Search for: All records

Acute respiratory distress syndrome (ARDS) is a fulminant inflammatory lung injury that develops in patients with critical illnesses, affecting 200,000 patients in the United States annually. However, a recent study suggests that most patients with ARDS are diagnosed late or missed completely and fail to receive life-saving treatments. This is primarily due to the dependency of current diagnosis criteria on chest x-ray, which is not necessarily available at the time of diagnosis. In machine learning, such an information is known as Privileged Information - information that is available at training but not at testing. However, in diagnosing ARDS, privileged information (chest x-rays) are sometimes only available for a portion of the training data. To address this issue, the Learning Using Partially Available Privileged Information (LUPAPI) paradigm is proposed. As there are multiple ways to incorporate partially available privileged information, three models built on classical SVM are described. Another complexity of diagnosing ARDS is the uncertainty in clinical interpretation of chest x-rays. To address this, the LUPAPI framework is then extended to incorporate label uncertainty, resulting in a novel and comprehensive machine learning paradigm - Learning Using Label Uncertainty and Partially Available Privileged Information (LULUPAPI). The proposed frameworks use Electronic Health Record (EHR) data as regular information, chest x-rays as partially available privileged information, and clinicians' confidence levels in ARDS diagnosis as a measure of label uncertainty. Experiments on an ARDS dataset demonstrate that both the LUPAPI and LULUPAPI models outperform SVM, with LULUPAPI performing better than LUPAPI. 

When training a machine learning algorithm for a supervised-learning task in some clinical applications, uncertainty in the correct labels of some patients may adversely affect the performance of the algorithm. For example, even clinical experts may have less confidence when assigning a medical diagnosis to some patients because of ambiguity in the patient's case or imperfect reliability of the diagnostic criteria. As a result, some cases used in algorithm training may be mislabeled, adversely affecting the algorithm's performance. However, experts may also be able to quantify their diagnostic uncertainty in these cases. We present a robust method implemented with support vector machines (SVM) to account for such clinical diagnostic uncertainty when training an algorithm to detect patients who develop the acute respiratory distress syndrome (ARDS). ARDS is a syndrome of the critically ill that is diagnosed using clinical criteria known to be imperfect. We represent uncertainty in the diagnosis of ARDS as a graded weight of confidence associated with each training label. We also performed a novel time-series sampling method to address the problem of intercorrelation among the longitudinal clinical data from each patient used in model training to limit overfitting. Preliminary results show that we can achieve meaningful improvement in the performance of algorithm to detect patients with ARDS on a hold-out sample, when we compare our method that accounts for the uncertainty of training labels with a conventional SVM algorithm.