.0% (colon) AUROC and generalized across scanners and hospitals. By design, the proposed anomaly detection can be expected to detect any pathological alteration in the diagnostic tail of gastrointestinal biopsies, including rare primary or metastatic cancers. This study establishes the first effective clinical application of AI-based anomaly detection in histopathology that can flag anomalous cases, facilitate case prioritization, reduce missed diagnoses and enhance the general safety of AI models, thereby driving AI adoption and automation in routine diagnostics and beyond. © 2024, CC BY-NC-ND.

关键词： Diseases

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Language Enhanced Model for Eye (LEME): An Open-Source Ophthalmology-Specific Large Language Model

arXiv

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arXiv 2024年

作者： Gilson, Aidan Ai, Xuguang Xie, Qianqian Srinivasan, Sahana Pushpanathan, Krithi Singer, Maxwell B. Huang, Jimin Kim, Hyunjae Long, Erping Wan, Peixing Del Priore, Luciano V. Ohno-Machado, Lucila Xu, Hua Liu, Dianbo Adelman, Ron A. Tham, Yih-Chung Chen, Qingyu Department of Ophthalmology Massachusetts Eye and Ear Harvard Medical School BostonMA United States Department of Biomedical Informatics and Data Science Yale School of Medicine Yale University New Haven United States Singapore Eye Research Institute Singapore National Eye Centre Singapore Centre for Innovation and Precision Eye Health Department of Ophthalmology Yong Loo Lin School of Medicine National University of Singapore Singapore Department of Ophthalmology and Visual Science Yale School of Medicine Yale University New Haven United States Department of Computer Science Korea University 145 Anam-ro Seongbuk-gu Seoul02841 Korea Republic of Division of Cancer Epidemiology and Genetics National Cancer Institute National Institutes of Health BethesdaMD United States Center for Cancer Research National Cancer Institute National Institutes of Health BethesdaMD United States Ophthalmology and Visual Science Academic Clinical Program Duke-NUS Medical School Singapore Singapore

Large Language Models (LLMs) are poised to revolutionize healthcare. Ophthalmology-specific LLMs remain scarce and underexplored. We introduced an open-source, specialized LLM for ophthalmology, termed Language Enhanced Model for Eye (LEME). LEME was initially pre-trained on the Llama2 70B framework and further fine-tuned with a corpus of ~127,000 non-copyrighted training instances curated from ophthalmology-specific case reports, abstracts, and open-source study materials. We benchmarked LEME against eight other LLMs, namely, GPT-3.5, GPT-4, three Llama2 models (7B, 13B, 70B), PMC-LLAMA 13B, Meditron 70B, and EYE-Llama (another ophthalmology-specific LLM). Evaluations included four internal validation tasks: abstract completion, fill-in-the-blank, multiple-choice questions (MCQ), and short-answer QA. External validation tasks encompassed long-form QA, MCQ, patient EHR summarization, and clinical QA. Evaluation metrics included Rouge-L scores, accuracy, and expert evaluation of correctness, completeness, and readability. In internal validations, LEME consistently outperformed its counterparts, achieving Rouge-L scores of 0.20 ± 0.03 in abstract completion (all p © 2024, CC BY.

关键词： Ophthalmology

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AI-based Automatic Segmentation of Prostate on Multi-modality Images: A Review

arXiv

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arXiv 2024年

作者： Jin, Rui Li, Derun Xiang, Dehui Zhang, Lei Zhou, Hailing Shi, Fei Zhu, Weifang Cai, Jing Peng, Tao Chen, Xinjian School of Future Science and Engineering Soochow University Suzhou China Department of Urology Peking University First Hospital Xicheng District Beijing100034 China MIPAV Lab The School of Electronic and Information Engineering Soochow University Jiangsu China Graduate Program of Medical Physics and Data Science Research Center Duke Kunshan University Jiangsu Kunshan215316 China Department of Mechanical Engineering and Product Design Engineering Swinburne University of Technology Melbourne Australia Department of Health Technology and Informatics The Hong Kong Polytechnic University Hong Kong Department of Radiation Oncology UT Southwestern Medical Center DallasTX United States The State Key Laboratory of Radiation Medicine and Protection Soochow University Jiangsu China

Prostate cancer represents a major threat to health. Early detection is vital in reducing the mortality rate among prostate cancer patients. One approach involves using multi-modality (CT, MRI, US, etc.) computer-aided diagnosis (CAD) systems for the prostate region. However, prostate segmentation is challenging due to imperfections in the images and the prostate’s complex tissue structure. The advent of precision medicine and a significant increase in clinical capacity have spurred the need for various data-driven tasks in the field of medical imaging. Recently, numerous machine learning and data mining tools have been integrated into various medical areas, including image segmentation. This article proposes a new classification method that differentiates supervision types, either in number or kind, during the training phase. Subsequently, we conducted a survey on artificial intelligence (AI)-based automatic prostate segmentation methods, examining the advantages and limitations of each. Additionally, we introduce variants of evaluation metrics for the verification and performance assessment of the segmentation method and summarize the current challenges. Finally, future research directions and development trends are discussed, reflecting the outcomes of our literature survey, suggesting high-precision detection and treatment of prostate cancer as a promising avenue. Impact Statement — Prostate cancer remains a significant health threat, necessitating early detection to reduce mortality rates. Current diagnostic approaches, particularly in medical imaging, face challenges in accurate prostate segmentation due to the organ's complex structure and imaging imperfections. Our review paper delves into AI-based automatic segmentation methods across various imaging modalities (CT, MRI, US), emphasizing their strengths, weaknesses, and the specific challenges they address. By classifying segmentation techniques based on supervision levels, we provide a comprehensive analys

关键词： Computer aided diagnosis

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Assessing the Potential of GPT-4 to Annotate Medical Notes Across Different Languages and Countries: A Model Evaluation Study

SSRN

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SSRN 2024年

作者： Saad Menezes, Maria Clara Hoffman, Alexander F. Tan, Amelia L.M. Nalbandyan, Mariné Omenn, Gilbert S. Mazzotti, Diego R. Hernández-Arango, Alejandro Visweswaran, Shyam Venkatesh, Shruthi Mandl, Kenneth D. Bourgeois, Florence T. Lee, James W.K. Makmur, Andrew Hanauer, David A. Semanik, Michael G. Kerivan, Lauren T. Hill, Terra Forero, Julian Restrepo Castro, Carlos Andrés C.R. Vigna, Matteo Ceriana, Piero Abu-El-rub, Noor Avillach, Paul Bellazzi, Riccardo Callaci, Thomas Gutiérrez-Sacristán, Alba Malovini, Alberto Mathew, Jomol P. Morris, Michele Murthy, Venkatesh Parimbelli, Enea Patel, Lav P. Sáez, Carlos Samayamuthu, Malarkodi Jebathilagam Thompson, Jeffrey A. Tibollo, Valentina Xia, Zongqi Kohane, Isaac S. Harvard Medical School Department of Biomedical Informatics 10 Shattuck Street BostonMA02115 United States School of Medicine and Public Health University of Wisconsin-Madison Office of Informatics and Information Technology 750 Highland Ave MadisonWI53705 United States University of Michigan Department of Computational Medicine & Bioinformatics Internal Medicine Human Genetics Environmental Health 100 Washtenaw Avenue Ann ArborMI48109 United States University of Kansas Medical Center Division of Medical Informatics Division of Pulmonary Critical Care and Sleep Medicine Department of Internal Medicine 3901 Rainbow Blvd Kansas CityKS66160 United States University of Antioquia Hospital Alma Máter de Antioquia Department of Internal Medicine Calle 64 N°51 D - 154 Medellín Colombia University of Pittsburgh Department of Biomedical Informatics 5607 Baum Blvd PittsburghPA15206 United States University of Pittsburgh Department of Neurology 3501 5th Avenue PittsburghPA15206 United States Boston Children's Hospital Computational Health Informatics Program 300 Longwood Avenue BostonMA02115 United States Boston Children's Hospital Department of Pediatrics 300 Longwood Avenue BostonMA02115 United States National University Health System Department of Surgery 1E Kent Ridge Rd Singapore119228 Singapore National University Health System Department of Diagnostic Imaging 1E Kent Ridge Rd Singapore119228 Singapore University of Michigan Department of Learning Health Sciences NCRC 100 2800 Plymouth Road Ann ArborMI48109 United States University of Kansas Medical Center Department of Surgery 3901 Rainbow Blvd Kansas CityKS66160 United States Istituti Clinici Scientifici Maugeri IRCCS Respiratory rehabilitation unit Via Maugeri 10 Pavia27100 Italy University of Kansas Medical Center 3901 Rainbow Blvd Kansas CityKS66160 United States University of Pavia Department of Electrical Computer and Biomedical Engineering via Ferrata 5 Pavia2710

Background: Physicians invest hours creating patient notes, which are rich in information but difficult for computers to analyze due to their unstructured format. GPT-4 reshaped our ability to process text, yet it is unknown how well this model can handle medical notes. This project aims to compare GPT-4’s ability to annotate medical notes against experienced physicians across three different languages at multiple institutions and countries. Methods: This study included eight sites from four countries - the United States, Colombia, Singapore, and Italy. Each site contributed seven de-identified notes (admission, progress, or consult) from hospitalized patients. GPT-4 assessed each note by answering 14 questions, including demographic information, clinical judgments, data quality, and patients’ eligibility for a hypothetical study enrollment. For validation, two physicians from each site independently evaluated GPT-4's responses. Findings: Overall, 56 medical notes, written in English, Italian, and Spanish, were analyzed. A total of 784 responses from GPT-4 were generated. Both physicians agreed with GPT-4’s response 79% of the time (622/784, 95%CI 76-82%). Only one of the two physicians agreed with GPT-4’s response 10% of the time (82/784, 95%CI 8-13%). Neither physician agreed with GPT-4’s response 10% of the time (80/784, 95%CI 8-13%). Both physicians agreed with GPT-4 more often in notes written in Spanish and Italian than in English, with agreement rates of 88% (86/98, 95%CI 79-93%), 84% (82/98, 95%CI 75-90%), and 77% (454/588, 95%CI 74-80%), respectively. Hallucinations were rare (10/784, 95%CI 0-2%). GPT-4 correctly selected patients for a hypothetical study enrollment based on three criteria 90% of the time (95%CI 81-98%). Interpretation: The findings indicate that GPT-4 annotations demonstrated a high agreement rate with physicians across all languages. We also demonstrate GPT-4's potential to assist in patient selection for studies. Funding: None. Declarati

关键词： Medical computing

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Weakly Supervised AI for Efficient Analysis of 3D Pathology Samples

arXiv

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arXiv 2023年

作者： Song, Andrew H. Williams, Mane Williamson, Drew F.K. Jaume, Guillaume Zhang, Andrew Chen, Bowen Serafin, Robert Liu, Jonathan T.C. Baras, Alex Parwani, Anil V. Mahmood, Faisal Department of Pathology Brigham and Women’s Hospital Harvard Medical School BostonMA United States Department of Pathology Massachusetts General Hospital Harvard Medical School BostonMA United States Cancer Program Broad Institute of Harvard and MIT CambridgeMA United States Data Science Program Dana-Farber Cancer Institute BostonMA United States Department of Biomedical Informatics Harvard Medical School BostonMA United States Harvard-MIT Division of Health Sciences and Technology Massachusetts Institute of Technology CambridgeMA United States Department of Mechanical Engineering Bioengineering Laboratory Medicine & Pathology University of Washington SeattleWA United States Department of Pathology Johns Hopkins Hospital BaltimoreMD United States Department of Biomedical Engineering Johns Hopkins Hospital BaltimoreMD United States Department of Pathology The Ohio State University ColumbusOH United States

Human tissue consists of complex structures that display a diversity of morphologies, forming a tissue microenvironment that is, by nature, three-dimensional (3D). However, the current standard-of-care involves slicing 3D tissue specimens into two-dimensional (2D) sections and selecting a few for microscopic evaluation1,2, with concomitant risks of sampling bias and misdiagnosis3–6. To this end, there have been intense efforts to capture 3D tissue morphology and transition to 3D pathology, with the development of multiple high-resolution 3D imaging modalities7–18. However, these tools have had little translation to clinical practice as manual evaluation of such large data by pathologists is impractical and there is a lack of computational platforms that can efficiently process the 3D images and provide patient-level clinical insights. Here we present Modality-Agnostic Multiple instance learning for volumetric Block Analysis (MAMBA), a deep-learning-based platform for processing 3D tissue images from diverse imaging modalities and predicting patient outcomes. Archived prostate cancer specimens were imaged with open-top light-sheet microscopy12–14 or microcomputed tomography15,16 and the resulting 3D datasets were used to train risk-stratification networks based on 5-year biochemical recurrence outcomes via MAMBA. With the 3D block-based approach, MAMBA achieves an area under the receiver operating characteristic curve (AUC) of 0.86 and 0.74, superior to 2D traditional single-slice-based prognostication (AUC of 0.79 and 0.57), suggesting superior prognostication with 3D morphological features. Further analyses reveal that the incorporation of greater tissue volume improves prognostic performance and mitigates risk prediction variability from sampling bias, suggesting that there is value in capturing larger extents of spatially heterogeneous 3D morphology. With the rapid growth and adoption of 3D spatial biology and pathology techniques by researchers and clinicians, M

关键词： Pathology

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