Deepta Rajan

Vivek Narayanaswamy, Yamen Mubarka, Rushil Anirudh et al.

We focus on the problem of producing well-calibrated out-of-distribution (OOD) detectors, in order to enable safe deployment of medical image classifiers. Motivated by the difficulty of curating suitable calibration datasets, synthetic augmentations have become highly prevalent for inlier/outlier specification. While there have been rapid advances in data augmentation techniques, this paper makes a striking finding that the space in which the inliers and outliers are synthesized, in addition to the type of augmentation, plays a critical role in calibrating OOD detectors. Using the popular energy-based OOD detection framework, we find that the optimal protocol is to synthesize latent-space inliers along with diverse pixel-space outliers. Based on empirical studies with multiple medical imaging benchmarks, we demonstrate that our approach consistently leads to superior OOD detection ($15\% - 35\%$ in AUROC) over the state-of-the-art in a variety of open-set recognition settings.

Jin Li, Deepta Rajan, Chintan Shah et al.

Histopathology images are gigapixel-sized and include features and information at different resolutions. Collecting annotations in histopathology requires highly specialized pathologists, making it expensive and time-consuming. Self-training can alleviate annotation constraints by learning from both labeled and unlabeled data, reducing the amount of annotations required from pathologists. We study the design of teacher-student self-training systems for Non-alcoholic Steatohepatitis (NASH) using clinical histopathology datasets with limited annotations. We evaluate the models on in-distribution and out-of-distribution test data under clinical data shifts. We demonstrate that through self-training, the best student model statistically outperforms the teacher with a $3\%$ absolute difference on the macro F1 score. The best student model also approaches the performance of a fully supervised model trained with twice as many annotations.

Jayaraman J. Thiagarajan, Vivek Narayanaswamy, Deepta Rajan et al.

Explanation techniques that synthesize small, interpretable changes to a given image while producing desired changes in the model prediction have become popular for introspecting black-box models. Commonly referred to as counterfactuals, the synthesized explanations are required to contain discernible changes (for easy interpretability) while also being realistic (consistency to the data manifold). In this paper, we focus on the case where we have access only to the trained deep classifier and not the actual training data. While the problem of inverting deep models to synthesize images from the training distribution has been explored, our goal is to develop a deep inversion approach to generate counterfactual explanations for a given query image. Despite their effectiveness in conditional image synthesis, we show that existing deep inversion methods are insufficient for producing meaningful counterfactuals. We propose DISC (Deep Inversion for Synthesizing Counterfactuals) that improves upon deep inversion by utilizing (a) stronger image priors, (b) incorporating a novel manifold consistency objective and (c) adopting a progressive optimization strategy. We find that, in addition to producing visually meaningful explanations, the counterfactuals from DISC are effective at learning classifier decision boundaries and are robust to unknown test-time corruptions.

Vivek Narayanaswamy, Jayaraman J. Thiagarajan, Deepta Rajan et al.

With increased interest in adopting AI methods for clinical diagnosis, a vital step towards safe deployment of such tools is to ensure that the models not only produce accurate predictions but also do not generalize to data regimes where the training data provide no meaningful evidence. Existing approaches for ensuring the distribution of model predictions to be similar to that of the true distribution rely on explicit uncertainty estimators that are inherently hard to calibrate. In this paper, we propose to train a loss estimator alongside the predictive model, using a contrastive training objective, to directly estimate the prediction uncertainties. Interestingly, we find that, in addition to producing well-calibrated uncertainties, this approach improves the generalization behavior of the predictor. Using a dermatology use-case, we show the impact of loss estimators on model generalization, in terms of both its fidelity on in-distribution data and its ability to detect out of distribution samples or new classes unseen during training.

Luyao Shi, Deepta Rajan, Shafiq Abedin et al.

Pulmonary Embolism (PE) is a life-threatening disorder associated with high mortality and morbidity. Prompt diagnosis and immediate initiation of therapeutic action is important. We explored a deep learning model to detect PE on volumetric contrast-enhanced chest CT scans using a 2-stage training strategy. First, a residual convolutional neural network (ResNet) was trained using annotated 2D images. In addition to the classification loss, an attention loss was added during training to help the network focus attention on PE. Next, a recurrent network was used to scan sequentially through the features provided by the pre-trained ResNet to detect PE. This combination allows the network to be trained using both a limited and sparse set of pixel-level annotated images and a large number of easily obtainable patient-level image-label pairs. We used 1,670 sparsely annotated studies and more than 10,000 labeled studies in our training. On a test set with 2,160 patient studies, the proposed method achieved an area under the ROC curve (AUC) of 0.812. The proposed framework is also able to provide localized attention maps that indicate possible PE lesions, which could potentially help radiologists accelerate the diagnostic process.

Deepta Rajan, Jayaraman J. Thiagarajan, Alexandros Karargyris et al.

Automated diagnostic assistants in healthcare necessitate accurate AI models that can be trained with limited labeled data, can cope with severe class imbalances and can support simultaneous prediction of multiple disease conditions. To this end, we present a deep learning framework that utilizes a number of key components to enable robust modeling in such challenging scenarios. Using an important use-case in chest X-ray classification, we provide several key insights on the effective use of data augmentation, self-training via distillation and confidence tempering for small data learning in medical imaging. Our results show that using 85% lesser labeled data, we can build predictive models that match the performance of classifiers trained in a large-scale data setting.

Jayaraman J. Thiagarajan, Prasanna Sattigeri, Deepta Rajan et al.

The wide-spread adoption of representation learning technologies in clinical decision making strongly emphasizes the need for characterizing model reliability and enabling rigorous introspection of model behavior. While the former need is often addressed by incorporating uncertainty quantification strategies, the latter challenge is addressed using a broad class of interpretability techniques. In this paper, we argue that these two objectives are not necessarily disparate and propose to utilize prediction calibration to meet both objectives. More specifically, our approach is comprised of a calibration-driven learning method, which is also used to design an interpretability technique based on counterfactual reasoning. Furthermore, we introduce \textit{reliability plots}, a holistic evaluation mechanism for model reliability. Using a lesion classification problem with dermoscopy images, we demonstrate the effectiveness of our approach and infer interesting insights about the model behavior.

Jayaraman J. Thiagarajan, Bindya Venkatesh, Deepta Rajan

Calibration error is commonly adopted for evaluating the quality of uncertainty estimators in deep neural networks. In this paper, we argue that such a metric is highly beneficial for training predictive models, even when we do not explicitly measure the uncertainties. This is conceptually similar to heteroscedastic neural networks that produce variance estimates for each prediction, with the key difference that we do not place a Gaussian prior on the predictions. We propose a novel algorithm that performs simultaneous interval estimation for different calibration levels and effectively leverages the intervals to refine the mean estimates. Our results show that, our approach is consistently superior to existing regularization strategies in deep regression models. Finally, we propose to augment partial dependence plots, a model-agnostic interpretability tool, with expected prediction intervals to reveal interesting dependencies between data and the target.

Deepta Rajan, David Beymer, Shafiqul Abedin et al.

Pulmonary embolisms (PE) are known to be one of the leading causes for cardiac-related mortality. Due to inherent variabilities in how PE manifests and the cumbersome nature of manual diagnosis, there is growing interest in leveraging AI tools for detecting PE. In this paper, we build a two-stage detection pipeline that is accurate, computationally efficient, robust to variations in PE types and kernels used for CT reconstruction, and most importantly, does not require dense annotations. Given the challenges in acquiring expert annotations in large-scale datasets, our approach produces state-of-the-art results with very sparse emboli contours (at 10mm slice spacing), while using models with significantly lower number of parameters. We achieve AUC scores of 0.94 on the validation set and 0.85 on the test set of highly severe PEs. Using a large, real-world dataset characterized by complex PE types and patients from multiple hospitals, we present an elaborate empirical study and provide guidelines for designing highly generalizable pipelines.

Tomasz Kornuta, Deepta Rajan, Chaitanya Shivade et al.

In this working notes paper, we describe IBM Research AI (Almaden) team's participation in the ImageCLEF 2019 VQA-Med competition. The challenge consists of four question-answering tasks based on radiology images. The diversity of imaging modalities, organs and disease types combined with a small imbalanced training set made this a highly complex problem. To overcome these difficulties, we implemented a modular pipeline architecture that utilized transfer learning and multi-task learning. Our findings led to the development of a novel model called Supporting Facts Network (SFN). The main idea behind SFN is to cross-utilize information from upstream tasks to improve the accuracy on harder downstream ones. This approach significantly improved the scores achieved in the validation set (18 point improvement in F-1 score). Finally, we submitted four runs to the competition and were ranked seventh.

Deepta Rajan, David Beymer, Girish Narayan

Acceleration of machine learning research in healthcare is challenged by lack of large annotated and balanced datasets. Furthermore, dealing with measurement inaccuracies and exploiting unsupervised data are considered to be central to improving existing solutions. In particular, a primary objective in predictive modeling is to generalize well to both unseen variations within the observed classes, and unseen classes. In this work, we consider such a challenging problem in machine learning driven diagnosis: detecting a gamut of cardiovascular conditions (e.g. infarction, dysrhythmia etc.) from limited channel ECG measurements. Though deep neural networks have achieved unprecedented success in predictive modeling, they rely solely on discriminative models that can generalize poorly to unseen classes. We argue that unsupervised learning can be utilized to construct effective latent spaces that facilitate better generalization. This work extensively compares the generalization of our proposed approach against a state-of-the-art deep learning solution. Our results show significant improvements in F1-scores.

Jayaraman J. Thiagarajan, Deepta Rajan, Prasanna Sattigeri

The hypothesis that computational models can be reliable enough to be adopted in prognosis and patient care is revolutionizing healthcare. Deep learning, in particular, has been a game changer in building predictive models, thus leading to community-wide data curation efforts. However, due to inherent variabilities in population characteristics and biological systems, these models are often biased to the training datasets. This can be limiting when models are deployed in new environments, when there are systematic domain shifts not known a priori. In this paper, we propose to emulate a large class of domain shifts, that can occur in clinical settings, with a given dataset, and argue that evaluating the behavior of predictive models in light of those shifts is an effective way to quantify their reliability. More specifically, we develop an approach for building realistic scenarios, based on analysis of \textit{disease landscapes} in multi-label classification. Using the openly available MIMIC-III EHR dataset for phenotyping, for the first time, our work sheds light into data regimes where deep clinical models can fail to generalize. This work emphasizes the need for novel validation mechanisms driven by real-world domain shifts in AI for healthcare.

Deepta Rajan, Jayaraman J. Thiagarajan

Processing temporal sequences is central to a variety of applications in health care, and in particular multi-channel Electrocardiogram (ECG) is a highly prevalent diagnostic modality that relies on robust sequence modeling. While Recurrent Neural Networks (RNNs) have led to significant advances in automated diagnosis with time-series data, they perform poorly when models are trained using a limited set of channels. A crucial limitation of existing solutions is that they rely solely on discriminative models, which tend to generalize poorly in such scenarios. In order to combat this limitation, we develop a generative modeling approach to limited channel ECG classification. This approach first uses a Seq2Seq model to implicitly generate the missing channel information, and then uses the latent representation to perform the actual supervisory task. This decoupling enables the use of unsupervised data and also provides highly robust metric spaces for subsequent discriminative learning. Our experiments with the Physionet dataset clearly evidence the effectiveness of our approach over standard RNNs in disease prediction.

Huan Song, Deepta Rajan, Jayaraman J. Thiagarajan et al.

With widespread adoption of electronic health records, there is an increased emphasis for predictive models that can effectively deal with clinical time-series data. Powered by Recurrent Neural Network (RNN) architectures with Long Short-Term Memory (LSTM) units, deep neural networks have achieved state-of-the-art results in several clinical prediction tasks. Despite the success of RNNs, its sequential nature prohibits parallelized computing, thus making it inefficient particularly when processing long sequences. Recently, architectures which are based solely on attention mechanisms have shown remarkable success in transduction tasks in NLP, while being computationally superior. In this paper, for the first time, we utilize attention models for clinical time-series modeling, thereby dispensing recurrence entirely. We develop the \textit{SAnD} (Simply Attend and Diagnose) architecture, which employs a masked, self-attention mechanism, and uses positional encoding and dense interpolation strategies for incorporating temporal order. Furthermore, we develop a multi-task variant of \textit{SAnD} to jointly infer models with multiple diagnosis tasks. Using the recent MIMIC-III benchmark datasets, we demonstrate that the proposed approach achieves state-of-the-art performance in all tasks, outperforming LSTM models and classical baselines with hand-engineered features.

Jayaraman J. Thiagarajan, Karthikeyan Natesan Ramamurthy, Deepta Rajan et al.

In this paper, we propose sparse coding-based approaches for segmentation of tumor regions from MR images. Sparse coding with data-adapted dictionaries has been successfully employed in several image recovery and vision problems. The proposed approaches obtain sparse codes for each pixel in brain magnetic resonance images considering their intensity values and location information. Since it is trivial to obtain pixel-wise sparse codes, and combining multiple features in the sparse coding setup is not straightforward, we propose to perform sparse coding in a high-dimensional feature space where non-linear similarities can be effectively modeled. We use the training data from expert-segmented images to obtain kernel dictionaries with the kernel K-lines clustering procedure. For a test image, sparse codes are computed with these kernel dictionaries, and they are used to identify the tumor regions. This approach is completely automated, and does not require user intervention to initialize the tumor regions in a test image. Furthermore, a low complexity segmentation approach based on kernel sparse codes, which allows the user to initialize the tumor region, is also presented. Results obtained with both the proposed approaches are validated against manual segmentation by an expert radiologist, and the proposed methods lead to accurate tumor identification.