Walter Karlen

Khrystyna Semkiv, Jia Zhang, Maria Laura Ferster et al.

Artifacts in the electroencephalogram (EEG) degrade signal quality and impact the analysis of brain activity. Current methods for detecting artifacts in sleep EEG rely on simple threshold-based algorithms that require manual intervention, which is time-consuming and impractical due to the vast volume of data that novel mobile recording systems generate. We propose a convolutional neural network (CNN) model incorporating a convolutional block attention module (CNN-CBAM) to detect and identify the location of artifacts in the sleep EEG with attention maps. We benchmarked this model against six other machine learning and signal processing approaches. We trained/tuned all models on 72 manually annotated EEG recordings obtained during home-based monitoring from 18 healthy participants with a mean (SD) age of 68.05 y ($\pm$5.02). We tested them on 26 separate recordings from 6 healthy participants with a mean (SD) age of 68.33 y ($\pm$4.08), with contained artifacts in 4\% of epochs. CNN-CBAM achieved the highest area under the receiver operating characteristic curve (0.88), sensitivity (0.81), and specificity (0.86) when compared to the other approaches. The attention maps from CNN-CBAM localized artifacts within the epoch with a sensitivity of 0.71 and specificity of 0.67. This work demonstrates the feasibility of automating the detection and localization of artifacts in wearable sleep EEG.

Gaetano Scebba, Jia Zhang, Sabrina Catanzaro et al.

Chronic wounds significantly impact quality of life. If not properly managed, they can severely deteriorate. Image-based wound analysis could aid in objectively assessing the wound status by quantifying important features that are related to healing. However, the high heterogeneity of the wound types, image background composition, and capturing conditions challenge the robust segmentation of wound images. We present Detect-and-Segment (DS), a deep learning approach to produce wound segmentation maps with high generalization capabilities. In our approach, dedicated deep neural networks detected the wound position, isolated the wound from the uninformative background, and computed the wound segmentation map. We evaluated this approach using one data set with images of diabetic foot ulcers. For further testing, 4 supplemental independent data sets with larger variety of wound types from different body locations were used. The Matthews' correlation coefficient (MCC) improved from 0.29 when computing the segmentation on the full image to 0.85 when combining detection and segmentation in the same approach. When tested on the wound images drawn from the supplemental data sets, the DS approach increased the mean MCC from 0.17 to 0.85. Furthermore, the DS approach enabled the training of segmentation models with up to 90% less training data while maintaining the segmentation performance.

Gaetano Scebba, Giulia Da Poian, Walter Karlen

Continuous monitoring of respiratory activity is desirable in many clinical applications to detect respiratory events. Non-contact monitoring of respiration can be achieved with near- and far-infrared spectrum cameras. However, current technologies are not sufficiently robust to be used in clinical applications. For example, they fail to estimate an accurate respiratory rate (RR) during apnea. We present a novel algorithm based on multispectral data fusion that aims at estimating RR also during apnea. The algorithm independently addresses the RR estimation and apnea detection tasks. Respiratory information is extracted from multiple sources and fed into an RR estimator and an apnea detector whose results are fused into a final respiratory activity estimation. We evaluated the system retrospectively using data from 30 healthy adults who performed diverse controlled breathing tasks while lying supine in a dark room and reproduced central and obstructive apneic events. Combining multiple respiratory information from multispectral cameras improved the root mean square error (RMSE) accuracy of the RR estimation from up to 4.64 monospectral data down to 1.60 breaths/min. The median F1 scores for classifying obstructive (0.75 to 0.86) and central apnea (0.75 to 0.93) also improved. Furthermore, the independent consideration of apnea detection led to a more robust system (RMSE of 4.44 vs. 7.96 breaths/min). Our findings may represent a step towards the use of cameras for vital sign monitoring in medical applications.

Patrick Schwab, Walter Karlen

Feature importance estimates that inform users about the degree to which given inputs influence the output of a predictive model are crucial for understanding, validating, and interpreting machine-learning models. However, providing fast and accurate estimates of feature importance for high-dimensional data, and quantifying the uncertainty of such estimates remain open challenges. Here, we frame the task of providing explanations for the decisions of machine-learning models as a causal learning task, and train causal explanation (CXPlain) models that learn to estimate to what degree certain inputs cause outputs in another machine-learning model. CXPlain can, once trained, be used to explain the target model in little time, and enables the quantification of the uncertainty associated with its feature importance estimates via bootstrap ensembling. We present experiments that demonstrate that CXPlain is significantly more accurate and faster than existing model-agnostic methods for estimating feature importance. In addition, we confirm that the uncertainty estimates provided by CXPlain ensembles are strongly correlated with their ability to accurately estimate feature importance on held-out data.

Patrick Schwab, Lorenz Linhardt, Walter Karlen

Learning representations for counterfactual inference from observational data is of high practical relevance for many domains, such as healthcare, public policy and economics. Counterfactual inference enables one to answer "What if...?" questions, such as "What would be the outcome if we gave this patient treatment $t_1$?". However, current methods for training neural networks for counterfactual inference on observational data are either overly complex, limited to settings with only two available treatments, or both. Here, we present Perfect Match (PM), a method for training neural networks for counterfactual inference that is easy to implement, compatible with any architecture, does not add computational complexity or hyperparameters, and extends to any number of treatments. PM is based on the idea of augmenting samples within a minibatch with their propensity-matched nearest neighbours. Our experiments demonstrate that PM outperforms a number of more complex state-of-the-art methods in inferring counterfactual outcomes across several benchmarks, particularly in settings with many treatments.

Patrick Schwab, Walter Karlen

Parkinson's disease is a neurodegenerative disease that can affect a person's movement, speech, dexterity, and cognition. Clinicians primarily diagnose Parkinson's disease by performing a clinical assessment of symptoms. However, misdiagnoses are common. One factor that contributes to misdiagnoses is that the symptoms of Parkinson's disease may not be prominent at the time the clinical assessment is performed. Here, we present a machine-learning approach towards distinguishing between people with and without Parkinson's disease using long-term data from smartphone-based walking, voice, tapping and memory tests. We demonstrate that our attentive deep-learning models achieve significant improvements in predictive performance over strong baselines (area under the receiver operating characteristic curve = 0.85) in data from a cohort of 1853 participants. We also show that our models identify meaningful features in the input data. Our results confirm that smartphone data collected over extended periods of time could in the future potentially be used as a digital biomarker for the diagnosis of Parkinson's disease.

Patrick Schwab, Emanuela Keller, Carl Muroi et al.

Patients in the intensive care unit (ICU) require constant and close supervision. To assist clinical staff in this task, hospitals use monitoring systems that trigger audiovisual alarms if their algorithms indicate that a patient's condition may be worsening. However, current monitoring systems are extremely sensitive to movement artefacts and technical errors. As a result, they typically trigger hundreds to thousands of false alarms per patient per day - drowning the important alarms in noise and adding to the exhaustion of clinical staff. In this setting, data is abundantly available, but obtaining trustworthy annotations by experts is laborious and expensive. We frame the problem of false alarm reduction from multivariate time series as a machine-learning task and address it with a novel multitask network architecture that utilises distant supervision through multiple related auxiliary tasks in order to reduce the number of expensive labels required for training. We show that our approach leads to significant improvements over several state-of-the-art baselines on real-world ICU data and provide new insights on the importance of task selection and architectural choices in distantly supervised multitask learning.