Brahmajee K. Nallamothu

Rachel T Gonzalez, Madeline R Abbott, Brahmajee Nallamothu et al.

The ubiquitous nature of mobile health (mHealth) technology has expanded opportunities for the integration of reinforcement learning into traditional clinical trial designs, allowing researchers to learn individualized treatment policies during the study. LowSalt4Life 2 (LS4L2) is a recent trial aimed at reducing sodium intake among hypertensive individuals through an app-based intervention. A reinforcement learning algorithm, which was deployed in one of the trial arms, was designed to send reminder notifications to promote app engagement in contexts where the notification would be effective, i.e., when a participant is likely to open the app in the next 30-minute and not when prior data suggested reduced effectiveness. Such an algorithm can improve app-based mHealth interventions by reducing participant burden and more effectively promoting behavior change. We encountered various challenges during the implementation of the learning algorithm, which we present as a template to solving challenges in future trials that deploy reinforcement learning algorithms. We provide template solutions based on LS4L2 for solving the key challenges of (i) defining a relevant reward, (ii) determining a meaningful timescale for optimization, (iii) specifying a robust statistical model that allows for automation, (iv) balancing model flexibility with computational cost, and (v) addressing missing values in gradually collected data.

Hamid R. Fazlali, Nader Karimi, S. M. Reza Soroushmehr et al.

Coronary artery disease (CAD) is the leading causes of death around the world. One of the most common imaging methods for diagnosing this disease is X-ray angiography. Diagnosing using these images is usually challenging due to non-uniform illumination, low contrast, presence of other body tissues, presence of catheter etc. These challenges make the diagnoses task of cardiologists tougher and more prone to misdiagnosis. In this paper we propose a new automated framework for coronary arteries segmentation, catheter detection and center-line extraction in x-ray angiography images. Our proposed segmentation method is based on superpixels. In this method at first three different superpixel scales are exploited and a measure for vesselness probability of each superpixel is determined. A majority voting is used for obtaining an initial segmentation map from these three superpixel scales. This initial segmentation is refined by finding the orthogonal line on each ridge pixel of vessel region. In this framework we use our catheter detection and tracking method which detects the catheter by finding its ridge in the first frame and traces in other frames by fitting a second order polynomial on it. Also we use the image ridges for extracting the coronary arteries centerlines. We evaluated our method qualitatively and quantitatively on two different challenging datasets and compared it with one of the previous well-known coronary arteries segmentation methods. Our method could detect the catheter and reduced the false positive rate in addition to achieving better segmentation results. The evaluation results prove that our method performs better in a much shorter time.