Your evidence? Machine learning algorithms for medical diagnosis and prediction

The power of many brains: Catalyzing neuropsychiatric discovery through open neuroimaging data and large-scale collaboration

Recent advances in open neuroimaging data are enhancing our comprehension of neuropsychiatric disorders. By pooling images from various cohorts, statistical power has increased, enabling the detection of subtle abnormalities and robust associations, and fostering new research methods. Global collaborations in imaging have furthered our knowledge of the neurobiological foundations of brain disorders and aided in imaging-based prediction for more targeted treatment. Large-scale magnetic resonance imaging initiatives are driving innovation in analytics and supporting generalizable psychiatric studies. We also emphasize the significant role of big data in understanding neural mechanisms and in the early identification and precise treatment of neuropsychiatric disorders. However, challenges such as data harmonization across different sites, privacy protection, and effective data sharing must be addressed. With proper governance and open science practices, we conclude with a projection of how large-scale imaging resources and collaborations could revolutionize diagnosis, treatment selection, and outcome prediction, contributing to optimal brain health.

[Quality indicators artificial intelligence]

The ability of some artificial intelligence (AI) systems to autonomously evolve and the sometimes very limited possibilities to comprehend their decision-making processes present new challenges to our legal system. At a European level this has led to reform efforts, of which the proposal for a European AI regulation promises to close regulatory gaps in existing product safety law through cross-sectoral AI-specific safety requirements. A prerequisite, however, would be that the EU legislator does not only avoid duplications and contradictions with existing safety requirements but also refrains from imposing exaggerated and unattainable demands. If this were to be taken into consideration, the new safety requirements could also be used to specify the undefined standard of care in liability law. Nevertheless, challenges in the context of provability continue to remain unresolved, posing a risk of rendering the legal protection efforts of the aggrieved party ineffective. It remains to be seen whether the EU legislator will address this need for reform with the recently proposed reform of product liability law by the Commission.

Trust and stakeholder perspectives on the implementation of AI tools in clinical radiology

OBJECTIVES

To define requirements that condition trust in artificial intelligence (AI) as clinical decision support in radiology from the perspective of various stakeholders and to explore ways to fulfil these requirements.

METHODS

Semi-structured interviews were conducted with twenty-five respondents-nineteen directly involved in the development, implementation, or use of AI applications in radiology and six working with AI in other areas of healthcare. We designed the questions to explore three themes: development and use of AI, professional decision-making, and management and organizational procedures connected to AI. The transcribed interviews were analysed in an iterative coding process from open coding to theoretically informed thematic coding.

RESULTS

We identified four aspects of trust that relate to reliability, transparency, quality verification, and inter-organizational compatibility. These aspects fall under the categories of substantial and procedural requirements.

CONCLUSIONS

Development of appropriate levels of trust in AI in healthcare is complex and encompasses multiple dimensions of requirements. Various stakeholders will have to be involved in developing AI solutions for healthcare and radiology to fulfil these requirements.

CLINICAL RELEVANCE STATEMENT

For AI to achieve advances in radiology, it must be given the opportunity to support, rather than replace, human expertise. Support requires trust. Identification of aspects and conditions for trust allows developing AI implementation strategies that facilitate advancing the field.

KEY POINTS

• Dimensions of procedural and substantial demands that need to be fulfilled to foster appropriate levels of trust in AI in healthcare are conditioned on aspects related to reliability, transparency, quality verification, and inter-organizational compatibility. •Creating the conditions for trust to emerge requires the involvement of various stakeholders, who will have to compensate the problem's inherent complexity by finding and promoting well-defined solutions.

A Siamese Network With Node Convolution for Individualized Predictions Based on Connectivity Maps Extracted From Resting-State fMRI Data

Deep learning has demonstrated great potential for objective diagnosis of neuropsychiatric disorders based on neuroimaging data, which includes the promising resting-state functional magnetic resonance imaging (RS-fMRI). However, the insufficient sample size has long been a bottleneck for deep model training for the purpose. In this study, we proposed a Siamese network with node convolution (SNNC) for individualized predictions based on RS-fMRI data. With the involvement of Siamese network, which uses sample pair (rather than a single sample) as input, the problem of insufficient sample size can largely be alleviated. To adapt to connectivity maps extracted from RS-fMRI data, we applied node convolution to each of the two branches of the Siamese network. For regression purposes, we replaced the contrastive loss in classic Siamese network with the mean square error loss and thus enabled Siamese network to quantitatively predict label differences. The label of a test sample can be predicted based on any of the training samples, by adding the label of the training sample to the predicted label difference between them. The final prediction for a test sample in this study was made by averaging the predictions based on each of the training samples. The performance of the proposed SNNC was evaluated with age and IQ predictions based on a public dataset (Cam-CAN). The results indicated that SNNC can make effective predictions even with a sample size of as small as 40, and SNNC achieved state-of-the-art accuracy among a variety of deep models and standard machine learning approaches.

Sex-related patterns in the electroencephalogram and their relevance in machine learning classifiers

Deep learning is increasingly being proposed for detecting neurological and psychiatric diseases from electroencephalogram (EEG) data but the method is prone to inadvertently incorporate biases from training data and exploit illegitimate patterns. The recent demonstration that deep learning can detect the sex from EEG implies potential sex-related biases in deep learning-based disease detectors for the many diseases with unequal prevalence between males and females. In this work, we present the male- and female-typical patterns used by a convolutional neural network that detects the sex from clinical EEG (81% accuracy in a separate test set with 142 patients). We considered neural sources, anatomical differences, and non-neural artifacts as sources of differences in the EEG curves. Using EEGs from 1140 patients, we found electrocardiac artifacts to be leaking into the supposedly brain activity-based classifiers. Nevertheless, the sex remained detectable after rejecting heart-related and other artifacts. In the cleaned data, EEG topographies were critical to detect the sex, but waveforms and frequencies were not. None of the traditional frequency bands was particularly important for sex detection. We were able to determine the sex even from EEGs with shuffled time points and therewith completely destroyed waveforms. Researchers should consider neural and non-neural sources as potential origins of sex differences in their data, they should maintain best practices of artifact rejection, even when datasets are large, and they should test their classifiers for sex biases.

Computational modelling in disorders of consciousness: Closing the gap towards personalised models for restoring consciousness

Disorders of consciousness are complex conditions characterised by persistent loss of responsiveness due to brain injury. They present diagnostic challenges and limited options for treatment, and highlight the urgent need for a more thorough understanding of how human consciousness arises from coordinated neural activity. The increasing availability of multimodal neuroimaging data has given rise to a wide range of clinically- and scientifically-motivated modelling efforts, seeking to improve data-driven stratification of patients, to identify causal mechanisms for patient pathophysiology and loss of consciousness more broadly, and to develop simulations as a means of testing in silico potential treatment avenues to restore consciousness. As a dedicated Working Group of clinicians and neuroscientists of the international Curing Coma Campaign, here we provide our framework and vision to understand the diverse statistical and generative computational modelling approaches that are being employed in this fast-growing field. We identify the gaps that exist between the current state-of-the-art in statistical and biophysical computational modelling in human neuroscience, and the aspirational goal of a mature field of modelling disorders of consciousness; which might drive improved treatments and outcomes in the clinic. Finally, we make several recommendations for how the field as a whole can work together to address these challenges.

Hammer or Measuring Tape? Artificial Intelligence and Justice in Healthcare

Artificial intelligence (AI) is a powerful tool for several healthcare tasks. AI tools are suited to optimize predictive models in medicine. Ethical debates about AI's extension of the predictive power of medical models suggest a need to adapt core principles of medical ethics. This article demonstrates that a popular interpretation of the principle of justice in healthcare needs amendment given the effect of AI on decision-making. The procedural approach to justice, exemplified with Norman Daniels and James Sabin's accountability for reasonableness conception, needs amendment because, as research into algorithmic fairness shows, it is insufficiently sensitive to differential effects of seemingly just principles on different groups of people. The same line of research generates methods to quantify differential effects and make them amenable for correction. Thus, what is needed to improve the principle of justice is a combination of procedures for selecting just criteria and principles and the use of algorithmic tools to measure the real impact these criteria and principles have. In this article, the author shows that algorithmic tools do not merely raise issues of justice but can also be used in their mitigation by informing us about the real effects certain distributional principles and criteria would create.

Application of artificial intelligence for overall survival risk stratification in oropharyngeal carcinoma: A validation of ProgTOOL

BACKGROUND

In recent years, there has been a surge in machine learning-based models for diagnosis and prognostication of outcomes in oncology. However, there are concerns relating to the model's reproducibility and generalizability to a separate patient cohort (i.e., external validation).

OBJECTIVES

This study primarily provides a validation study for a recently introduced and publicly available machine learning (ML) web-based prognostic tool (ProgTOOL) for overall survival risk stratification of oropharyngeal squamous cell carcinoma (OPSCC). Additionally, we reviewed the published studies that have utilized ML for outcome prognostication in OPSCC to examine how many of these models were externally validated, type of external validation, characteristics of the external dataset, and diagnostic performance characteristics on the internal validation (IV) and external validation (EV) datasets were extracted and compared.

METHODS

We used a total of 163 OPSCC patients obtained from the Helsinki University Hospital to externally validate the ProgTOOL for generalizability. In addition, PubMed, OvidMedline, Scopus, and Web of Science databases were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

RESULTS

The ProgTOOL produced a predictive performance of 86.5% balanced accuracy, Mathew's correlation coefficient of 0.78, Net Benefit (0.7) and Brier score (0.06) for overall survival stratification of OPSCC patients as either low-chance or high-chance. In addition, out of a total of 31 studies found to have used ML for the prognostication of outcomes in OPSCC, only seven (22.6%) reported a form of EV. Three studies (42.9%) each used either temporal EV or geographical EV while only one study (14.2%) used expert as a form of EV. Most of the studies reported a reduction in performance when externally validated.

CONCLUSION

The performance of the model in this validation study indicates that it may be generalized, therefore, bringing recommendations of the model for clinical evaluation closer to reality. However, the number of externally validated ML-based models for OPSCC is still relatively small. This significantly limits the transfer of these models for clinical evaluation and subsequently reduces the likelihood of the use of these models in daily clinical practice. As a gold standard, we recommend the use of geographical EV and validation studies to reveal biases and overfitting of these models. These recommendations are poised to facilitate the implementation of these models in clinical practice.

A Current Review of Machine Learning and Deep Learning Models in Oral Cancer Diagnosis: Recent Technologies, Open Challenges, and Future Research Directions

Cancer is a problematic global health issue with an extremely high fatality rate throughout the world. The application of various machine learning techniques that have appeared in the field of cancer diagnosis in recent years has provided meaningful insights into efficient and precise treatment decision-making. Due to rapid advancements in sequencing technologies, the detection of cancer based on gene expression data has improved over the years. Different types of cancer affect different parts of the body in different ways. Cancer that affects the mouth, lip, and upper throat is known as oral cancer, which is the sixth most prevalent form of cancer worldwide. India, Bangladesh, China, the United States, and Pakistan are the top five countries with the highest rates of oral cavity disease and lip cancer. The major causes of oral cancer are excessive use of tobacco and cigarette smoking. Many people’s lives can be saved if oral cancer (OC) can be detected early. Early identification and diagnosis could assist doctors in providing better patient care and effective treatment. OC screening may advance with the implementation of artificial intelligence (AI) techniques. AI can provide assistance to the oncology sector by accurately analyzing a large dataset from several imaging modalities. This review deals with the implementation of AI during the early stages of cancer for the proper detection and treatment of OC. Furthermore, performance evaluations of several DL and ML models have been carried out to show that the DL model can overcome the difficult challenges associated with early cancerous lesions in the mouth. For this review, we have followed the rules recommended for the extension of scoping reviews and meta-analyses (PRISMA-ScR). Examining the reference lists for the chosen articles helped us gather more details on the subject. Additionally, we discussed AI’s drawbacks and its potential use in research on oral cancer. There are methods for reducing risk factors, such as reducing the use of tobacco and alcohol, as well as immunization against HPV infection to avoid oral cancer, or to lessen the burden of the disease. Additionally, officious methods for preventing oral diseases include training programs for doctors and patients as well as facilitating early diagnosis via screening high-risk populations for the disease.

Predicting COVID-19 Cases in South Korea Using Stringency and Niño Sea Surface Temperature Indices

Most coronavirus disease 2019 (COVID-19) models use a combination of agent-based and equation-based models with only a few incorporating environmental factors in their prediction models. Many studies have shown that human and environmental factors play huge roles in disease transmission and spread, but few have combined the use of both factors, especially for SARS-CoV-2. In this study, both man-made policies (Stringency Index) and environment variables (Niño SST Index) were combined to predict the number of COVID-19 cases in South Korea. The performance indicators showed satisfactory results in modeling COVID-19 cases using the Non-linear Autoregressive Exogenous Model (NARX) as the modeling method, and Stringency Index (SI) and Niño Sea Surface Temperature (SST) as model variables. In this study, we showed that the accuracy of SARS-CoV-2 transmission forecasts may be further improved by incorporating both the Niño SST and SI variables and combining these variables with NARX may outperform other models. Future forecasting work by modelers should consider including climate or environmental variables (i.e., Niño SST) to enhance the prediction of transmission and spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

The Deception of Certainty: how Non-Interpretable Machine Learning Outcomes Challenge the Epistemic Authority of Physicians. A deliberative-relational Approach

Developments in Machine Learning (ML) have attracted attention in a wide range of healthcare fields to improve medical practice and the benefit of patients. Particularly, this should be achieved by providing more or less automated decision recommendations to the treating physician. However, some hopes placed in ML for healthcare seem to be disappointed, at least in part, by a lack of transparency or traceability. Skepticism exists primarily in the fact that the physician, as the person responsible for diagnosis, therapy, and care, has no or insufficient insight into how such recommendations are reached. The following paper aims to make understandable the specificity of the deliberative model of a physician-patient relationship that has been achieved over decades. By outlining the (social-)epistemic and inherently normative relationship between physicians and patients, I want to show how this relationship might be altered by non-traceable ML recommendations. With respect to some healthcare decisions, such changes in deliberative practice may create normatively far-reaching challenges. Therefore, in the future, a differentiation of decision-making situations in healthcare with respect to the necessary depth of insight into the process of outcome generation seems essential.

A multi-variate heart disease optimization and recognition framework

Cardiovascular diseases (CVD) are the most widely spread diseases all over the world among the common chronic diseases. CVD represents one of the main causes of morbidity and mortality. Therefore, it is vital to accurately detect the existence of heart diseases to help to save the patient life and prescribe a suitable treatment. The current evolution in artificial intelligence plays an important role in helping physicians diagnose different diseases. In the present work, a hybrid framework for the detection of heart diseases using medical voice records is suggested. A framework that consists of four layers, namely “Segmentation” Layer, “Features Extraction” Layer, “Learning and Optimization” Layer, and “Export and Statistics” Layer is proposed. In the first layer, a novel segmentation technique based on the segmentation of variable durations and directions (i.e., forward and backward) is suggested. Using the proposed technique, 11 datasets with 14,416 numerical features are generated. The second layer is responsible for feature extraction. Numerical and graphical features are extracted from the resulting datasets. In the third layer, numerical features are passed to 5 different Machine Learning (ML) algorithms, while graphical features are passed to 8 different Convolutional Neural Networks (CNN) with transfer learning to select the most suitable configurations. Grid Search and Aquila Optimizer (AO) are used to optimize the hyperparameters of ML and CNN configurations, respectively. In the last layer, the output of the proposed hybrid framework is validated using different performance metrics. The best-reported metrics are (1) 100% accuracy using ML algorithms including Extra Tree Classifier (ETC) and Random Forest Classifier (RFC) and (2) 99.17% accuracy using CNN.

Explanatory pragmatism: a context-sensitive framework for explainable medical AI

Explainable artificial intelligence (XAI) is an emerging, multidisciplinary field of research that seeks to develop methods and tools for making AI systems more explainable or interpretable. XAI researchers increasingly recognise explainability as a context-, audience- and purpose-sensitive phenomenon, rather than a single well-defined property that can be directly measured and optimised. However, since there is currently no overarching definition of explainability, this poses a risk of miscommunication between the many different researchers within this multidisciplinary space. This is the problem we seek to address in this paper. We outline a framework, called Explanatory Pragmatism, which we argue has two attractive features. First, it allows us to conceptualise explainability in explicitly context-, audience- and purpose-relative terms, while retaining a unified underlying definition of explainability. Second, it makes visible any normative disagreements that may underpin conflicting claims about explainability regarding the purposes for which explanations are sought. Third, it allows us to distinguish several dimensions of AI explainability. We illustrate this framework by applying it to a case study involving a machine learning model for predicting whether patients suffering disorders of consciousness were likely to recover consciousness.

Feeding the machine: Challenges to reproducible predictive modeling in resting-state connectomics

In this critical review, we examine the application of predictive models, for example, classifiers, trained using machine learning (ML) to assist in interpretation of functional neuroimaging data. Our primary goal is to summarize how ML is being applied and critically assess common practices. Our review covers 250 studies published using ML and resting-state functional MRI (fMRI) to infer various dimensions of the human functional connectome. Results for holdout ("lockbox") performance was, on average, ∼13% less accurate than performance measured through cross-validation alone, highlighting the importance of lockbox data, which was included in only 16% of the studies. There was also a concerning lack of transparency across the key steps in training and evaluating predictive models. The summary of this literature underscores the importance of the use of a lockbox and highlights several methodological pitfalls that can be addressed by the imaging community. We argue that, ideally, studies are motivated both by the reproducibility and generalizability of findings as well as the potential clinical significance of the insights. We offer recommendations for principled integration of machine learning into the clinical neurosciences with the goal of advancing imaging biomarkers of brain disorders, understanding causative determinants for health risks, and parsing heterogeneous patient outcomes.

Radiomics-guided deep neural networks stratify lung adenocarcinoma prognosis from CT scans

Deep learning (DL) is a breakthrough technology for medical imaging with high sample size requirements and interpretability issues. Using a pretrained DL model through a radiomics-guided approach, we propose a methodology for stratifying the prognosis of lung adenocarcinomas based on pretreatment CT. Our approach allows us to apply DL with smaller sample size requirements and enhanced interpretability. Baseline radiomics and DL models for the prognosis of lung adenocarcinomas were developed and tested using local (n = 617) cohort. The DL models were further tested in an external validation (n = 70) cohort. The local cohort was divided into training and test cohorts. A radiomics risk score (RRS) was developed using Cox-LASSO. Three pretrained DL networks derived from natural images were used to extract the DL features. The features were further guided using radiomics by retaining those DL features whose correlations with the radiomics features were high and Bonferroni-corrected p-values were low. The retained DL features were subject to a Cox-LASSO when constructing DL risk scores (DRS). The risk groups stratified by the RRS and DRS showed a significant difference in training, testing, and validation cohorts. The DL features were interpreted using existing radiomics features, and the texture features explained the DL features well.

A Survey on Explainable Artificial Intelligence (XAI): Toward Medical XAI

Recently, artificial intelligence and machine learning in general have demonstrated remarkable performances in many tasks, from image processing to natural language processing, especially with the advent of deep learning (DL). Along with research progress, they have encroached upon many different fields and disciplines. Some of them require high level of accountability and thus transparency, for example, the medical sector. Explanations for machine decisions and predictions are thus needed to justify their reliability. This requires greater interpretability, which often means we need to understand the mechanism underlying the algorithms. Unfortunately, the blackbox nature of the DL is still unresolved, and many machine decisions are still poorly understood. We provide a review on interpretabilities suggested by different research works and categorize them. The different categories show different dimensions in interpretability research, from approaches that provide "obviously" interpretable information to the studies of complex patterns. By applying the same categorization to interpretability in medical research, it is hoped that: 1) clinicians and practitioners can subsequently approach these methods with caution; 2) insight into interpretability will be born with more considerations for medical practices; and 3) initiatives to push forward data-based, mathematically grounded, and technically grounded medical education are encouraged.

Computing schizophrenia: ethical challenges for machine learning in psychiatry

Recent advances in machine learning (ML) promise far-reaching improvements across medical care, not least within psychiatry. While to date no psychiatric application of ML constitutes standard clinical practice, it seems crucial to get ahead of these developments and address their ethical challenges early on. Following a short general introduction concerning ML in psychiatry, we do so by focusing on schizophrenia as a paradigmatic case. Based on recent research employing ML to further the diagnosis, treatment, and prediction of schizophrenia, we discuss three hypothetical case studies of ML applications with view to their ethical dimensions. Throughout this discussion, we follow the principlist framework by Tom Beauchamp and James Childress to analyse potential problems in detail. In particular, we structure our analysis around their principles of beneficence, non-maleficence, respect for autonomy, and justice. We conclude with a call for cautious optimism concerning the implementation of ML in psychiatry if close attention is paid to the particular intricacies of psychiatric disorders and its success evaluated based on tangible clinical benefit for patients.

[The predictable human : Possibilities and risks of AI-based prediction of cognitive abilities, personality traits and mental illnesses]

New approaches to the use of artificial intelligence (AI) to analyze data from neuroimaging but also passively collected data from so-called wearables, such as smartphones or smartwatches, as well as data that can be extracted from social media and other online activities, already make it possible to predict cognitive abilities, personality traits, and mental illnesses, as well as to reveal acute mental states. In this article, we explain the methodological concepts behind these current developments, illuminate the possibilities and limitations, and address ethical and social aspects arising from the use.

Mapping research strands of ethics of artificial intelligence in healthcare: A bibliometric and content analysis

The growth of artificial intelligence in promoting healthcare is rapidly progressing. Notwithstanding its promising nature, however, AI in healthcare embodies certain ethical challenges as well. This research aims to delineate the most influential elements of scientific research on AI ethics in healthcare by conducting bibliometric, social network analysis, and cluster-based content analysis of scientific articles. Not only did the bibliometric analysis identify the most influential authors, countries, institutions, sources, and documents, but it also recognized four ethical concerns associated with 12 medical issues. These ethical categories are composed of normative, meta-ethics, epistemological and medical practice. The content analysis complemented this list of ethical categories and distinguished seven more ethical categories: ethics of relationships, medico-legal concerns, ethics of robots, ethics of ambient intelligence, patients' rights, physicians' rights, and ethics of predictive analytics. This analysis likewise identified 40 general research gaps in the literature and plausible future research strands. This analysis furthers conversations on the ethics of AI and associated emerging technologies such as nanotech and biotech in healthcare, hence, advances convergence research on the ethics of AI in healthcare. Practically, this research will provide a map for policymakers and AI engineers and scientists on what dimensions of AI-based medical interventions require stricter policies and guidelines and robust ethical design and development.

The roles of machine learning methods in limiting the spread of deadly diseases: A systematic review

Machine learning (ML) methods can be leveraged to prevent the spread of deadly infectious disease outbreak (e.g., COVID-19). This can be done by applying machine learning methods in predicting and detecting the deadly infectious disease. Most reviews did not discuss about the machine learning algorithms, datasets and performance measurements used for various applications in predicting and detecting the deadly infectious disease. In contrast, this paper outlines the literature review based on two major ways (e.g., prediction, detection) to limit the spread of deadly disease outbreaks. Hence, this study aims to investigate the state of the art, challenges and future works of leveraging ML methods to detect and predict deadly disease outbreaks according to two categories mentioned earlier. Specifically, this study provides a review on various approaches (e.g., individual and ensemble models), types of datasets, parameters or variables and performance measures used in the previous works. The literature review included all articles from journals and conference proceedings published from 2010 through 2020 in Scopus indexed databases using the search terms Predicting Disease Outbreaks and/or Detecting Disease using Machine Learning. The findings from this review focus on commonly used machine learning approaches, challenges and future works to limit the spread of deadly disease outbreaks through preventions and detections.

The Role of Artificial Intelligence in Fighting the COVID-19 Pandemic

The first few months of 2020 have profoundly changed the way we live our lives and carry out our daily activities. Although the widespread use of futuristic robotaxis and self-driving commercial vehicles has not yet become a reality, the COVID-19 pandemic has dramatically accelerated the adoption of Artificial Intelligence (AI) in different fields. We have witnessed the equivalent of two years of digital transformation compressed into just a few months. Whether it is in tracing epidemiological peaks or in transacting contactless payments, the impact of these developments has been almost immediate, and a window has opened up on what is to come. Here we analyze and discuss how AI can support us in facing the ongoing pandemic. Despite the numerous and undeniable contributions of AI, clinical trials and human skills are still required. Even if different strategies have been developed in different states worldwide, the fight against the pandemic seems to have found everywhere a valuable ally in AI, a global and open-source tool capable of providing assistance in this health emergency. A careful AI application would enable us to operate within this complex scenario involving healthcare, society and research.

Discrimination in the age of artificial intelligence

In this paper, I examine whether the use of artificial intelligence (AI) and automated decision-making (ADM) aggravates issues of discrimination as has been argued by several authors. For this purpose, I first take up the lively philosophical debate on discrimination and present my own definition of the concept. Equipped with this account, I subsequently review some of the recent literature on the use AI/ADM and discrimination. I explain how my account of discrimination helps to understand that the general claim in view of the aggravation of discrimination is unwarranted. Finally, I argue that the use of AI/ADM can, in fact, increase issues of discrimination, but in a different way than most critics assume: it is due to its epistemic opacity that AI/ADM threatens to undermine our moral deliberation which is essential for reaching a common understanding of what should count as discrimination. As a consequence, it turns out that algorithms may actually help to detect hidden forms of discrimination.

Machine learning for psychiatry: getting doctors at the black box?

Recent developments in the field of machine learning have spurred high hopes for diagnostic support for psychiatric patients based on brain MRI. But while technical advances are undoubtedly remarkable, the current trajectory of mostly proof-of-concept studies performed on retrospective, often repository-derived data, may not be well suited to yield a substantial impact in clinical practice. Here we review these developments and challenges, arguing for the need of stronger involvement of and input from medical doctors in order to pave the way for machine learning in clinical psychiatry.

Designing Futuristic Telemedicine Using Artificial Intelligence and Robotics in the COVID-19 Era

Technological innovations such as artificial intelligence and robotics may be of potential use in telemedicine and in building capacity to respond to future pandemics beyond the current COVID-19 era. Our international consortium of interdisciplinary experts in clinical medicine, health policy, and telemedicine have identified gaps in uptake and implementation of telemedicine or telehealth across geographics and medical specialties. This paper discusses various artificial intelligence and robotics-assisted telemedicine or telehealth applications during COVID-19 and presents an alternative artificial intelligence assisted telemedicine framework to accelerate the rapid deployment of telemedicine and improve access to quality and cost-effective healthcare. We postulate that the artificial intelligence assisted telemedicine framework would be indispensable in creating futuristic and resilient health systems that can support communities amidst pandemics.

As if sand were stone. New concepts and metrics to probe the ground on which to build trustable AI

BACKGROUND

We focus on the importance of interpreting the quality of the labeling used as the input of predictive models to understand the reliability of their output in support of human decision-making, especially in critical domains, such as medicine.

METHODS

Accordingly, we propose a framework distinguishing the reference labeling (or Gold Standard) from the set of annotations from which it is usually derived (the Diamond Standard). We define a set of quality dimensions and related metrics: representativeness (are the available data representative of its reference population?); reliability (do the raters agree with each other in their ratings?); and accuracy (are the raters' annotations a true representation?). The metrics for these dimensions are, respectively, the degree of correspondence, Ψ, the degree of weighted concordance ϱ, and the degree of fineness, Φ. We apply and evaluate these metrics in a diagnostic user study involving 13 radiologists.

RESULTS

We evaluate Ψ against hypothesis-testing techniques, highlighting that our metrics can better evaluate distribution similarity in high-dimensional spaces. We discuss how Ψ could be used to assess the reliability of new predictions or for train-test selection. We report the value of ϱ for our case study and compare it with traditional reliability metrics, highlighting both their theoretical properties and the reasons that they differ. Then, we report the degree of fineness as an estimate of the accuracy of the collected annotations and discuss the relationship between this latter degree and the degree of weighted concordance, which we find to be moderately but significantly correlated. Finally, we discuss the implications of the proposed dimensions and metrics with respect to the context of Explainable Artificial Intelligence (XAI).

CONCLUSION

We propose different dimensions and related metrics to assess the quality of the datasets used to build predictive models and Medical Artificial Intelligence (MAI). We argue that the proposed metrics are feasible for application in real-world settings for the continuous development of trustable and interpretable MAI systems.

Diagnostic significance of C-reactive protein and hematological parameters in acute toxoplasmosis

Abstract

Toxoplasmosis is a zoonosis caused by Toxoplasma gondii, which can be acquired by oral contact and may cause severe health problems especially for pregnant (congenital toxoplasmosis) and immunocompromised patients. This study aimed to verify the diagnostic significance of hematological parameters and C-reactive protein (CRP) for toxoplasmosis acute detection. A case-control study was carried out between December 2017 and May 2018, in samples of convenience independent of age and sex. The case group was formed by 25 patients with positive anti-Toxoplasma gondii IgG/IgM antibody and the control group was formed by 21 patients with non-positive anti-Toxoplasma gondii IgG/IgM antibody. The results of the hematological parameters and CRP were analyzed in these patients. The patients with Toxoplasma gondii IgM antibody reagent showed higher lymphocytes counting and lower neutrophils counting than the control group. C-reactive protein levels were not different between the groups case and control. ROC curve analysis highlighted that the cut-off value of > 32.00% for lymphocytes and < 57.50% for neutrophils were able to produce specificity higher than 90% for IgM antibody detection. The Naïve Bayes classifier was considered suitable (AUC ≈ 0.700) to separate both groups according to their white cell counting. Changes in lymphocytes and neutrophils may be useful parameters for toxoplasmosis identification and may be used as a tool in the complementary diagnosis of toxoplasmosis.

Graphic abstract

Your evidence? Machine learning algorithms for medical diagnosis and prediction

Computer systems for medical diagnosis based on machine learning are not mere science fiction. Despite undisputed potential benefits, such systems may also raise problems. Two (interconnected) issues are particularly significant from an ethical point of view: The first issue is that epistemic opacity is at odds with a common desire for understanding and potentially undermines information rights. The second (related) issue concerns the assignment of responsibility in cases of failure. The core of the two issues seems to be that understanding and responsibility are concepts that are intrinsically tied to the discursive practice of giving and asking for reasons. The challenge is to find ways to make the outcomes of machine learning algorithms compatible with our discursive practice. This comes down to the claim that we should try to integrate discursive elements into machine learning algorithms. Under the title of "explainable AI" initiatives heading in this direction are already under way. Extensive research in this field is needed for finding adequate solutions.