Sebastian D. Goodfellow

Sujay Nagaraj, Andrew J. Goodwin, Dmytro Lopushanskyy et al.

Central Venous Lines (C-Lines) and Arterial Lines (A-Lines) are routinely used in the Critical Care Unit (CCU) for blood sampling, medication administration, and high-frequency blood pressure measurement. Judiciously accessing these lines is important, as over-utilization is associated with significant in-hospital morbidity and mortality. Documenting the frequency of line-access is an important step in reducing these adverse outcomes. Unfortunately, the current gold-standard for documentation is manual and subject to error, omission, and bias. The high-frequency blood pressure waveform data from sensors in these lines are often noisy and full of artifacts. Standard approaches in signal processing remove noise artifacts before meaningful analysis. However, from bedside observations, we characterized a distinct artifact that occurs during each instance of C-Line or A-Line use. These artifacts are buried amongst physiological waveform and extraneous noise. We focus on Machine Learning (ML) models that can detect these artifacts from waveform data in real-time - finding needles in needle stacks, in order to automate the documentation of line-access. We built and evaluated ML classifiers running in real-time at a major children's hospital to achieve this goal. We demonstrate the utility of these tools for reducing documentation burden, increasing available information for bedside clinicians, and informing unit-level initiatives to improve patient safety.

Dmitrii Shubin, Danny Eytan, Sebastian D. Goodfellow

Self-supervised learning methods for computer vision have demonstrated the effectiveness of pre-training feature representations, resulting in well-generalizing Deep Neural Networks, even if the annotated data are limited. However, representation learning techniques require a significant amount of time for model training, with most of the time spent on precise hyper-parameter optimization and selection of augmentation techniques. We hypothesized that if the annotated dataset has enough morphological diversity to capture the diversity of the general population, as is common in medical imaging due to conserved similarities of tissue morphology, the variance error of the trained model is the dominant component of the Bias-Variance Trade-off. Therefore, we proposed the Variance Aware Training (VAT) method that exploits this data property by introducing the variance error into the model loss function, thereby, explicitly regularizing the model. Additionally, we provided a theoretical formulation and proof of the proposed method to aid interpreting the approach. Our method requires selecting only one hyper-parameter and matching or improving the performance of state-of-the-art self-supervised methods while achieving an order of magnitude reduction in the GPU training time. We validated VAT on three medical imaging datasets from diverse domains and for various learning objectives. These included a Magnetic Resonance Imaging (MRI) dataset for the heart semantic segmentation (MICCAI 2017 ACDC challenge), fundus photography dataset for ordinary regression of diabetic retinopathy progression (Kaggle 2019 APTOS Blindness Detection challenge), and classification of histopathologic scans of lymph node sections (PatchCamelyon dataset). Our code is available at https://github.com/DmitriiShubin/Variance-Aware-Training.

Tom Beer, Bar Eini-Porat, Sebastian Goodfellow et al.

Deep neural networks (DNN) have shown remarkable success in the classification of physiological signals. In this study we propose a method for examining to what extent does a DNN's performance rely on rediscovering existing features of the signals, as opposed to discovering genuinely new features. Moreover, we offer a novel method of "removing" a hand-engineered feature from the network's hypothesis space, thus forcing it to try and learn representations which are different from known ones, as a method of scientific exploration. We then build on existing work in the field of interpretability, specifically class activation maps, to try and infer what new features the network has learned. We demonstrate this approach using ECG and EEG signals. With respect to ECG signals we show that for the specific task of classifying atrial fibrillation, DNNs are likely rediscovering known features. We also show how our method could be used to discover new features, by selectively removing some ECG features and "rediscovering" them. We further examine how could our method be used as a tool for examining scientific hypotheses. We simulate this scenario by looking into the importance of eye movements in classifying sleep from EEG. We show that our tool can successfully focus a researcher's attention by bringing to light patterns in the data that would be hidden otherwise.