Free, publicly-accessible full text available December 13, 2024
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Free, publicly-accessible full text available January 1, 2025
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Predicting polycystic ovary syndrome with machine learning algorithms from electronic health recordsmore » « less
Introduction Predictive models have been used to aid early diagnosis of PCOS, though existing models are based on small sample sizes and limited to fertility clinic populations. We built a predictive model using machine learning algorithms based on an outpatient population at risk for PCOS to predict risk and facilitate earlier diagnosis, particularly among those who meet diagnostic criteria but have not received a diagnosis.
Methods This is a retrospective cohort study from a SafetyNet hospital’s electronic health records (EHR) from 2003-2016. The study population included 30,601 women aged 18-45 years without concurrent endocrinopathy who had any visit to Boston Medical Center for primary care, obstetrics and gynecology, endocrinology, family medicine, or general internal medicine. Four prediction outcomes were assessed for PCOS. The first outcome was PCOS ICD-9 diagnosis with additional model outcomes of algorithm-defined PCOS. The latter was based on Rotterdam criteria and merging laboratory values, radiographic imaging, and ICD data from the EHR to define irregular menstruation, hyperandrogenism, and polycystic ovarian morphology on ultrasound.
Results We developed predictive models using four machine learning methods: logistic regression, supported vector machine, gradient boosted trees, and random forests. Hormone values (follicle-stimulating hormone, luteinizing hormone, estradiol, and sex hormone binding globulin) were combined to create a multilayer perceptron score using a neural network classifier. Prediction of PCOS prior to clinical diagnosis in an out-of-sample test set of patients achieved an average AUC of 85%, 81%, 80%, and 82%, respectively in Models I, II, III and IV. Significant positive predictors of PCOS diagnosis across models included hormone levels and obesity; negative predictors included gravidity and positive bHCG.
Conclusion Machine learning algorithms were used to predict PCOS based on a large at-risk population. This approach may guide early detection of PCOS within EHR-interfaced populations to facilitate counseling and interventions that may reduce long-term health consequences. Our model illustrates the potential benefits of an artificial intelligence-enabled provider assistance tool that can be integrated into the EHR to reduce delays in diagnosis. However, model validation in other hospital-based populations is necessary.
Free, publicly-accessible full text available January 30, 2025 -
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The application of compressed sensing (CS)-enabled data reconstruction for accelerating magnetic resonance imaging (MRI) remains a challenging problem. This is due to the fact that the information lost in k-space from the acceleration mask makes it difficult to reconstruct an image similar to the quality of a fully sampled image. Multiple deep learning-based structures have been proposed for MRI reconstruction using CS, in both the k-space and image domains, and using unrolled optimization methods. However, the drawback of these structures is that they are not fully utilizing the information from both domains (k-space and image). Herein, we propose a deep learning-based attention hybrid variational network that performs learning in both the k-space and image domains. We evaluate our method on a well-known open-source MRI dataset (652 brain cases and 1172 knee cases) and a clinical MRI dataset of 243 patients diagnosed with strokes from our institution to demonstrate the performance of our network. Our model achieves an overall peak signal-to-noise ratio/structural similarity of 40.92 ± 0.29/0.9577 ± 0.0025 (fourfold) and 37.03 ± 0.25/0.9365 ± 0.0029 (eightfold) for the brain dataset, 31.09 ± 0.25/0.6901 ± 0.0094 (fourfold) and 29.49 ± 0.22/0.6197 ± 0.0106 (eightfold) for the knee dataset, and 36.32 ± 0.16/0.9199 ± 0.0029 (20-fold) and 33.70 ± 0.15/0.8882 ± 0.0035 (30-fold) for the stroke dataset. In addition to quantitative evaluation, we undertook a blinded comparison of image quality across networks performed by a subspecialty trained radiologist. Overall, we demonstrate that our network achieves a superior performance among others under multiple reconstruction tasks.
Free, publicly-accessible full text available December 1, 2024 -
Free, publicly-accessible full text available November 12, 2024
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We develop a framework to learn bio-inspired foraging policies using human data. We conduct an experiment where humans are virtually immersed in an open field foraging environment and are trained to collect the highest amount of rewards. A Markov Decision Process (MDP) framework is introduced to model the human decision dynamics. Then, Imitation Learning (IL) based on maximum likelihood estimation is used to train Neural Networks (NN) that map human decisions to observed states. The results show that passive imitation substantially underperforms humans. We further refine the human-inspired policies via Reinforcement Learning (RL) using the on-policy Proximal Policy Optimization (PPO) algorithm which shows better stability than other algorithms and can steadily improve the policies pre-trained with IL. We show that the combination of IL and RL match human performance and that the artificial agents trained with our approach can quickly adapt to reward distribution shift. We finally show that good performance and robustness to reward distribution shift strongly depend on combining allocentric information with an egocentric representation of the environment.
Free, publicly-accessible full text available September 15, 2024 -
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Major histocompatibility complex Class I (MHC-I) molecules bind to peptides derived from intracellular antigens and present them on the surface of cells, allowing the immune system (T cells) to detect them. Elucidating the process of this presentation is essential for regulation and potential manipulation of the cellular immune system. Predicting whether a given peptide binds to an MHC molecule is an important step in the above process and has motivated the introduction of many computational approaches to address this problem. NetMHCPan, a pan-specific model for predicting binding of peptides to any MHC molecule, is one of the most widely used methods which focuses on solving this binary classification problem using shallow neural networks. The recent successful results of Deep Learning (DL) methods, especially Natural Language Processing (NLP-based) pretrained models in various applications, including protein structure determination, motivated us to explore their use in this problem. Specifically, we consider the application of deep learning models pretrained on large datasets of protein sequences to predict MHC Class I-peptide binding. Using the standard performance metrics in this area, and the same training and test sets, we show that our models outperform NetMHCpan4.1, currently considered as the-state-of-the-art.
Free, publicly-accessible full text available August 17, 2024 -
Free, publicly-accessible full text available June 4, 2024
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Srinivasan, Kathiravan (Ed.)Despite their satisfactory performance, most existing listwise Learning-To-Rank (LTR) models do not consider the crucial issue of robustness. A data set can be contaminated in various ways, including human error in labeling or annotation, distributional data shift, and malicious adversaries who wish to degrade the algorithm’s performance. It has been shown that Distributionally Robust Optimization (DRO) is resilient against various types of noise and perturbations. To fill this gap, we introduce a new listwise LTR model called Distributionally Robust Multi-output Regression Ranking (DRMRR) . Different from existing methods, the scoring function of DRMRR was designed as a multivariate mapping from a feature vector to a vector of deviation scores, which captures local context information and cross-document interactions. In this way, we are able to incorporate the LTR metrics into our model. DRMRR uses a Wasserstein DRO framework to minimize a multi-output loss function under the most adverse distributions in the neighborhood of the empirical data distribution defined by a Wasserstein ball. We present a compact and computationally solvable reformulation of the min-max formulation of DRMRR. Our experiments were conducted on two real-world applications: medical document retrieval and drug response prediction, showing that DRMRR notably outperforms state-of-the-art LTR models. We also conducted an extensive analysis to examine the resilience of DRMRR against various types of noise: Gaussian noise, adversarial perturbations, and label poisoning. Accordingly, DRMRR is not only able to achieve significantly better performance than other baselines, but it can maintain a relatively stable performance as more noise is added to the data.more » « less
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Abstract Background Hypertension is a prevalent cardiovascular disease with severe longer-term implications. Conventional management based on clinical guidelines does not facilitate personalized treatment that accounts for a richer set of patient characteristics.
Methods Records from 1/1/2012 to 1/1/2020 at the Boston Medical Center were used, selecting patients with either a hypertension diagnosis or meeting diagnostic criteria (≥ 130 mmHg systolic or ≥ 90 mmHg diastolic, n = 42,752). Models were developed to recommend a class of antihypertensive medications for each patient based on their characteristics. Regression immunized against outliers was combined with a nearest neighbor approach to associate with each patient an affinity group of other patients. This group was then used to make predictions of future Systolic Blood Pressure (SBP) under each prescription type. For each patient, we leveraged these predictions to select the class of medication that minimized their future predicted SBP.
Results The proposed model, built with a distributionally robust learning procedure, leads to a reduction of 14.28 mmHg in SBP, on average. This reduction is 70.30% larger than the reduction achieved by the standard-of-care and 7.08% better than the corresponding reduction achieved by the 2nd best model which uses ordinary least squares regression. All derived models outperform following the previous prescription or the current ground truth prescription in the record. We randomly sampled and manually reviewed 350 patient records; 87.71% of these model-generated prescription recommendations passed a sanity check by clinicians.
Conclusion Our data-driven approach for personalized hypertension treatment yielded significant improvement compared to the standard-of-care. The model implied potential benefits of computationally deprescribing and can support situations with clinical equipoise.
