Farah E. Shamout

L. Julian Lechuga Lopez, Tim G. J. Rudner, Farah E. Shamout · oxford

Machine learning-aided clinical decision support has the potential to significantly improve patient care. However, existing efforts in this domain for principled quantification of uncertainty have largely been limited to applications of ad-hoc solutions that do not consistently improve reliability. In this work, we consider stochastic neural networks and design a tailor-made multimodal data-driven (M2D2) prior distribution over network parameters. We use simple and scalable Gaussian mean-field variational inference to train a Bayesian neural network using the M2D2 prior. We train and evaluate the proposed approach using clinical time-series data in MIMIC-IV and corresponding chest X-ray images in MIMIC-CXR for the classification of acute care conditions. Our empirical results show that the proposed method produces a more reliable predictive model compared to deterministic and Bayesian neural network baselines.

Mouath Abu-Daoud, Leen Kharouf, Omar El Hajj et al.

Arabic remains one of the most underrepresented languages in natural language processing research, particularly in medical applications, due to the limited availability of open-source data and benchmarks. The lack of resources hinders efforts to evaluate and advance the multilingual capabilities of Large Language Models (LLMs). In this paper, we introduce MedAraBench, a large-scale dataset consisting of Arabic multiple-choice question-answer pairs across various medical specialties. We constructed the dataset by manually digitizing a large repository of academic materials created by medical professionals in the Arabic-speaking region. We then conducted extensive preprocessing and split the dataset into training and test sets to support future research efforts in the area. To assess the quality of the data, we adopted two frameworks, namely expert human evaluation and LLM-as-a-judge. Our dataset is diverse and of high quality, spanning 19 specialties and five difficulty levels. For benchmarking purposes, we assessed the performance of eight state-of-the-art open-source and proprietary models, such as GPT-5, Gemini 2.0 Flash, and Claude 4-Sonnet. Our findings highlight the need for further domain-specific enhancements. We release the dataset and evaluation scripts to broaden the diversity of medical data benchmarks, expand the scope of evaluation suites for LLMs, and enhance the multilingual capabilities of models for deployment in clinical settings.

Congbo Ma, Yichun Zhang, Yousef Al-Jazzazi et al.

Inaccuracies in existing or generated clinical text may lead to serious adverse consequences, especially if it is a misdiagnosis or incorrect treatment suggestion. With Large Language Models (LLMs) increasingly being used across diverse healthcare applications, comprehensive evaluation through dedicated benchmarks is crucial. However, such datasets remain scarce, especially across diverse languages and contexts. In this paper, we introduce MedErrBench, the first multilingual benchmark for error detection, localization, and correction, developed under the guidance of experienced clinicians. Based on an expanded taxonomy of ten common error types, MedErrBench covers English, Arabic and Chinese, with natural clinical cases annotated and reviewed by domain experts. We assessed the performance of a range of general-purpose, language-specific, and medical-domain language models across all three tasks. Our results reveal notable performance gaps, particularly in non-English settings, highlighting the need for clinically grounded, language-aware systems. By making MedErrBench and our evaluation protocols publicly-available, we aim to advance multilingual clinical NLP to promote safer and more equitable AI-based healthcare globally. The dataset is available in the supplementary material. An anonymized version of the dataset is available at: https://github.com/congboma/MedErrBench.

Nasir Hayat, Krzysztof J. Geras, Farah E. Shamout

Multi-modal fusion approaches aim to integrate information from different data sources. Unlike natural datasets, such as in audio-visual applications, where samples consist of "paired" modalities, data in healthcare is often collected asynchronously. Hence, requiring the presence of all modalities for a given sample is not realistic for clinical tasks and significantly limits the size of the dataset during training. In this paper, we propose MedFuse, a conceptually simple yet promising LSTM-based fusion module that can accommodate uni-modal as well as multi-modal input. We evaluate the fusion method and introduce new benchmark results for in-hospital mortality prediction and phenotype classification, using clinical time-series data in the MIMIC-IV dataset and corresponding chest X-ray images in MIMIC-CXR. Compared to more complex multi-modal fusion strategies, MedFuse provides a performance improvement by a large margin on the fully paired test set. It also remains robust across the partially paired test set containing samples with missing chest X-ray images. We release our code for reproducibility and to enable the evaluation of competing models in the future.

Saeed Shurrab, Alejandro Guerra-Manzanares, Farah E. Shamout

Self-supervised learning methods for medical images primarily rely on the imaging modality during pretraining. While such approaches deliver promising results, they do not leverage associated patient or scan information collected within Electronic Health Records (EHR). Here, we propose to incorporate EHR data during self-supervised pretraining with a Masked Siamese Network (MSN) to enhance the quality of chest X-ray representations. We investigate three types of EHR data, including demographic, scan metadata, and inpatient stay information. We evaluate our approach on three publicly available chest X-ray datasets, MIMIC-CXR, CheXpert, and NIH-14, using two vision transformer (ViT) backbones, specifically ViT-Tiny and ViT-Small. In assessing the quality of the representations via linear evaluation, our proposed method demonstrates significant improvement compared to vanilla MSN and state-of-the-art self-supervised learning baselines. Our work highlights the potential of EHR-enhanced self-supervised pre-training for medical imaging. The code is publicly available at: https://github.com/nyuad-cai/CXR-EHR-MSN

Alejandro Guerra-Manzanares, L. Julian Lechuga Lopez, Michail Maniatakos et al.

Machine Learning (ML) has recently shown tremendous success in modeling various healthcare prediction tasks, ranging from disease diagnosis and prognosis to patient treatment. Due to the sensitive nature of medical data, privacy must be considered along the entire ML pipeline, from model training to inference. In this paper, we conduct a review of recent literature concerning Privacy-Preserving Machine Learning (PPML) for healthcare. We primarily focus on privacy-preserving training and inference-as-a-service, and perform a comprehensive review of existing trends, identify challenges, and discuss opportunities for future research directions. The aim of this review is to guide the development of private and efficient ML models in healthcare, with the prospects of translating research efforts into real-world settings.

Sarmad Mehrdad, Farah E. Shamout, Yao Wang et al.

Unrecognized patient deterioration can lead to high morbidity and mortality. Most existing deterioration prediction models require a large number of clinical information, typically collected in hospital settings, such as medical images or comprehensive laboratory tests. This is infeasible for telehealth solutions and highlights a gap in deterioration prediction models that are based on minimal data, which can be recorded at a large scale in any clinic, nursing home, or even at the patient's home. In this study, we propose and develop a prognostic model that predicts if a patient will experience deterioration in the forthcoming 3-24 hours. The model sequentially processes routine triadic vital signs: (a) oxygen saturation, (b) heart rate, and (c) temperature. The model is also provided with basic patient information, including sex, age, vaccination status, vaccination date, and status of obesity, hypertension, or diabetes. We train and evaluate the model using data collected from 37,006 COVID-19 patients at NYU Langone Health in New York, USA. The model achieves an area under the receiver operating characteristic curve (AUROC) of 0.808-0.880 for 3-24 hour deterioration prediction. We also conduct occlusion experiments to evaluate the importance of each input feature, where the results reveal the significance of continuously monitoring the variations of the vital signs. Our results show the prospect of accurate deterioration forecast using a minimum feature set that can be relatively easily obtained using wearable devices and self-reported patient information.

Costanza Armanini, Tuka Alhanai, Farah E. Shamout et al.

Developing accurate hand gesture perception models is critical for various robotic applications, enabling effective communication between humans and machines and directly impacting neurorobotics and interactive robots. Recently, surface electromyography (sEMG) has been explored for its rich informational context and accessibility when combined with advanced machine learning approaches and wearable systems. The literature presents numerous approaches to boost performance while ensuring robustness for neurorobots using sEMG, often resulting in models requiring high processing power, large datasets, and less scalable solutions. This paper addresses this challenge by proposing the decoding of muscle synchronization rather than individual muscle activation. We study coherence-based functional muscle networks as the core of our perception model, proposing that functional synchronization between muscles and the graph-based network of muscle connectivity encode contextual information about intended hand gestures. This can be decoded using shallow machine learning approaches without the need for deep temporal networks. Our technique could impact myoelectric control of neurorobots by reducing computational burdens and enhancing efficiency. The approach is benchmarked on the Ninapro database, which contains 12 EMG signals from 40 subjects performing 17 hand gestures. It achieves an accuracy of 85.1%, demonstrating improved performance compared to existing methods while requiring much less computational power. The results support the hypothesis that a coherence-based functional muscle network encodes critical information related to gesture execution, significantly enhancing hand gesture perception with potential applications for neurorobotic systems and interactive machines.

L. Julián Lechuga López, Farah E. Shamout, Tim G. J. Rudner

As artificial intelligence systems move toward clinical deployment, ensuring reliable prediction behavior is fundamental for safety-critical decision-making tasks. One proposed safeguard is selective prediction, where models can defer uncertain predictions to human experts for review. In this work, we empirically evaluate the reliability of uncertainty-based selective prediction in multilabel clinical condition classification using multimodal ICU data. Across a range of state-of-the-art unimodal and multimodal models, we find that selective prediction can substantially degrade performance despite strong standard evaluation metrics. This failure is driven by severe class-dependent miscalibration, whereby models assign high uncertainty to correct predictions and low uncertainty to incorrect ones, particularly for underrepresented clinical conditions. Our results show that commonly used aggregate metrics can obscure these effects, limiting their ability to assess selective prediction behavior in this setting. Taken together, our findings characterize a task-specific failure mode of selective prediction in multimodal clinical condition classification and highlight the need for calibration-aware evaluation to provide strong guarantees of safety and robustness in clinical AI.

Mouath Abu Daoud, Chaimae Abouzahir, Leen Kharouf et al.

Large Language Models (LLMs) have demonstrated significant promise for various applications in healthcare. However, their efficacy in the Arabic medical domain remains unexplored due to the lack of high-quality domain-specific datasets and benchmarks. This study introduces MedArabiQ, a novel benchmark dataset consisting of seven Arabic medical tasks, covering multiple specialties and including multiple choice questions, fill-in-the-blank, and patient-doctor question answering. We first constructed the dataset using past medical exams and publicly available datasets. We then introduced different modifications to evaluate various LLM capabilities, including bias mitigation. We conducted an extensive evaluation with five state-of-the-art open-source and proprietary LLMs, including GPT-4o, Claude 3.5-Sonnet, and Gemini 1.5. Our findings highlight the need for the creation of new high-quality benchmarks that span different languages to ensure fair deployment and scalability of LLMs in healthcare. By establishing this benchmark and releasing the dataset, we provide a foundation for future research aimed at evaluating and enhancing the multilingual capabilities of LLMs for the equitable use of generative AI in healthcare.

Chaimae Abouzahir, Congbo Ma, Nizar Habash et al.

In recent years, Large Language Models (LLMs) have become widely used in medical applications, such as clinical decision support, medical education, and medical question answering. Yet, these models are often English-centric, limiting their robustness and reliability for linguistically diverse communities. Recent work has highlighted discrepancies in performance in low-resource languages for various medical tasks, but the underlying causes remain poorly understood. In this study, we conduct a cross-lingual empirical analysis of LLM performance on Arabic and English medical question and answering. Our findings reveal a persistent language-driven performance gap that intensifies with increasing task complexity. Tokenization analysis exposes structural fragmentation in Arabic medical text, while reliability analysis suggests that model-reported confidence and explanations exhibit limited correlation with correctness. Together, these findings underscore the need for language-aware design and evaluation strategies in LLMs for medical tasks.

Saeed Shurrab, Mariam Al-Omari, Dana El Samad et al.

Electronic Health Records (EHR) contain rich longitudinal patient information and are widely used in predictive modeling applications. However, effectively leveraging historical data remains challenging due to long trajectories, heterogeneous events, temporal irregularity, and the varying relevance of past clinical context. Existing approaches often rely on fixed windows or uniform aggregation, which can obscure clinically important signals. In this work, we introduce EHR-RAGp, a retrieval-augmented foundation model that dynamically integrates the most relevant patient history across diverse clinical event types. We propose a prototype-guided retrieval module that acts as an alignment mechanism and estimates the relevance of retrieved historical chunks with respect to a given prediction task, guiding the model towards the most informative context. Across multiple clinical prediction tasks, EHR-RAGp consistently outperforms state-of-the-art EHR foundation models and transformer-based baselines. Furthermore, integrating EHR-RAGp with existing clinical foundation models yields substantial performance gains. Overall, EHR-RAGp provides a scalable and efficient framework for leveraging long-range clinical context to improve downstream performance.

Baraa Al Jorf, Farah E. Shamout

Building effective clinical decision support systems requires the synthesis of complex heterogeneous multimodal data. Such modalities include temporal electronic health records data, medical images, radiology reports, and clinical notes. Large language model (LLM)-based agents have shown impressive performance in various healthcare tasks, especially those involving textual modalities. Considering the fragmentation of healthcare data across hospital systems, collaborative agent frameworks present a promising direction to mitigate data sharing challenges. However, the effectiveness of LLM agents for multimodal clinical risk prediction remains largely unexamined. In this work, we conduct a systematic evaluation of LLM-based agents for clinical prediction tasks using large-scale real-world data. We assess performance in unimodal and multimodal settings and quantify performance gaps between single agent and multi-agent systems. Our findings highlight that single agent frameworks outperform naive multi-agent systems, are better at handling multimodal data, and are better calibrated. This underscores a critical need for improving multi-agent collaboration to better handle heterogeneous inputs. By open-sourcing our code and evaluation framework, this work offers a new benchmark to support future developments relating to agentic systems in healthcare.

Benjamin Stadnick, Jan Witowski, Vishwaesh Rajiv et al.

Artificial intelligence (AI) is showing promise in improving clinical diagnosis. In breast cancer screening, recent studies show that AI has the potential to improve early cancer diagnosis and reduce unnecessary workup. As the number of proposed models and their complexity grows, it is becoming increasingly difficult to re-implement them. To enable reproducibility of research and to enable comparison between different methods, we release a meta-repository containing models for classification of screening mammograms. This meta-repository creates a framework that enables the evaluation of AI models on any screening mammography data set. At its inception, our meta-repository contains five state-of-the-art models with open-source implementations and cross-platform compatibility. We compare their performance on seven international data sets. Our framework has a flexible design that can be generalized to other medical image analysis tasks. The meta-repository is available at https://www.github.com/nyukat/mammography_metarepository.

Nasir Hayat, Hazem Lashen, Farah E. Shamout

Despite the success of deep neural networks in chest X-ray (CXR) diagnosis, supervised learning only allows the prediction of disease classes that were seen during training. At inference, these networks cannot predict an unseen disease class. Incorporating a new class requires the collection of labeled data, which is not a trivial task, especially for less frequently-occurring diseases. As a result, it becomes inconceivable to build a model that can diagnose all possible disease classes. Here, we propose a multi-label generalized zero shot learning (CXR-ML-GZSL) network that can simultaneously predict multiple seen and unseen diseases in CXR images. Given an input image, CXR-ML-GZSL learns a visual representation guided by the input's corresponding semantics extracted from a rich medical text corpus. Towards this ambitious goal, we propose to map both visual and semantic modalities to a latent feature space using a novel learning objective. The objective ensures that (i) the most relevant labels for the query image are ranked higher than irrelevant labels, (ii) the network learns a visual representation that is aligned with its semantics in the latent feature space, and (iii) the mapped semantics preserve their original inter-class representation. The network is end-to-end trainable and requires no independent pre-training for the offline feature extractor. Experiments on the NIH Chest X-ray dataset show that our network outperforms two strong baselines in terms of recall, precision, f1 score, and area under the receiver operating characteristic curve. Our code is publicly available at: https://github.com/nyuad-cai/CXR-ML-GZSL.git

L. Julián Lechuga López, Shaza Elsharief, Dhiyaa Al Jorf et al.

Uncertainty Quantification (UQ) is pivotal in enhancing the robustness, reliability, and interpretability of Machine Learning (ML) systems for healthcare, optimizing resources and improving patient care. Despite the emergence of ML-based clinical decision support tools, the lack of principled quantification of uncertainty in ML models remains a major challenge. Current reviews have a narrow focus on analyzing the state-of-the-art UQ in specific healthcare domains without systematically evaluating method efficacy across different stages of model development, and despite a growing body of research, its implementation in healthcare applications remains limited. Therefore, in this survey, we provide a comprehensive analysis of current UQ in healthcare, offering an informed framework that highlights how different methods can be integrated into each stage of the ML pipeline including data processing, training and evaluation. We also highlight the most popular methods used in healthcare and novel approaches from other domains that hold potential for future adoption in the medical context. We expect this study will provide a clear overview of the challenges and opportunities of implementing UQ in the ML pipeline for healthcare, guiding researchers and practitioners in selecting suitable techniques to enhance the reliability, safety and trust from patients and clinicians on ML-driven healthcare solutions.

Hassan Alhuzali, Walid Al-Eisawi, Muhammad Abdul-Mageed et al.

We introduce AraHealthQA 2025, the Comprehensive Arabic Health Question Answering Shared Task, held in conjunction with ArabicNLP 2025 (co-located with EMNLP 2025). This shared task addresses the paucity of high-quality Arabic medical QA resources by offering two complementary tracks: MentalQA, focusing on Arabic mental health Q&A (e.g., anxiety, depression, stigma reduction), and MedArabiQ, covering broader medical domains such as internal medicine, pediatrics, and clinical decision making. Each track comprises multiple subtasks, evaluation datasets, and standardized metrics, facilitating fair benchmarking. The task was structured to promote modeling under realistic, multilingual, and culturally nuanced healthcare contexts. We outline the dataset creation, task design and evaluation framework, participation statistics, baseline systems, and summarize the overall outcomes. We conclude with reflections on the performance trends observed and prospects for future iterations in Arabic health QA.

Alejandro Guerra-Manzanares, Farah E. Shamout

Multimodal fusion leverages information across modalities to learn better feature representations with the goal of improving performance in fusion-based tasks. However, multimodal datasets, especially in medical settings, are typically smaller than their unimodal counterparts, which can impede the performance of multimodal models. Additionally, the increase in the number of modalities is often associated with an overall increase in the size of the multimodal network, which may be undesirable in medical use cases. Utilizing smaller unimodal encoders may lead to sub-optimal performance, particularly when dealing with high-dimensional clinical data. In this paper, we propose the Modality-INformed knowledge Distillation (MIND) framework, a multimodal model compression approach based on knowledge distillation that transfers knowledge from ensembles of pre-trained deep neural networks of varying sizes into a smaller multimodal student. The teacher models consist of unimodal networks, allowing the student to learn from diverse representations. MIND employs multi-head joint fusion models, as opposed to single-head models, enabling the use of unimodal encoders in the case of unimodal samples without requiring imputation or masking of absent modalities. As a result, MIND generates an optimized multimodal model, enhancing both multimodal and unimodal representations. It can also be leveraged to balance multimodal learning during training. We evaluate MIND on binary and multilabel clinical prediction tasks using time series data and chest X-ray images. Additionally, we assess the generalizability of the MIND framework on three non-medical multimodal multiclass datasets. Experimental results demonstrate that MIND enhances the performance of the smaller multimodal network across all five tasks, as well as various fusion methods and multimodal architectures, compared to state-of-the-art baselines.

Alejandro Guerra-Manzanares, Farah E. Shamout

The aim of multimodal neural networks is to combine diverse data sources, referred to as modalities, to achieve enhanced performance compared to relying on a single modality. However, training of multimodal networks is typically hindered by modality overfitting, where the network relies excessively on one of the available modalities. This often yields sub-optimal performance, hindering the potential of multimodal learning and resulting in marginal improvements relative to unimodal models. In this work, we present the Modality-Informed Learning ratE Scheduler (MILES) for training multimodal joint fusion models in a balanced manner. MILES leverages the differences in modality-wise conditional utilization rates during training to effectively balance multimodal learning. The learning rate is dynamically adjusted during training to balance the speed of learning from each modality by the multimodal model, aiming for enhanced performance in both multimodal and unimodal predictions. We extensively evaluate MILES on four multimodal joint fusion tasks and compare its performance to seven state-of-the-art baselines. Our results show that MILES outperforms all baselines across all tasks and fusion methods considered in our study, effectively balancing modality usage during training. This results in improved multimodal performance and stronger modality encoders, which can be leveraged when dealing with unimodal samples or absent modalities. Overall, our work highlights the impact of balancing multimodal learning on improving model performance.

Alejandro Guerra-Manzanares, Omar El-Herraoui, Michail Maniatakos et al.

One of the key challenges of collaborative machine learning, without data sharing, is multimodal data heterogeneity in real-world settings. While Federated Learning (FL) enables model training across multiple clients, existing frameworks, such as horizontal and vertical FL, are only effective in `ideal' settings that meet specific assumptions. Hence, they struggle to address scenarios where neither all modalities nor all samples are represented across the participating clients. To address this gap, we propose BlendFL, a novel FL framework that seamlessly blends the principles of horizontal and vertical FL in a synchronized and non-restrictive fashion despite the asymmetry across clients. Specifically, any client within BlendFL can benefit from either of the approaches, or both simultaneously, according to its available dataset. In addition, BlendFL features a decentralized inference mechanism, empowering clients to run collaboratively trained local models using available local data, thereby reducing latency and reliance on central servers for inference. We also introduce BlendAvg, an adaptive global model aggregation strategy that prioritizes collaborative model updates based on each client's performance. We trained and evaluated BlendFL and other state-of-the-art baselines on three classification tasks using a large-scale real-world multimodal medical dataset and a popular multimodal benchmark. Our results highlight BlendFL's superior performance for both multimodal and unimodal classification. Ablation studies demonstrate BlendFL's faster convergence compared to traditional approaches, accelerating collaborative learning. Overall, in our study we highlight the potential of BlendFL for handling multimodal data heterogeneity for collaborative learning in real-world settings where data privacy is crucial, such as in healthcare and finance.

Saeed Shurrab, Aadim Nepal, Terrence J. Lee-St. John et al.

Stroke is a major public health problem, affecting millions worldwide. Deep learning has recently demonstrated promise for enhancing the diagnosis and risk prediction of stroke. However, existing methods rely on costly medical imaging modalities, such as computed tomography. Recent studies suggest that retinal imaging could offer a cost-effective alternative for cerebrovascular health assessment due to the shared clinical pathways between the retina and the brain. Hence, this study explores the impact of leveraging retinal images and clinical data for stroke detection and risk prediction. We propose a multimodal deep neural network that processes Optical Coherence Tomography (OCT) and infrared reflectance retinal scans, combined with clinical data, such as demographics, vital signs, and diagnosis codes. We pretrained our model using a self-supervised learning framework using a real-world dataset consisting of $37$ k scans, and then fine-tuned and evaluated the model using a smaller labeled subset. Our empirical findings establish the predictive ability of the considered modalities in detecting lasting effects in the retina associated with acute stroke and forecasting future risk within a specific time horizon. The experimental results demonstrate the effectiveness of our proposed framework by achieving $5$\% AUROC improvement as compared to the unimodal image-only baseline, and $8$\% improvement compared to an existing state-of-the-art foundation model. In conclusion, our study highlights the potential of retinal imaging in identifying high-risk patients and improving long-term outcomes.

Nasir Hayat, Krzysztof J. Geras, Farah E. Shamout

The healthcare domain is characterized by heterogeneous data modalities, such as imaging and physiological data. In practice, the variety of medical data assists clinicians in decision-making. However, most of the current state-of-the-art deep learning models solely rely upon carefully curated data of a single modality. In this paper, we propose a dynamic training approach to learn modality-specific data representations and to integrate auxiliary features, instead of solely relying on a single modality. Our preliminary experiments results for a patient phenotyping task using physiological data in MIMIC-IV & chest radiographs in the MIMIC- CXR dataset show that our proposed approach achieves the highest area under the receiver operating characteristic curve (AUROC) (0.764 AUROC) compared to the performance of the benchmark method in previous work, which only used physiological data (0.740 AUROC). For a set of five recurring or chronic diseases with periodic acute episodes, including cardiac dysrhythmia, conduction disorders, and congestive heart failure, the AUROC improves from 0.747 to 0.798. This illustrates the benefit of leveraging the chest imaging modality in the phenotyping task and highlights the potential of multi-modal learning in medical applications.

Ghadeer O. Ghosheh, Bana Alamad, Kai-Wen Yang et al.

Existing prognostic tools mainly focus on predicting the risk of mortality among patients with coronavirus disease 2019. However, clinical evidence suggests that COVID-19 can result in non-mortal complications that affect patient prognosis. To support patient risk stratification, we aimed to develop a prognostic system that predicts complications common to COVID-19. In this retrospective study, we used data collected from 3,352 COVID-19 patient encounters admitted to 18 facilities between April 1 and April 30, 2020, in Abu Dhabi (AD), UAE. The hospitals were split based on geographical proximity to assess for our proposed system's learning generalizability, AD Middle region and AD Western & Eastern regions, A and B, respectively. Using data collected during the first 24 hours of admission, the machine learning-based prognostic system predicts the risk of developing any of seven complications during the hospital stay. The complications include secondary bacterial infection, AKI, ARDS, and elevated biomarkers linked to increased patient severity, including d-dimer, interleukin-6, aminotransferases, and troponin. During training, the system applies an exclusion criteria, hyperparameter tuning, and model selection for each complication-specific model. The system achieves good accuracy across all complications and both regions. In test set A (587 patient encounters), the system achieves 0.91 AUROC for AKI and >0.80 AUROC for most of the other complications. In test set B (225 patient encounters), the respective system achieves 0.90 AUROC for AKI, elevated troponin, and elevated interleukin-6, and >0.80 AUROC for most of the other complications. The best performing models, as selected by our system, were mainly gradient boosting models and logistic regression. Our results show that a data-driven approach using machine learning can predict the risk of such complications with high accuracy.

Farah E. Shamout, Yiqiu Shen, Nan Wu et al.

During the coronavirus disease 2019 (COVID-19) pandemic, rapid and accurate triage of patients at the emergency department is critical to inform decision-making. We propose a data-driven approach for automatic prediction of deterioration risk using a deep neural network that learns from chest X-ray images and a gradient boosting model that learns from routine clinical variables. Our AI prognosis system, trained using data from 3,661 patients, achieves an area under the receiver operating characteristic curve (AUC) of 0.786 (95% CI: 0.745-0.830) when predicting deterioration within 96 hours. The deep neural network extracts informative areas of chest X-ray images to assist clinicians in interpreting the predictions and performs comparably to two radiologists in a reader study. In order to verify performance in a real clinical setting, we silently deployed a preliminary version of the deep neural network at New York University Langone Health during the first wave of the pandemic, which produced accurate predictions in real-time. In summary, our findings demonstrate the potential of the proposed system for assisting front-line physicians in the triage of COVID-19 patients.