Andreas Theissler

Shuyuan Yang, Grant Boone, Timo Markert et al.

Robot-Assisted Minimally Invasive Surgery (RAMIS) enhances surgeon dexterity, with newer platforms leveraging haptic feedback to further improve performance. Such force information has broader potential to inform performance assessment, tactile localization, and surgical autonomy. This motivates the need for accessible approaches to integrating force sensing into RAMIS tools. This work presents a method for integrating a six-axis commercial force sensor into the distal end of a standard cable-driven surgical instrument, enabling end-effector force measurement while preserving the original mechanical functionality of the device. The proposed design emphasizes reproducibility and accessibility for research applications, requiring no specialized manufacturing tools. A transformer neural network integrates force sensor measurements with robot state information to aid estimation of applied forces at the end-effector, compensating for internal cable forces arising from actuation. Our proposed approach achieved normalized errors below 6%, and generalized to unseen conditions better than purely proximal data-driven sensing approaches. High internal cable forces caused sensor saturation and reduced axial force observability, which can degrade performance along the tool's major axis and under higher load conditions. Given current levels of performance, the balance of system integrability and performance enables applications and research into timely topics of haptic feedback, skill assessment, and force-informed autonomy in RAMIS. Videos and code are available at https://enhanced-telerobotics.github.io/shaft force sensing.

Stefan Kraft, Andreas Theissler, Vera Wienhausen-Wilke et al.

Detecting arousals in sleep is essential for diagnosing sleep disorders. However, using Machine Learning (ML) in clinical practice is impeded by fundamental issues, primarily due to mismatches between clinical protocols and ML methods. Clinicians typically annotate only the onset of arousals, while ML methods rely on annotations for both the beginning and end. Additionally, there is no standardized evaluation methodology tailored to clinical needs for arousal detection models. This work addresses these issues by introducing a novel post-processing and evaluation framework emphasizing approximate localization and precise event count (ALPEC) of arousals. We recommend that ML practitioners focus on detecting arousal onsets, aligning with clinical practice. We examine the impact of this shift on current training and evaluation schemes, addressing simplifications and challenges. We utilize a novel comprehensive polysomnographic dataset (CPS) that reflects the aforementioned clinical annotation constraints and includes modalities not present in existing polysomnographic datasets. We release the dataset alongside this paper, demonstrating the benefits of leveraging multimodal data for arousal onset detection. Our findings significantly contribute to integrating ML-based arousal detection in clinical settings, reducing the gap between technological advancements and clinical needs.

Stefan Kraft, Andreas Theissler, Vera Wienhausen-Wilke et al.

Artificial intelligence (AI) systems increasingly match or surpass human experts in biomedical signal interpretation. However, their effective integration into clinical practice requires more than high predictive accuracy. Clinicians must discern \textit{when} and \textit{why} to trust algorithmic recommendations. This work presents an application-grounded user study with eight professional sleep medicine practitioners, who score nocturnal arousal events in polysomnographic data under three conditions: (i) manual scoring, (ii) black-box (BB) AI assistance, and (iii) transparent white-box (WB) AI assistance. Assistance is provided either from the \textit{start} of scoring or as a post-hoc quality-control (\textit{QC}) review. We systematically evaluate how the type and timing of assistance influence event-level and clinically most relevant count-based performance, time requirements, and user experience. When evaluated against the clinical standard used to train the AI, both AI and human-AI teams significantly outperform unaided experts, with collaboration also reducing inter-rater variability. Notably, transparent AI assistance applied as a targeted QC step yields median event-level performance improvements of approximately 30\% over black-box assistance, and QC timing further enhances count-based outcomes. While WB and QC approaches increase the time required for scoring, start-time assistance is faster and preferred by most participants. Participants overwhelmingly favor transparency, with seven out of eight expressing willingness to adopt the system with minor or no modifications. In summary, strategically timed transparent AI assistance effectively balances accuracy and clinical efficiency, providing a promising pathway toward trustworthy AI integration and user acceptance in clinical workflows.