Thomas Yu Chow Tam

Thomas Yu Chow Tam, Litian Liang, Ke Chen et al.

Deep learning (DL) models have shown significant potential in Alzheimer's Disease (AD) classification. However, understanding and interpreting these models remains challenging, which hinders the adoption of these models in clinical practice. Techniques such as saliency maps have been proven effective in providing visual and empirical clues about how these models work, but there still remains a gap in understanding which specific brain regions DL models focus on and whether these brain regions are pathologically associated with AD. To bridge such gap, in this study, we developed a quantitative disease-focusing strategy to first enhance the interpretability of DL models using saliency maps and brain segmentations; then we propose a disease-focus (DF) score that quantifies how much a DL model focuses on brain areas relevant to AD pathology based on clinically known MRI-based pathological regions of AD. Using this strategy, we compared several state-of-the-art DL models, including a baseline 3D ResNet model, a pretrained MedicalNet model, and a MedicalNet with data augmentation to classify patients with AD vs. cognitive normal patients using MRI data; then we evaluated these models in terms of their abilities to focus on disease-relevant regions. Our results show interesting disease-focusing patterns with different models, particularly characteristic patterns with the pretrained models and data augmentation, and also provide insight into their classification performance. These results suggest that the approach we developed for quantitatively assessing the abilities of DL models to focus on disease-relevant regions may help improve interpretability of these models for AD classification and facilitate their adoption for AD diagnosis in clinical practice. The code is publicly available at https://github.com/Liang-lt/ADNI.

Thomas Yu Chow Tam, Sonish Sivarajkumar, Sumit Kapoor et al.

With generative artificial intelligence (AI), particularly large language models (LLMs), continuing to make inroads in healthcare, it is critical to supplement traditional automated evaluations with human evaluations. Understanding and evaluating the output of LLMs is essential to assuring safety, reliability, and effectiveness. However, human evaluation's cumbersome, time-consuming, and non-standardized nature presents significant obstacles to comprehensive evaluation and widespread adoption of LLMs in practice. This study reviews existing literature on human evaluation methodologies for LLMs in healthcare. We highlight a notable need for a standardized and consistent human evaluation approach. Our extensive literature search, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, includes publications from January 2018 to February 2024. The review examines the human evaluation of LLMs across various medical specialties, addressing factors such as evaluation dimensions, sample types and sizes, selection, and recruitment of evaluators, frameworks and metrics, evaluation process, and statistical analysis type. Drawing on the diverse evaluation strategies employed in these studies, we propose a comprehensive and practical framework for human evaluation of LLMs: QUEST: Quality of Information, Understanding and Reasoning, Expression Style and Persona, Safety and Harm, and Trust and Confidence. This framework aims to improve the reliability, generalizability, and applicability of human evaluation of LLMs in different healthcare applications by defining clear evaluation dimensions and offering detailed guidelines.