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Deep learning has enabled breakthroughs in automated diagnosis from medical imaging, with many successful applications in ophthalmology. However, standard medical image classi cation approaches only assess disease presence at the time of acquisition, neglecting the common clinical setting of longitudinal imaging. For slow, progressive eye diseases like age-related macular degeneration (AMD) and primary open-angle glaucoma (POAG), patients undergo repeated imaging over time to track disease progression and forecasting the future risk of developing a disease is critical to properly plan treatment. Our proposed Longitudinal Transformer for Survival Analysis (LTSA) enables dynamic disease prognosis from longitudinal medical imaging, modeling the time to disease from sequences of fundus photography images captured over long, irregular time periods. Using longitudinal imaging data from the Age-Related Eye Disease Study (AREDS) and Ocular Hypertension Treatment Study (OHTS), LTSA signi cantly outperformed a single-image baseline in 19/20 head-to- head comparisons on late AMD prognosis and 18/20 comparisons on POAG prognosis. A temporal attention analysis also suggested that, while the most recent image is typically the most in uential, prior imaging still provides additional prognostic value. 

Abstract Deep learning has become a popular tool for computer-aided diagnosis using medical images, sometimes matching or exceeding the performance of clinicians. However, these models can also reflect and amplify human bias, potentially resulting inaccurate missed diagnoses. Despite this concern, the problem of improving model fairness in medical image classification by deep learning has yet to be fully studied. To address this issue, we propose an algorithm that leverages the marginal pairwise equal opportunity to reduce bias in medical image classification. Our evaluations across four tasks using four independent large-scale cohorts demonstrate that our proposed algorithm not only improves fairness in individual and intersectional subgroups but also maintains overall performance. Specifically, the relative change in pairwise fairness difference between our proposed model and the baseline model was reduced by over 35%, while the relative change in AUC value was typically within 1%. By reducing the bias generated by deep learning models, our proposed approach can potentially alleviate concerns about the fairness and reliability of image-based computer-aided diagnosis. 

We present FireSim, an open-source simulation platform that enables cycle-exact microarchitectural simulation of large scale-out clusters by combining FPGA-accelerated simulation of silicon-proven RTL designs with a scalable, distributed network simulation. Unlike prior FPGA-accelerated simulation tools, FireSim runs on Amazon EC2 F1, a public cloud FPGA platform, which greatly improves usability, provides elasticity, and lowers the cost of large-scale FPGA-based experiments. We describe the design and implementation of FireSim and show how it can provide sufficient performance to run modern applications at scale, to enable true hardware-software co-design. As an example, we demonstrate automatically generating and deploying a target cluster of 1,024 3.2 GHz quad-core server nodes, each with 16 GB of DRAM, interconnected by a 200 Gbit/s network with 2 microsecond latency, which simulates at a 3.4 MHz processor clock rate (less than 1,000x slowdown over real-time). In aggregate, this FireSim instantiation simulates 4,096 cores and 16 TB of memory, runs ~ 14 billion instructions per second, and harnesses 12.8 million dollars worth of FPGAs-at a total cost of only ~ $100 per simulation hour to the user. We present several examples to show how FireSim can be used to explore various research directions in warehouse-scale machine design, including modeling networks with high-bandwidth and low-latency, integrating arbitrary RTL designs for a variety of commodity and specialized datacenter nodes, and modeling a variety of datacenter organizations, as well as reusing the scale-out FireSim infrastructure to enable fast, massively parallel cycle-exact single-node microarchitectural experimentation.