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Automatic assessment of impairment and disease severity is a key challenge in data-driven medicine. We propose a framework to address this challenge, which leverages AI models trained exclusively on healthy individuals. The COnfidence-Based chaRacterization of Anomalies (COBRA) score exploits the decrease in confidence of these models when presented with impaired or diseased patients to quantify their deviation from the healthy population. We applied the COBRA score to address a key limitation of current clinical evaluation of upper-body impairment in stroke patients. The gold-standard Fugl-Meyer Assessment (FMA) requires in-person administration by a trained assessor for 30-45 minutes, which restricts monitoring frequency and precludes physicians from adapting rehabilitation protocols to the progress of each patient. The COBRA score, computed automatically in under one minute, is shown to be strongly correlated with the FMA on an independent test cohort for two different data modalities: wearable sensors (ρ = 0.814, 95% CI [0.700,0.888]) and video (ρ = 0.736, 95% C.I [0.584, 0.838]). To demonstrate the generalizability of the approach to other conditions, the COBRA score was also applied to quantify severity of knee osteoarthritis from magnetic-resonance imaging scans, again achieving significant correlation with an independent clinical assessment (ρ = 0.644, 95% C.I [0.585,0.696]).

 

Learning representations for individual instances when only bag-level labels are available is a fundamental challenge in multiple instance learning (MIL). Recent works have shown promising results using contrastive self-supervised learning (CSSL), which learns to push apart representations corresponding to two different randomly-selected instances. Unfortunately, in real-world applications such as medical image classification, there is often class imbalance, so randomly-selected instances mostly belong to the same majority class, which precludes CSSL from learning inter-class differences. To address this issue, we propose a novel framework, Iterative Self-paced Supervised Contrastive Learning for MIL Representations (ItS2CLR), which improves the learned representation by exploiting instance-level pseudo labels derived from the bag-level labels. The framework employs a novel self-paced sampling strategy to ensure the accuracy of pseudo labels. We evaluate ItS2CLR on three medical datasets, showing that it improves the quality of instance-level pseudo labels and representations, and outperforms existing MIL methods in terms of both bag and instance level accuracy. Code is available at this https URL 

Learning representations for individual instances when only bag-level labels are available is a fundamental challenge in multiple instance learning (MIL). Recent works have shown promising results using contrastive self-supervised learning (CSSL), which learns to push apart representations corresponding to two different randomly-selected instances. Unfortunately, in real-world applications such as medical image classification, there is often class imbalance, so randomly-selected instances mostly belong to the same majority class, which precludes CSSL from learning inter-class differences. To address this issue, we propose a novel framework, Iterative Self-paced Supervised Contrastive Learning for MIL Representations (ItS2CLR), which improves the learned representation by exploiting instance-level pseudo labels derived from the bag-level labels. The framework employs a novel self-paced sampling strategy to ensure the accuracy of pseudo labels. We evaluate ItS2CLR on three medical datasets, showing that it improves the quality of instance-level pseudo labels and representations, and outperforms existing MIL methods in terms of both bag and instance level accuracy. Code is available at https://github.com/Kangningthu/ItS2CLR 

While cross entropy (CE) is the most commonly used loss function to train deep neural networks for classification tasks, many alternative losses have been developed to obtain better empirical performance. Among them, which one is the best to use is still a mystery, because there seem to be multiple factors affecting the answer, such as properties of the dataset, the choice of network architecture, and so on. This paper studies the choice of loss function by examining the last-layer features of deep networks, drawing inspiration from a recent line work showing that the global optimal solution of CE and mean-square-error (MSE) losses exhibits a Neural Collapse phenomenon. That is, for sufficiently large networks trained until convergence, (i) all features of the same class collapse to the corresponding class mean and (ii) the means associated with different classes are in a configuration where their pairwise distances are all equal and maximized. We extend such results and show through global solution and landscape analyses that a broad family of loss functions including commonly used label smoothing (LS) and focal loss (FL) exhibits Neural Collapse. Hence, all relevant losses (i.e., CE, LS, FL, MSE) produce equivalent features on training data. In particular, based on the unconstrained feature model assumption, we provide either the global landscape analysis for LS loss or the local landscape analysis for FL loss and show that the (only!) global minimizers are neural collapse solutions, while all other critical points are strict saddles whose Hessian exhibit negative curvature directions either in the global scope for LS loss or in the local scope for FL loss near the optimal solution. The experiments further show that Neural Collapse features obtained from all relevant losses (i.e., CE, LS, FL, MSE) lead to largely identical performance on test data as well, provided that the network is sufficiently large and trained until convergence. 

Deep learning in the presence of noisy annotations has been studied extensively in classification, but much less in segmentation tasks. In this work, we study the learning dynamics of deep segmentation networks trained on inaccurately-annotated data. We discover a phenomenon that has been previously reported in the context of classification: the networks tend to first fit the clean pixel-level labels during an "early-learning" phase, before eventually memorizing the false annotations. However, in contrast to classification, memorization in segmentation does not arise simultaneously for all semantic categories. Inspired by these findings, we propose a new method for segmentation from noisy annotations with two key elements. First, we detect the beginning of the memorization phase separately for each category during training. This allows us to adaptively correct the noisy annotations in order to exploit early learning. Second, we incorporate a regularization term that enforces consistency across scales to boost robustness against annotation noise. Our method outperforms standard approaches on a medical-imaging segmentation task where noises are synthesized to mimic human annotation errors. It also provides robustness to realistic noisy annotations present in weakly-supervised semantic segmentation, achieving state-of-the-art results on PASCAL VOC 2012. 

Automatic action identification from video and kinematic data is an important machine learning problem with applications ranging from robotics to smart health. Most existing works focus on identifying coarse actions such as running, climbing, or cutting a vegetable, which have relatively long durations. This is an important limitation for applications that require the identification of subtle motions at high temporal resolution. For example, in stroke recovery, quantifying rehabilitation dose requires differentiating motions with sub-second durations. Our goal is to bridge this gap. To this end, we introduce a large-scale, multimodal dataset, StrokeRehab, as a new action-recognition benchmark that includes subtle short-duration actions labeled at a high temporal resolution. These short-duration actions are called functional primitives, and consist of reaches, transports, repositions, stabilizations, and idles. The dataset consists of high-quality Inertial Measurement Unit sensors and video data of 41 stroke-impaired patients performing activities of daily living like feeding, brushing teeth, etc. We show that current state-of-the-art models based on segmentation produce noisy predictions when applied to these data, which often leads to overcounting of actions. To address this, we propose a novel approach for high-resolution action identification, inspired by speech-recognition techniques, which is based on a sequence-to-sequence model that directly predicts the sequence of actions. This approach outperforms current state-of-the-art methods on the StrokeRehab dataset, as well as on the standard benchmark datasets 50Salads, Breakfast, and Jigsaws. 

To improve the performance of neural networks for parameter estimation in quantitative MRI, in particular when the noise propagation varies throughout the space of biophysical parameters.

A theoretically well‐founded loss function is proposed that normalizes the squared error of each estimate with respective Cramér–Rao bound (CRB)—a theoretical lower bound for the variance of an unbiased estimator. This avoids a dominance of hard‐to‐estimate parameters and areas in parameter space, which are often of little interest. The normalization with corresponding CRB balances the large errors of fundamentally more noisy estimates and the small errors of fundamentally less noisy estimates, allowing the network to better learn to estimate the latter. Further, proposed loss function provides an absolute evaluation metric for performance: A network has an average loss of 1 if it is a maximally efficient unbiased estimator, which can be considered the ideal performance. The performance gain with proposed loss function is demonstrated at the example of an eight‐parameter magnetization transfer model that is fitted to phantom and in vivo data.

Networks trained with proposed loss function perform close to optimal, that is, their loss converges to approximately 1, and their performance is superior to networks trained with the standard mean‐squared error (MSE). The proposed loss function reduces the bias of the estimates compared to the MSE loss, and improves the match of the noise variance to the CRB. This performance gain translates to in vivo maps that align better with the literature.

Normalizing the squared error with the CRB during the training of neural networks improves their performance in estimating biophysical parameters.