Mayanka Chandrashekar

Mayanka Chandrashekar, Ian Goethert, Md Inzamam Ul Haque et al.

Objectives: This study aims to assess the impact of domain shift on chest X-ray classification accuracy and to analyze the influence of ground truth label quality and demographic factors such as age group, sex, and study year. Materials and Methods: We used a DenseNet121 model pretrained MIMIC-CXR dataset for deep learning-based multilabel classification using ground truth labels from radiology reports extracted using the CheXpert and CheXbert Labeler. We compared the performance of the 14 chest X-ray labels on the MIMIC-CXR and Veterans Healthcare Administration chest X-ray dataset (VA-CXR). The VA-CXR dataset comprises over 259k chest X-ray images spanning between the years 2010 and 2022. Results: The validation of ground truth and the assessment of multi-label classification performance across various NLP extraction tools revealed that the VA-CXR dataset exhibited lower disagreement rates than the MIMIC-CXR datasets. Additionally, there were notable differences in AUC scores between models utilizing CheXpert and CheXbert. When evaluating multi-label classification performance across different datasets, minimal domain shift was observed in unseen datasets, except for the label "Enlarged Cardiomediastinum." The study year's subgroup analyses exhibited the most significant variations in multi-label classification model performance. These findings underscore the importance of considering domain shifts in chest X-ray classification tasks, particularly concerning study years. Conclusion: Our study reveals the significant impact of domain shift and demographic factors on chest X-ray classification, emphasizing the need for improved transfer learning and equitable model development. Addressing these challenges is crucial for advancing medical imaging and enhancing patient care.

Xiao Wang, Isaac Lyngaas, Aristeidis Tsaris et al.

Transformer models trained on long sequences often achieve higher accuracy than short sequences. Unfortunately, conventional transformers struggle with long sequence training due to the overwhelming computation and memory requirements. Existing methods for long sequence training offer limited speedup and memory reduction, and may compromise accuracy. This paper presents a novel and efficient distributed training method, the Long Short-Sequence Transformer (LSS Transformer), for training transformer with long sequences. It distributes a long sequence into segments among GPUs, with each GPU computing a partial self-attention for its segment. Then, it uses a fused communication and a novel double gradient averaging technique to avoid the need to aggregate partial self-attention and minimize communication overhead. We evaluated the performance between LSS Transformer and the state-of-the-art Nvidia sequence parallelism on a Wikipedia enwik8 dataset. Results show that our proposed method lead to 5.6x faster and 10.2x more memory-efficient implementation compared to state-of-the-art sequence parallelism on 144 Nvidia V100 GPUs. Moreover, our algorithm scales to an extreme sequence length of 50,112 at 3,456 GPUs, achieving 161% super-linear parallel efficiency and a throughput of 32 petaflops.

Kathryn Knight, Ioana Danciu, Olga Ovchinnikova et al.

The compilation and analysis of radiological images poses numerous challenges for researchers. The sheer volume of data as well as the computational needs of algorithms capable of operating on images are extensive. Additionally, the assembly of these images alone is difficult, as these exams may differ widely in terms of clinical context, structured annotation available for model training, modality, and patient identifiers. In this paper, we describe our experiences and challenges in establishing a trusted collection of radiology images linked to the United States Department of Veterans Affairs (VA) electronic health record database. We also discuss implications in making this repository research-ready for medical investigators. Key insights include uncovering the specific procedures required for transferring images from a clinical to a research-ready environment, as well as roadblocks and bottlenecks in this process that may hinder future efforts at automation.

Maria Mahbub, Robert J. Klein, Myvizhi Esai Selvan et al.

Lung cancer (LC) is the third most common cancer and the leading cause of cancer deaths in the US. Although smoking is the primary risk factor, the occurrence of LC in never-smokers and familial aggregation studies highlight a genetic component. Genetic biomarkers identified through genome-wide association studies (GWAS) are promising tools for assessing LC risk. We introduce HEMERA (Human-Explainable Transformer Model for Estimating Lung Cancer Risk using GWAS Data), a new framework that applies explainable transformer-based deep learning to GWAS data of single nucleotide polymorphisms (SNPs) for predicting LC risk. Unlike prior approaches, HEMERA directly processes raw genotype data without clinical covariates, introducing additive positional encodings, neural genotype embeddings, and refined variant filtering. A post hoc explainability module based on Layer-wise Integrated Gradients enables attribution of model predictions to specific SNPs, aligning strongly with known LC risk loci. Trained on data from 27,254 Million Veteran Program participants, HEMERA achieved >99% AUC (area under receiver characteristics) score. These findings support transparent, hypothesis-generating models for personalized LC risk assessment and early intervention.

Julia Ive, Paulina Bondaronek, Vishal Yadav et al.

Introduction: Healthcare AI models often inherit biases from their training data. While efforts have primarily targeted bias in structured data, mental health heavily depends on unstructured data. This study aims to detect and mitigate linguistic differences related to non-biological differences in the training data of AI models designed to assist in pediatric mental health screening. Our objectives are: (1) to assess the presence of bias by evaluating outcome parity across sex subgroups, (2) to identify bias sources through textual distribution analysis, and (3) to develop a de-biasing method for mental health text data. Methods: We examined classification parity across demographic groups and assessed how gendered language influences model predictions. A data-centric de-biasing method was applied, focusing on neutralizing biased terms while retaining salient clinical information. This methodology was tested on a model for automatic anxiety detection in pediatric patients. Results: Our findings revealed a systematic under-diagnosis of female adolescent patients, with a 4% lower accuracy and a 9% higher False Negative Rate (FNR) compared to male patients, likely due to disparities in information density and linguistic differences in patient notes. Notes for male patients were on average 500 words longer, and linguistic similarity metrics indicated distinct word distributions between genders. Implementing our de-biasing approach reduced diagnostic bias by up to 27%, demonstrating its effectiveness in enhancing equity across demographic groups. Discussion: We developed a data-centric de-biasing framework to address gender-based content disparities within clinical text. By neutralizing biased language and enhancing focus on clinically essential information, our approach demonstrates an effective strategy for mitigating bias in AI healthcare models trained on text.

Mohammed Alawad, Shang Gao, Mayanka Chandra Shekar et al.

A key component of deep learning (DL) for natural language processing (NLP) is word embeddings. Word embeddings that effectively capture the meaning and context of the word that they represent can significantly improve the performance of downstream DL models for various NLP tasks. Many existing word embeddings techniques capture the context of words based on word co-occurrence in documents and text; however, they often cannot capture broader domain-specific relationships between concepts that may be crucial for the NLP task at hand. In this paper, we propose a method to integrate external knowledge from medical terminology ontologies into the context captured by word embeddings. Specifically, we use a medical knowledge graph, such as the unified medical language system (UMLS), to find connections between clinical terms in cancer pathology reports. This approach aims to minimize the distance between connected clinical concepts. We evaluate the proposed approach using a Multitask Convolutional Neural Network (MT-CNN) to extract six cancer characteristics -- site, subsite, laterality, behavior, histology, and grade -- from a dataset of ~900K cancer pathology reports. The results show that the MT-CNN model which uses our domain informed embeddings outperforms the same MT-CNN using standard word2vec embeddings across all tasks, with an improvement in the overall micro- and macro-F1 scores by 4.97\%and 22.5\%, respectively.

Mayanka Chandrashekar, Yugyung Lee

Building robust and real-time classifiers with diverse datasets are one of the most significant challenges to deep learning researchers. It is because there is a considerable gap between a model built with training (seen) data and real (unseen) data in applications. Recent works including Zero-Shot Learning (ZSL), have attempted to deal with this problem of overcoming the apparent gap through transfer learning. In this paper, we propose a novel model, called Class Representative Learning Model (CRL), that can be especially effective in image classification influenced by ZSL. In the CRL model, first, the learning step is to build class representatives to represent classes in datasets by aggregating prominent features extracted from a Convolutional Neural Network (CNN). Second, the inferencing step in CRL is to match between the class representatives and new data. The proposed CRL model demonstrated superior performance compared to the current state-of-the-art research in ZSL and mobile deep learning. The proposed CRL model has been implemented and evaluated in a parallel environment, using Apache Spark, for both distributed learning and recognition. An extensive experimental study on the benchmark datasets, ImageNet-1K, CalTech-101, CalTech-256, CIFAR-100, shows that CRL can build a class distribution model with drastic improvement in learning and recognition performance without sacrificing accuracy compared to the state-of-the-art performances in image classification.