Katy Blumer

Katy Blumer, Subhashini Venugopalan, Michael P. Brenner et al.

We analyze a dataset of retinal images using linear probes: linear regression models trained on some "target" task, using embeddings from a deep convolutional (CNN) model trained on some "source" task as input. We use this method across all possible pairings of 93 tasks in the UK Biobank dataset of retinal images, leading to ~164k different models. We analyze the performance of these linear probes by source and target task and by layer depth. We observe that representations from the middle layers of the network are more generalizable. We find that some target tasks are easily predicted irrespective of the source task, and that some other target tasks are more accurately predicted from correlated source tasks than from embeddings trained on the same task.

Maithra Raghu, Katy Blumer, Greg Corrado et al.

In a wide array of areas, algorithms are matching and surpassing the performance of human experts, leading to consideration of the roles of human judgment and algorithmic prediction in these domains. The discussion around these developments, however, has implicitly equated the specific task of prediction with the general task of automation. We argue here that automation is broader than just a comparison of human versus algorithmic performance on a task; it also involves the decision of which instances of the task to give to the algorithm in the first place. We develop a general framework that poses this latter decision as an optimization problem, and we show how basic heuristics for this optimization problem can lead to performance gains even on heavily-studied applications of AI in medicine. Our framework also serves to highlight how effective automation depends crucially on estimating both algorithmic and human error on an instance-by-instance basis, and our results show how improvements in these error estimation problems can yield significant gains for automation as well.

Maithra Raghu, Katy Blumer, Rory Sayres et al.

The issue of disagreements amongst human experts is a ubiquitous one in both machine learning and medicine. In medicine, this often corresponds to doctor disagreements on a patient diagnosis. In this work, we show that machine learning models can be trained to give uncertainty scores to data instances that might result in high expert disagreements. In particular, they can identify patient cases that would benefit most from a medical second opinion. Our central methodological finding is that Direct Uncertainty Prediction (DUP), training a model to predict an uncertainty score directly from the raw patient features, works better than Uncertainty Via Classification, the two-step process of training a classifier and postprocessing the output distribution to give an uncertainty score. We show this both with a theoretical result, and on extensive evaluations on a large scale medical imaging application.

Avinash V. Varadarajan, Ryan Poplin, Katy Blumer et al.

Refractive error, one of the leading cause of visual impairment, can be corrected by simple interventions like prescribing eyeglasses. We trained a deep learning algorithm to predict refractive error from the fundus photographs from participants in the UK Biobank cohort, which were 45 degree field of view images and the AREDS clinical trial, which contained 30 degree field of view images. Our model use the "attention" method to identify features that are correlated with refractive error. Mean absolute error (MAE) of the algorithm's prediction compared to the refractive error obtained in the AREDS and UK Biobank. The resulting algorithm had a MAE of 0.56 diopters (95% CI: 0.55-0.56) for estimating spherical equivalent on the UK Biobank dataset and 0.91 diopters (95% CI: 0.89-0.92) for the AREDS dataset. The baseline expected MAE (obtained by simply predicting the mean of this population) was 1.81 diopters (95% CI: 1.79-1.84) for UK Biobank and 1.63 (95% CI: 1.60-1.67) for AREDS. Attention maps suggested that the foveal region was one of the most important areas used by the algorithm to make this prediction, though other regions also contribute to the prediction. The ability to estimate refractive error with high accuracy from retinal fundus photos has not been previously known and demonstrates that deep learning can be applied to make novel predictions from medical images. Given that several groups have recently shown that it is feasible to obtain retinal fundus photos using mobile phones and inexpensive attachments, this work may be particularly relevant in regions of the world where autorefractors may not be readily available.

Ryan Poplin, Avinash V. Varadarajan, Katy Blumer et al.

Traditionally, medical discoveries are made by observing associations and then designing experiments to test these hypotheses. However, observing and quantifying associations in images can be difficult because of the wide variety of features, patterns, colors, values, shapes in real data. In this paper, we use deep learning, a machine learning technique that learns its own features, to discover new knowledge from retinal fundus images. Using models trained on data from 284,335 patients, and validated on two independent datasets of 12,026 and 999 patients, we predict cardiovascular risk factors not previously thought to be present or quantifiable in retinal images, such as such as age (within 3.26 years), gender (0.97 AUC), smoking status (0.71 AUC), HbA1c (within 1.39%), systolic blood pressure (within 11.23mmHg) as well as major adverse cardiac events (0.70 AUC). We further show that our models used distinct aspects of the anatomy to generate each prediction, such as the optic disc or blood vessels, opening avenues of further research.