Tongan Cai

Tongan Cai, Haomiao Ni, Wenchao Ma et al.

Effective stroke triage in emergency settings often relies on clinicians' ability to identify subtle abnormalities in facial muscle coordination. While recent AI models have shown promise in detecting such patterns from patient facial videos, their reliance on real patient data raises significant ethical and privacy challenges -- especially when training robust and generalizable models across institutions. To address these concerns, we propose SafeTriage, a novel method designed to de-identify patient facial videos while preserving essential motion cues crucial for stroke diagnosis. SafeTriage leverages a pretrained video motion transfer (VMT) model to map the motion characteristics of real patient faces onto synthetic identities. This approach retains diagnostically relevant facial dynamics without revealing the patients' identities. To mitigate the distribution shift between normal population pre-training videos and patient population test videos, we introduce a conditional generative model for visual prompt tuning, which adapts the input space of the VMT model to ensure accurate motion transfer without needing to fine-tune the VMT model backbone. Comprehensive evaluation, including quantitative metrics and clinical expert assessments, demonstrates that SafeTriage-produced synthetic videos effectively preserve stroke-relevant facial patterns, enabling reliable AI-based triage. Our evaluations also show that SafeTriage provides robust privacy protection while maintaining diagnostic accuracy, offering a secure and ethically sound foundation for data sharing and AI-driven clinical analysis in neurological disorders.

Tongan Cai, Haomiao Ni, Mingli Yu et al.

In an emergency room (ER) setting, stroke triage or screening is a common challenge. A quick CT is usually done instead of MRI due to MRI's slow throughput and high cost. Clinical tests are commonly referred to during the process, but the misdiagnosis rate remains high. We propose a novel multimodal deep learning framework, DeepStroke, to achieve computer-aided stroke presence assessment by recognizing patterns of minor facial muscles incoordination and speech inability for patients with suspicion of stroke in an acute setting. Our proposed DeepStroke takes one-minute facial video data and audio data readily available during stroke triage for local facial paralysis detection and global speech disorder analysis. Transfer learning was adopted to reduce face-attribute biases and improve generalizability. We leverage a multi-modal lateral fusion to combine the low- and high-level features and provide mutual regularization for joint training. Novel adversarial training is introduced to obtain identity-free and stroke-discriminative features. Experiments on our video-audio dataset with actual ER patients show that DeepStroke outperforms state-of-the-art models and achieves better performance than both a triage team and ER doctors, attaining a 10.94% higher sensitivity and maintaining 7.37% higher accuracy than traditional stroke triage when specificity is aligned. Meanwhile, each assessment can be completed in less than six minutes, demonstrating the framework's great potential for clinical translation.