Application of Artificial Intelligence to Gastroenterology and Hepatology

Background 
Deep learning (DL) based solutions have been proposed for interpretation of several imaging modalities including radiography, CT, and MR. For chest radiographs, DL algorithms have found success in the evaluation of abnormalities such as lung nodules, pulmonary tuberculosis, cystic fibrosis, pneumoconiosis, and location of peripherally inserted central catheters. Chest radiography represents the most commonly performed radiological test for a multitude of non-emergent and emergent clinical indications. This study aims to assess accuracy of deep learning (DL) algorithm for detection of abnormalities on routine frontal chest radiographs (CXR), and assessment of stability or change in findings over serial radiographs.


Methods and findings 
We processed 874 de-identified frontal CXR from 724 adult patients (> 18 years) with DL (Qure AI). Scores and prediction statistics from DL were generated and recorded for the presence of pulmonary opacities, pleural effusions, hilar prominence, and enlarged cardiac silhouette. To establish a standard of reference (SOR), two thoracic radiologists assessed all CXR for these abnormalities. Four other radiologists (test radiologists), unaware of SOR and DL findings, independently assessed the presence of radiographic abnormalities. A total 724 radiographs were assessed for detection of findings. A subset of 150 radiographs with follow up examinations was used to asses change over time. Data were analyzed with receiver operating characteristics analyses and post-hoc power analysis.


Results 
About 42% (305/ 724) CXR had no findings according to SOR; single and multiple abnormalities were seen in 23% (168/724) and 35% (251/724) of CXR. There was no statistical difference between DL and SOR for all abnormalities (p = 0.2–0.8). The area under the curve (AUC) for DL and test radiologists ranged between 0.837–0.929 and 0.693–0.923, respectively. DL had lowest AUC (0.758) for assessing changes in pulmonary opacities over follow up CXR. Presence of chest wall implanted devices negatively affected the accuracy of DL algorithm for evaluation of pulmonary and hilar abnormalities.


Conclusions 
DL algorithm can aid in interpretation of CXR findings and their stability over follow up CXR. However, in its present version, it is unlikely to replace radiologists due to its limited specificity for categorizing specific findings.

/pdf/deep-learning-in-chest-radiography-detection-of-findings-and-4sssgoe8eu.pdf

Deep learning in chest radiography: Detection of findings and presence of change.

The diagnosis of diseases is decisive for planning proper treatment and ensuring the well-being of patients. Human error hinders accurate diagnostics, as interpreting medical information is a complex and cognitively challenging task. The application of artificial intelligence (AI) can improve the level of diagnostic accuracy and efficiency. While the current literature has examined various approaches to diagnosing various diseases, an overview of fields in which AI has been applied, including their performance aiming to identify emergent digitalized healthcare services, has not yet been adequately realized in extant research. By conducting a critical review, we portray the AI landscape in diagnostics and provide a snapshot to guide future research. This paper extends academia by proposing a research agenda. Practitioners understand the extent to which AI improves diagnostics and how healthcare benefits from it. However, several issues need to be addressed before successful application of AI in disease diagnostics can be achieved.

/pdf/artificial-intelligence-in-disease-diagnostics-a-critical-3ywhftiw61.pdf

Artificial intelligence in disease diagnostics: A critical review and classification on the current state of research guiding future direction

Energy efficiency has aroused great interest in research worldwide, because energy consumption has increased in recent years, especially in the residential sector. The advances in energy conversion, along with new forms of communication, and information technologies have paved the way for what is now known as smart homes. The Internet of Things (IoT) is the convergence of various heterogeneous technologies from different application domains that are used to interconnect things through the Internet, thus allowing for the detection, monitoring, and remote control of multiple devices. Home automation systems (HAS) combined with IoT, big data technologies, and machine learning are alternatives that promise to contribute to greater energy efficiency. This work presents HEMS-IoT, a big data and machine learning-based smart home energy management system for home comfort, safety, and energy saving. We used the J48 machine learning algorithm and Weka API to learn user behaviors and energy consumption patterns and classify houses with respect to energy consumption. Likewise, we relied on RuleML and Apache Mahout to generate energy-saving recommendations based on user preferences to preserve smart home comfort and safety. To validate our system, we present a case study where we monitor a smart home to ensure comfort and safety and reduce energy consumption.

HEMS-IoT: A Big Data and Machine Learning-Based Smart Home System for Energy Saving

Objectives To investigate the potential of deep learning in assessing pneumoconiosis depicted on digital chest radiographs and to compare its performance with certified radiologists. Methods We retrospectively collected a dataset consisting of 1881 chest X-ray images in the form of digital radiography. These images were acquired in a screening setting on subjects who had a history of working in an environment that exposed them to harmful dust. Among these subjects, 923 were diagnosed with pneumoconiosis, and 958 were normal. To identify the subjects with pneumoconiosis, we applied a classical deep convolutional neural network (CNN) called Inception-V3 to these image sets and validated the classification performance of the trained models using the area under the receiver operating characteristic curve (AUC). In addition, we asked two certified radiologists to independently interpret the images in the testing dataset and compared their performance with the computerised scheme. Results The Inception-V3 CNN architecture, which was trained on the combination of the three image sets, achieved an AUC of 0.878 (95% CI 0.811 to 0.946). The performance of the two radiologists in terms of AUC was 0.668 (95% CI 0.555 to 0.782) and 0.772 (95% CI 0.677 to 0.866), respectively. The agreement between the two readers was moderate (kappa: 0.423, p Conclusion Our experimental results demonstrated that the deep leaning solution could achieve a relatively better performance in classification as compared with other models and the certified radiologists, suggesting the feasibility of deep learning techniques in screening pneumoconiosis.

https://oem.bmj.com/content/oemed/early/2020/05/28/oemed-2019-106386.full.pdf

Potential of deep learning in assessing pneumoconiosis depicted on digital chest radiography

To diagnose pneumoconiosis using a computer-aided diagnosis system based on digital chest radiographs. Lung fields were first extracted by combining the traditional Otsu-threshold method with a morphological reconstruction on digital radiographs (DRs), and then subdivided into six non-overlapping regions (region (a-f)). Twenty-two wavelet-based energy texture features were calculated exclusively from each region and selected using a decision tree algorithm. A support vector machine (SVM) with a linear kernel was trained using samples with texture features to classify an individual region of a healthy subject or a pneumoconiosis patient. The final classification results were obtained by integrating these individual classifiers with the weighted voting method. All models were developed on a dataset of 85 healthy controls and 40 stage I or II pneumoconiosis patients and validated by using the bootstrap resampling with replacement method. The areas under receiver operating characteristic curves (AUCs) of regions (c) and (f) were 0.688 and 0.563, which were worse than those of the other four regions. Region (c) and (f) were both excluded from the individual classifiers that were going to be assembled further. When built on the selected texture features, each individual SVM showed a higher diagnostic performance for the training set and the test set. The classification performance after an ensemble was 0.997 and 0.961 of the AUC value for the training and test sets, respectively. The final results were 0.974 ± 0.018 for AUC value and 0.929 ± 0.018 for accuracy. The integrated SVM model built on the selected feature set showed the highest diagnostic performance among all individual SVM models. The model has good potential in diagnosing pneumoconiosis based on digital chest radiographs.

/pdf/the-development-and-evaluation-of-a-computerized-diagnosis-12gm7ut8zs.pdf

The development and evaluation of a computerized diagnosis scheme for pneumoconiosis on digital chest radiographs

Background Artificial neural network (ANN) has demonstrated the ability to assimilate information from multiple sources to enable the detection of subtle and complex patterns. In this research, we evaluated an ANN model in the diagnosis of pancreatic cancer using multiple serum markers. Methods In this retrospective analysis, 913 serum specimens collected at the Department of General Surgery of Beijing Friendship Hospital were analyzed for carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 125 (CA125), and carcinoembryonic antigen (CEA). The three tumor marker values were used as inputs into an ANN and randomized into a training set of 658 (70.31% were malignant) and a test set of the remaining 255 samples (70.69% were malignant). The samples were also evaluated using a Logistic regression (LR) model. Results The ANN-derived composite index was superior to each of the serum tumor markers alone and the Logistic regression model. The areas under receiver operating characteristic curves (AUROC) was 0.905 (95% confidence Interval (CI) 0.868-0.942) for ANN, 0.812 (95% CI 0.762-0.863) for the Logistic regression model, 0.845 (95% CI 0.798-0.893) for CA19-9, 0.795 (95% CI 0.738-0.851) for CA125, and 0.800 (95% CI 0.746-0.854) for CEA. ANN analysis of multiple markers yielded a high level of diagnostic accuracy (83.53%) compared to LR (74.90%). Conclusion The performance of ANN model in the diagnosis of pancreatic cancer is better than the single tumor marker and LR model.

Diagnosis of pancreatic carcinoma based on combined measurement of multiple serum tumor markers using artificial neural network analysis.

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The development and evaluation of a computerized diagnosis scheme for pneumoconiosis on digital chest radiographs

Diagnosis of pancreatic carcinoma based on combined measurement of multiple serum tumor markers using artificial neural network analysis.