Daniel F. Heitjan

Alex Treacher, Kevin Nguyen, Dylan Owens et al.

This work demonstrates the ability to produce readily interpretable statistical metrics for model fit, fixed effects covariance coefficients, and prediction confidence. Importantly, this work compares 4 suitable and commonly applied epistemic UQ approaches, BNN, SWAG, MC dropout, and ensemble approaches in their ability to calculate these statistical metrics for the ARMED MEDL models. In our experiment for AD prognosis, not only do the UQ methods provide these benefits, but several UQ methods maintain the high performance of the original ARMED method, some even provide a modest (but not statistically significant) performance improvement. The ensemble models, especially the ensemble method with a 90% subsampling, performed well across all metrics we tested with (1) high performance that was comparable to the non-UQ ARMED model, (2) properly deweights the confounds probes and assigns them statistically insignificant p-values, (3) attains relatively high calibration of the output prediction confidence. Based on the results, the ensemble approaches, especially with a subsampling of 90%, provided the best all-round performance for prediction and uncertainty estimation, and achieved our goals to provide statistical significance for model fit, statistical significance covariate coefficients, and confidence in prediction, while maintaining the baseline performance of MEDL using ARMED

Anjali Balagopal, Howard Morgan, Michael Dohopoloski et al.

Automatic segmentation of medical images with DL algorithms has proven to be highly successful. With most of these algorithms, inter-observer variation is an acknowledged problem, leading to sub-optimal results. This problem is even more significant in post-operative clinical target volume (post-op CTV) segmentation due to the absence of macroscopic visual tumor in the image. This study, using post-op CTV segmentation as the test bed, tries to determine if physician styles are consistent and learnable, if there is an impact of physician styles on treatment outcome and toxicity; and how to explicitly deal with physician styles in DL algorithms to facilitate its clinical acceptance. A classifier is trained to identify which physician has contoured the CTV from just the contour and corresponding CT scan, to determine if physician styles are consistent and learnable. Next, we evaluate if adapting automatic segmentation to physician styles would be clinically feasible based on a lack of difference between outcomes. For modeling different physician styles of CTV segmentation, a concept called physician style-aware (PSA) segmentation is proposed which is an encoder-multidecoder network trained with perceptual loss. With the proposed physician style-aware network (PSA-Net), Dice similarity coefficient (DSC) accuracy increases on an average of 3.4% for all physicians from a general model that is not style adapted. We show that stylistic contouring variations also exist between institutions that follow the same segmentation guidelines and show the effectiveness of the proposed method in adapting to new institutional styles. We observed an accuracy improvement of 5% in terms of DSC when adapting to the style of a separate institution.