Chihcheng Hsieh

Chihcheng Hsieh, Isabel Blanco Nobre, Sandra Costa Sousa et al.

This study investigates the effects of including patients' clinical information on the performance of deep learning (DL) classifiers for disease location in chest X-ray images. Although current classifiers achieve high performance using chest X-ray images alone, our interviews with radiologists indicate that clinical data is highly informative and essential for interpreting images and making proper diagnoses. In this work, we propose a novel architecture consisting of two fusion methods that enable the model to simultaneously process patients' clinical data (structured data) and chest X-rays (image data). Since these data modalities are in different dimensional spaces, we propose a spatial arrangement strategy, spatialization, to facilitate the multimodal learning process in a Mask R-CNN model. We performed an extensive experimental evaluation using MIMIC-Eye, a dataset comprising modalities: MIMIC-CXR (chest X-ray images), MIMIC IV-ED (patients' clinical data), and REFLACX (annotations of disease locations in chest X-rays). Results show that incorporating patients' clinical data in a DL model together with the proposed fusion methods improves the disease localization in chest X-rays by 12\% in terms of Average Precision compared to a standard Mask R-CNN using only chest X-rays. Further ablation studies also emphasize the importance of multimodal DL architectures and the incorporation of patients' clinical data in disease localization. The architecture proposed in this work is publicly available to promote the scientific reproducibility of our study (https://github.com/ChihchengHsieh/multimodal-abnormalities-detection)

Catarina Moreira, Yu-Liang Chou, Chihcheng Hsieh et al.

This study investigates the impact of machine learning models on the generation of counterfactual explanations by conducting a benchmark evaluation over three different types of models: a decision tree (fully transparent, interpretable, white-box model), a random forest (semi-interpretable, grey-box model), and a neural network (fully opaque, black-box model). We tested the counterfactual generation process using four algorithms (DiCE, WatcherCF, prototype, and GrowingSpheresCF) in the literature in 25 different datasets. Our findings indicate that: (1) Different machine learning models have little impact on the generation of counterfactual explanations; (2) Counterfactual algorithms based uniquely on proximity loss functions are not actionable and will not provide meaningful explanations; (3) One cannot have meaningful evaluation results without guaranteeing plausibility in the counterfactual generation. Algorithms that do not consider plausibility in their internal mechanisms will lead to biased and unreliable conclusions if evaluated with the current state-of-the-art metrics; (4) A counterfactual inspection analysis is strongly recommended to ensure a robust examination of counterfactual explanations and the potential identification of biases.

André Luís, Chihcheng Hsieh, Isabel Blanco Nobre et al.

This paper proposes a novel multimodal DL architecture incorporating medical images and eye-tracking data for abnormality detection in chest x-rays. Our results show that applying eye gaze data directly into DL architectures does not show superior predictive performance in abnormality detection chest X-rays. These results support other works in the literature and suggest that human-generated data, such as eye gaze, needs a more thorough investigation before being applied to DL architectures.

Chihcheng Hsieh, Catarina Moreira, Isabel Blanco Nobre et al.

X-ray images are vital in medical diagnostics, but their effectiveness is limited without clinical context. Radiologists often find chest X-rays insufficient for diagnosing underlying diseases, necessitating the integration of structured clinical features with radiology reports. To address this, we introduce DALL-M, a novel framework that enhances clinical datasets by generating contextual synthetic data. DALL-M augments structured patient data, including vital signs (e.g., heart rate, oxygen saturation), radiology findings (e.g., lesion presence), and demographic factors. It integrates this tabular data with contextual knowledge extracted from radiology reports and domain-specific resources (e.g., Radiopaedia, Wikipedia), ensuring clinical consistency and reliability. DALL-M follows a three-phase process: (i) clinical context storage, (ii) expert query generation, and (iii) context-aware feature augmentation. Using large language models (LLMs), it generates both contextual synthetic values for existing clinical features and entirely new, clinically relevant features. Applied to 799 cases from the MIMIC-IV dataset, DALL-M expanded the original 9 clinical features to 91. Empirical validation with machine learning models (including Decision Trees, Random Forests, XGBoost, and TabNET) demonstrated a 16.5% improvement in F1 score and a 25% increase in Precision and Recall. DALL-M bridges an important gap in clinical data augmentation by preserving data integrity while enhancing predictive modeling in healthcare. Our results show that integrating LLM-generated synthetic features significantly improves model performance, making DALL-M a scalable and practical approach for AI-driven medical diagnostics.

Chihcheng Hsieh, Catarina Moreira, Chun Ouyang

Predictive process analytics often apply machine learning to predict the future states of a running business~process. However, the internal mechanisms of many existing predictive algorithms are opaque and a human decision-maker is unable to understand \emph{why} a certain activity was predicted. Recently, counterfactuals have been proposed in the literature to derive human-understandable explanations from predictive models. Current counterfactual approaches consist of finding the minimum feature change that can make a certain prediction flip its outcome. Although many algorithms have been proposed, their application to multi-dimensional sequence data like event logs has not been explored in the literature. In this paper, we explore the use of a recent, popular model-agnostic counterfactual algorithm, DiCE, in the context of predictive process analytics. The analysis reveals that DiCE is unable to derive explanations for process predictions, due to (1) process domain knowledge not being taken into account, (2) long traces of process execution that often tend to be less understandable, and (3) difficulties in optimising the counterfactual search with categorical variables. We design an extension of DiCE, namely DiCE4EL (DiCE for Event Logs), that can generate counterfactual explanations for process prediction, and propose an approach that supports deriving milestone-aware counterfactual explanations at key intermediate stages along process execution to promote interpretability. We apply our approach to a publicly available real-life event log and the analysis results demonstrate the effectiveness of the proposed approach.