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Huang SC, Jensen M, Yeung-Levy S, Lungren MP, Poon H, Chaudhari AS. A Systematic Review and Implementation Guidelines of Multimodal Foundation Models in Medical Imaging. RESEARCH SQUARE 2025:rs.3.rs-5537908. [PMID: 40343333 PMCID: PMC12060978 DOI: 10.21203/rs.3.rs-5537908/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 05/11/2025]
Abstract
Artificial Intelligence (AI) holds immense potential to transform healthcare, yet progress is often hindered by the reliance on large labeled datasets and unimodal data. Multimodal Foundation Models (FMs), particularly those leveraging Self-Supervised Learning (SSL) on multimodal data, offer a paradigm shift towards label-efficient, holistic patient modeling. However, the rapid emergence of these complex models has created a fragmented landscape. Here, we provide a systematic review of multimodal FMs for medical imaging applications. Through rigorous screening of 1,144 publications (2012-2024) and in-depth analysis of 48 studies, we establish a unified terminology and comprehensively assess the current state-of-the-art. Our review aggregates current knowledge, critically identifies key limitations and underexplored opportunities, and culminates in actionable guidelines for researchers, clinicians, developers, and policymakers. This work provides a crucial roadmap to navigate and accelerate the responsible development and clinical translation of next-generation multimodal AI in healthcare.
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2
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Zambrano Chaves JM, Huang SC, Xu Y, Xu H, Usuyama N, Zhang S, Wang F, Xie Y, Khademi M, Yang Z, Awadalla H, Gong J, Hu H, Yang J, Li C, Gao J, Gu Y, Wong C, Wei M, Naumann T, Chen M, Lungren MP, Chaudhari A, Yeung-Levy S, Langlotz CP, Wang S, Poon H. A clinically accessible small multimodal radiology model and evaluation metric for chest X-ray findings. Nat Commun 2025; 16:3108. [PMID: 40169573 PMCID: PMC11962106 DOI: 10.1038/s41467-025-58344-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 03/19/2025] [Indexed: 04/03/2025] Open
Abstract
Large foundation models show promise in biomedicine but face challenges in clinical use due to performance gaps, accessibility, cost, and lack of scalable evaluation. Here we show that open-source small multimodal models can bridge these gaps in radiology by generating free-text findings from chest X-ray images. Our data-centric approach leverages 697K curated radiology image-text pairs to train a specialized, domain-adapted chest X-ray encoder. We integrate this encoder with pre-trained language models via a lightweight adapter that aligns image and text modalities. To enable robust, clinically relevant evaluation, we develop and validate CheXprompt, a GPT-4-based metric for assessing factual accuracy aligned with radiologists' evaluations. Benchmarked with CheXprompt and other standard factuality metrics, LLaVA-Rad (7B) achieves state-of-the-art performance, outperforming much larger models like GPT-4V and Med-PaLM M (84B). While not immediately ready for real-time clinical deployment, LLaVA-Rad is a scalable, privacy-preserving and cost-effective step towards clinically adaptable multimodal AI for radiology.
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Affiliation(s)
| | | | - Yanbo Xu
- Microsoft Research, Redmond, WA, USA
| | - Hanwen Xu
- University of Washington, Seattle, WA, USA
| | | | | | - Fei Wang
- University of Southern California, Los Angeles, CA, USA
| | - Yujia Xie
- Microsoft Research, Redmond, WA, USA
| | | | - Ziyi Yang
- Microsoft Research, Redmond, WA, USA
| | | | | | | | | | | | | | - Yu Gu
- Microsoft Research, Redmond, WA, USA
| | | | - Mu Wei
- Microsoft Research, Redmond, WA, USA
| | | | - Muhao Chen
- University of California, Davis, CA, USA
| | - Matthew P Lungren
- Microsoft Research, Redmond, WA, USA
- Stanford University, Stanford, CA, USA
- University of California, San Francisco, CA, USA
| | | | | | | | - Sheng Wang
- University of Washington, Seattle, WA, USA.
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3
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Hudu SA, Alshrari AS, Abu-Shoura EJI, Osman A, Jimoh AO. A Critical Review of the Prospect of Integrating Artificial Intelligence in Infectious Disease Diagnosis and Prognosis. Interdiscip Perspect Infect Dis 2025; 2025:6816002. [PMID: 40225950 PMCID: PMC11991796 DOI: 10.1155/ipid/6816002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2024] [Accepted: 02/20/2025] [Indexed: 04/15/2025] Open
Abstract
This paper explores the transformative potential of integrating artificial intelligence (AI) in the diagnosis and prognosis of infectious diseases. By analyzing diverse datasets, including clinical symptoms, laboratory results, and imaging data, AI algorithms can significantly enhance early detection and personalized treatment strategies. This paper reviews how AI-driven models improve diagnostic accuracy, predict patient outcomes, and contribute to effective disease management. It also addresses the challenges and ethical considerations associated with AI, including data privacy, algorithmic bias, and equitable access to healthcare. Highlighting case studies and recent advancements, the paper underscores AI's role in revolutionizing infectious disease management and its implications for future healthcare delivery.
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Affiliation(s)
- Shuaibu Abdullahi Hudu
- Department of Basic and Clinical Medical Sciences, Faculty of Dentistry, Zarqa University, Zarqa 13110, Jordan
| | - Ahmed Subeh Alshrari
- Department of Medical Laboratory Technology, Faculty of Applied Medical Science, Northern Border University, Arar 91431, Saudi Arabia
| | | | - Amira Osman
- Department of Basic and Clinical Medical Sciences, Faculty of Dentistry, Zarqa University, Zarqa 13110, Jordan
- Department of Histology and Cell Biology, Faculty of Medicine, Kafrelsheikh University, Kafr El Sheikh, Egypt
| | - Abdulgafar Olayiwola Jimoh
- Department of Pharmacology and Therapeutics, Faculty of Basic Clinical Sciences, College of Health Sciences, Usmanu Danfodiyo University, Sokoto 840232, Sokoto State, Nigeria
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4
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Kabir MM, Rahman A, Hasan MN, Mridha MF. Computer vision algorithms in healthcare: Recent advancements and future challenges. Comput Biol Med 2025; 185:109531. [PMID: 39675214 DOI: 10.1016/j.compbiomed.2024.109531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 10/05/2024] [Accepted: 12/03/2024] [Indexed: 12/17/2024]
Abstract
Computer vision has emerged as a promising technology with numerous applications in healthcare. This systematic review provides an overview of advancements and challenges associated with computer vision in healthcare. The review highlights the application areas where computer vision has made significant strides, including medical imaging, surgical assistance, remote patient monitoring, and telehealth. Additionally, it addresses the challenges related to data quality, privacy, model interpretability, and integration with existing healthcare systems. Ethical and legal considerations, such as patient consent and algorithmic bias, are also discussed. The review concludes by identifying future directions and opportunities for research, emphasizing the potential impact of computer vision on healthcare delivery and outcomes. Overall, this systematic review underscores the importance of understanding both the advancements and challenges in computer vision to facilitate its responsible implementation in healthcare.
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Affiliation(s)
- Md Mohsin Kabir
- School of Innovation, Design and Engineering, Mälardalens University, Västerås, 722 20, Sweden.
| | - Ashifur Rahman
- Department of Computer Science and Engineering, Bangladesh University of Business and Technology, Mirpur-2, Dhaka, 1216, Bangladesh.
| | - Md Nahid Hasan
- Department of Computer Science, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, United States.
| | - M F Mridha
- Department of Computer Science, American International University-Bangladesh, Dhaka, 1229, Dhaka, Bangladesh.
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5
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Vásquez-Venegas C, Wu C, Sundar S, Prôa R, Beloy FJ, Medina JR, McNichol M, Parvataneni K, Kurtzman N, Mirshawka F, Aguirre-Jerez M, Ebner DK, Celi LA. Detecting and Mitigating the Clever Hans Effect in Medical Imaging: A Scoping Review. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024:10.1007/s10278-024-01335-z. [PMID: 39643820 DOI: 10.1007/s10278-024-01335-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Revised: 11/04/2024] [Accepted: 11/06/2024] [Indexed: 12/09/2024]
Abstract
The Clever Hans effect occurs when machine learning models rely on spurious correlations instead of clinically relevant features and poses significant challenges to the development of reliable artificial intelligence (AI) systems in medical imaging. This scoping review provides an overview of methods for identifying and addressing the Clever Hans effect in medical imaging AI algorithms. A total of 173 papers published between 2010 and 2024 were reviewed, and 37 articles were selected for detailed analysis, with classification into two categories: detection and mitigation approaches. Detection methods include model-centric, data-centric, and uncertainty and bias-based approaches, while mitigation strategies encompass data manipulation techniques, feature disentanglement and suppression, and domain knowledge-driven approaches. Despite the progress in detecting and mitigating the Clever Hans effect, the majority of current machine learning studies in medical imaging do not report or test for shortcut learning, highlighting the need for more rigorous validation and transparency in AI research. Future research should focus on creating standardized benchmarks, developing automated detection tools, and exploring the integration of detection and mitigation strategies to comprehensively address shortcut learning. Establishing community-driven best practices and leveraging interdisciplinary collaboration will be crucial for ensuring more reliable, generalizable, and equitable AI systems in healthcare.
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Affiliation(s)
- Constanza Vásquez-Venegas
- Scientific Image Analysis Lab, Faculty of Medicine, Universidad de Chile, Santiago, 8380453, RM, Chile.
- Department of Computer Science, Faculty of Engineering, Universidad de Concepción, Concepción, 4030000, Biobio, Chile.
| | - Chenwei Wu
- University of Michigan, Ann Arbor, 48105, MI, USA
| | - Saketh Sundar
- Harvard College, Harvard University, Cambridge, MA, USA
| | - Renata Prôa
- Harvard School of Public Health, Harvard University, Boston, MA, USA
- Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | | | - Megan McNichol
- Division of Knowledge Services, Department of Information Services, Beth Israel Lahey Health, Cambridge, MA, USA
| | - Krishnaveni Parvataneni
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | - Felipe Mirshawka
- School of Biomedical Engineering, Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Daniel K Ebner
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Leo Anthony Celi
- Laboratory for Computational Physiology, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Condrea F, Rapaka S, Itu L, Sharma P, Sperl J, Ali AM, Leordeanu M. Anatomically aware dual-hop learning for pulmonary embolism detection in CT pulmonary angiograms. Comput Biol Med 2024; 174:108464. [PMID: 38613894 DOI: 10.1016/j.compbiomed.2024.108464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 04/01/2024] [Accepted: 04/08/2024] [Indexed: 04/15/2024]
Abstract
Pulmonary Embolisms (PE) represent a leading cause of cardiovascular death. While medical imaging, through computed tomographic pulmonary angiography (CTPA), represents the gold standard for PE diagnosis, it is still susceptible to misdiagnosis or significant diagnosis delays, which may be fatal for critical cases. Despite the recently demonstrated power of deep learning to bring a significant boost in performance in a wide range of medical imaging tasks, there are still very few published researches on automatic pulmonary embolism detection. Herein we introduce a deep learning based approach, which efficiently combines computer vision and deep neural networks for pulmonary embolism detection in CTPA. Our method brings novel contributions along three orthogonal axes: (1) automatic detection of anatomical structures; (2) anatomical aware pretraining, and (3) a dual-hop deep neural net for PE detection. We obtain state-of-the-art results on the publicly available multicenter large-scale RSNA dataset.
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Affiliation(s)
- Florin Condrea
- Institute of Mathematics of the Romanian Academy "Simion Stoilow, Bucharest, Romania; Advanta, Siemens, 15 Noiembrie Bvd, Brasov, 500097, Romania.
| | | | - Lucian Itu
- Advanta, Siemens, 15 Noiembrie Bvd, Brasov, 500097, Romania
| | | | | | - A Mohamed Ali
- Siemens Healthcare Private Limited, Mumbai, 400079, India
| | - Marius Leordeanu
- Institute of Mathematics of the Romanian Academy "Simion Stoilow, Bucharest, Romania; Advanta, Siemens, 15 Noiembrie Bvd, Brasov, 500097, Romania; Polytechnic University of Bucharest, Bucharest, Romania
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Wang Z, Feng N, Zhou Y, Cheng X, Zhou C, Ma A, Wang Q, Li Y, Chen Y. Mesophilic Argonaute-Mediated Polydisperse Droplet Biosensor for Amplification-Free, One-Pot, and Multiplexed Nucleic Acid Detection Using Deep Learning. Anal Chem 2024; 96:2068-2077. [PMID: 38259216 DOI: 10.1021/acs.analchem.3c04426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Detection of nucleic acids from a single multiplexed and amplification-free test is critical for ensuring food safety, clinical diagnostics, and environmental monitoring. In this study, we introduced a mesophilic Argonaute protein from Clostridium butyricum (CbAgo), which exhibits nucleic acid endonuclease activity, to achieve a programmable, amplification-free system (PASS) for rapid nucleic acid quantification at ambient temperatures in one pot. By using CbAgo-mediated binding with specific guide DNA (gDNA) and subsequent targeted cleavage of wild-type target DNAs complementary to gDNA, PASS can detect multiple foodborne pathogen DNA (<102 CFU/mL) simultaneously. The fluorescence signals were then transferred to polydisperse emulsions and analyzed by using deep learning. This simplifies the process and increases the suitability of polydisperse emulsions compared to traditional digital PCR, which requires homogeneous droplets for accurate detection. We believe that PASS has the potential to become a next-generation point-of-care digital nucleic acid detection method.
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Affiliation(s)
- Zhipan Wang
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan 430070, Hubei, China
| | - Niu Feng
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan 430070, Hubei, China
| | - Yanan Zhou
- State Key Laboratory of Agricultural Microbiology and College of Life Science and Technology, Huazhong Agricultural University, Wuhan 430070, Hubei, China
| | - Xinrui Cheng
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan 430070, Hubei, China
| | - Cuiyun Zhou
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan 430070, Hubei, China
| | - Aimin Ma
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan 430070, Hubei, China
| | - Qinyu Wang
- Department of Computer Science and Technology, Wuhan University of Science and Technology, Wuhan 430000, Hubei China
| | - Yingjun Li
- State Key Laboratory of Agricultural Microbiology and College of Life Science and Technology, Huazhong Agricultural University, Wuhan 430070, Hubei, China
| | - Yiping Chen
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan 430070, Hubei, China
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8
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Zhang L, Guo W, Lv C. Modern technologies and solutions to enhance surveillance and response systems for emerging zoonotic diseases. SCIENCE IN ONE HEALTH 2023; 3:100061. [PMID: 39077381 PMCID: PMC11262286 DOI: 10.1016/j.soh.2023.100061] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/29/2023] [Indexed: 07/31/2024]
Abstract
Background Zoonotic diseases originating in animals pose a significant threat to global public health. Recent outbreaks, such as coronavirus disease 2019 (COVID-19), have caused widespread illness, death, and socioeconomic disruptions worldwide. To cope with these diseases effectively, it is crucial to strengthen surveillance capabilities and establish rapid response systems. Aim The aim of this review to examine the modern technologies and solutions that have the potential to enhance zoonotic disease surveillance and outbreak responses and provide valuable insights into how cutting-edge innovations could be leveraged to prevent, detect, and control emerging zoonotic disease outbreaks. Herein, we discuss advanced tools including big data analytics, artificial intelligence, the Internet of Things, geographic information systems, remote sensing, molecular diagnostics, point-of-care testing, telemedicine, digital contact tracing, and early warning systems. Results These technologies enable real-time monitoring, the prediction of outbreak risks, early anomaly detection, rapid diagnosis, and targeted interventions during outbreaks. When integrated through collaborative partnerships, these strategies can significantly improve the speed and effectiveness of zoonotic disease control. However, several challenges persist, particularly in resource-limited settings, such as infrastructure limitations, costs, data integration and training requirements, and ethical implementation. Conclusion With strategic planning and coordinated efforts, modern technologies and solutions offer immense potential to bolster surveillance and outbreak responses, and serve as a critical resource against emerging zoonotic disease threats worldwide.
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Affiliation(s)
- Li Zhang
- Huazhong Agricultural University, Wuhan 430070, China
| | - Wenqiang Guo
- Huazhong Agricultural University, Wuhan 430070, China
| | - Chenrui Lv
- Huazhong Agricultural University, Wuhan 430070, China
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9
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Kim K, Yang H, Lee J, Lee WG. Metaverse Wearables for Immersive Digital Healthcare: A Review. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2303234. [PMID: 37740417 PMCID: PMC10625124 DOI: 10.1002/advs.202303234] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/15/2023] [Indexed: 09/24/2023]
Abstract
The recent exponential growth of metaverse technology has been instrumental in reshaping a myriad of sectors, not least digital healthcare. This comprehensive review critically examines the landscape and future applications of metaverse wearables toward immersive digital healthcare. The key technologies and advancements that have spearheaded the metamorphosis of metaverse wearables are categorized, encapsulating all-encompassed extended reality, such as virtual reality, augmented reality, mixed reality, and other haptic feedback systems. Moreover, the fundamentals of their deployment in assistive healthcare (especially for rehabilitation), medical and nursing education, and remote patient management and treatment are investigated. The potential benefits of integrating metaverse wearables into healthcare paradigms are multifold, encompassing improved patient prognosis, enhanced accessibility to high-quality care, and high standards of practitioner instruction. Nevertheless, these technologies are not without their inherent challenges and untapped opportunities, which span privacy protection, data safeguarding, and innovation in artificial intelligence. In summary, future research trajectories and potential advancements to circumvent these hurdles are also discussed, further augmenting the incorporation of metaverse wearables within healthcare infrastructures in the post-pandemic era.
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Affiliation(s)
- Kisoo Kim
- Intelligent Optical Module Research CenterKorea Photonics Technology Institute (KOPTI)Gwangju61007Republic of Korea
| | - Hyosill Yang
- Department of NursingCollege of Nursing ScienceKyung Hee UniversitySeoul02447Republic of Korea
| | - Jihun Lee
- Department of Mechanical EngineeringCollege of EngineeringKyung Hee UniversityYongin17104Republic of Korea
| | - Won Gu Lee
- Department of Mechanical EngineeringCollege of EngineeringKyung Hee UniversityYongin17104Republic of Korea
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10
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Sahiner B, Chen W, Samala RK, Petrick N. Data drift in medical machine learning: implications and potential remedies. Br J Radiol 2023; 96:20220878. [PMID: 36971405 PMCID: PMC10546450 DOI: 10.1259/bjr.20220878] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 03/29/2023] Open
Abstract
Data drift refers to differences between the data used in training a machine learning (ML) model and that applied to the model in real-world operation. Medical ML systems can be exposed to various forms of data drift, including differences between the data sampled for training and used in clinical operation, differences between medical practices or context of use between training and clinical use, and time-related changes in patient populations, disease patterns, and data acquisition, to name a few. In this article, we first review the terminology used in ML literature related to data drift, define distinct types of drift, and discuss in detail potential causes within the context of medical applications with an emphasis on medical imaging. We then review the recent literature regarding the effects of data drift on medical ML systems, which overwhelmingly show that data drift can be a major cause for performance deterioration. We then discuss methods for monitoring data drift and mitigating its effects with an emphasis on pre- and post-deployment techniques. Some of the potential methods for drift detection and issues around model retraining when drift is detected are included. Based on our review, we find that data drift is a major concern in medical ML deployment and that more research is needed so that ML models can identify drift early, incorporate effective mitigation strategies and resist performance decay.
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Affiliation(s)
- Berkman Sahiner
- Center for Devices and Radiological Health, U.S. Food and Drug Administration 10903 New Hampshire Avenue, Silver Spring, MD 20993-0002
| | - Weijie Chen
- Center for Devices and Radiological Health, U.S. Food and Drug Administration 10903 New Hampshire Avenue, Silver Spring, MD 20993-0002
| | - Ravi K. Samala
- Center for Devices and Radiological Health, U.S. Food and Drug Administration 10903 New Hampshire Avenue, Silver Spring, MD 20993-0002
| | - Nicholas Petrick
- Center for Devices and Radiological Health, U.S. Food and Drug Administration 10903 New Hampshire Avenue, Silver Spring, MD 20993-0002
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11
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Xue H, Hu G, Hong N, Dunnick NR, Jin Z. How to keep artificial intelligence evolving in the medical imaging world? Challenges and opportunities. Sci Bull (Beijing) 2023; 68:648-652. [PMID: 36964087 DOI: 10.1016/j.scib.2023.03.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2023]
Affiliation(s)
- Huadan Xue
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Ge Hu
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Nan Hong
- Department of Radiology, Peking University People's Hospital, Beijing 100044, China.
| | - N Reed Dunnick
- Department of Radiology, University of Michigan, Ann Arbor 48109, USA.
| | - Zhengyu Jin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
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