Kevin Wu

Kevin Yuanbo Wu, Jin Li, Aaron Esser-Kahn et al.

Despite having triggered devastating pandemics in the past, our ability to quantitatively assess the emergence potential of individual strains of animal influenza viruses remains limited. This study introduces Emergenet, a tool to infer a digital twin of sequence evolution to chart how new variants might emerge in the wild. Our predictions based on Emergenets built only using 220,151 Hemagglutinnin (HA) sequences consistently outperform WHO seasonal vaccine recommendations for H1N1/H3N2 subtypes over two decades (average match-improvement: 3.73 AAs, 28.40\%), and are at par with state-of-the-art approaches that use more detailed phenotypic annotations. Finally, our generative models are used to scalably calculate the current odds of emergence of animal strains not yet in human circulation, which strongly correlates with CDC's expert-assessed Influenza Risk Assessment Tool (IRAT) scores (Pearson's $r = 0.721, p = 10^{-4}$). A minimum five orders of magnitude speedup over CDC's assessment (seconds vs months) then enabled us to analyze 6,354 animal strains collected post-2020 to identify 35 strains with high emergence scores ($> 7.7$). The Emergenet framework opens the door to preemptive pandemic mitigation through targeted inoculation of animal hosts before the first human infection.

Eric Wu, Kevin Wu, James Zou

Medical AI algorithms can often experience degraded performance when evaluated on previously unseen sites. Addressing cross-site performance disparities is key to ensuring that AI is equitable and effective when deployed on diverse patient populations. Multi-site evaluations are key to diagnosing such disparities as they can test algorithms across a broader range of potential biases such as patient demographics, equipment types, and technical parameters. However, such tests do not explain why the model performs worse. Our framework provides a method for quantifying the marginal and cumulative effect of each type of bias on the overall performance difference when a model is evaluated on external data. We demonstrate its usefulness in a case study of a deep learning model trained to detect the presence of pneumothorax, where our framework can help explain up to 60% of the discrepancy in performance across different sites with known biases like disease comorbidities and imaging parameters.