Abductive reasoning as the basis to reproduce expert criteria in ECG Atrial Fibrillation identification
This work addresses the problem of inconsistent labeling in medical datasets for clinicians, though it is incremental as it combines existing methods with a knowledge-based framework.
The paper tackled automatic detection of atrial fibrillation and arrhythmias in ECG signals by developing an interpretable method using abductive reasoning, achieving a top F1 score of 0.83 in a challenge and improving to 0.85 with model simplification.
Objective: This work aims at providing a new method for the automatic detection of atrial fibrillation, other arrhythmia and noise on short single lead ECG signals, emphasizing the importance of the interpretability of the classification results. Approach: A morphological and rhythm description of the cardiac behavior is obtained by a knowledge-based interpretation of the signal using the \textit{Construe} abductive framework. Then, a set of meaningful features are extracted for each individual heartbeat and as a summary of the full record. The feature distributions were used to elucidate the expert criteria underlying the labeling of the 2017 Physionet/CinC Challenge dataset, enabling a manual partial relabeling to improve the consistency of the classification rules. Finally, state-of-the-art machine learning methods are combined to provide an answer on the basis of the feature values. Main results: The proposal tied for the first place in the official stage of the Challenge, with a combined $F_1$ score of 0.83, and was even improved in the follow-up stage to 0.85 with a significant simplification of the model. Significance: This approach demonstrates the potential of \textit{Construe} to provide robust and valuable descriptions of temporal data even with significant amounts of noise and artifacts. Also, we discuss the importance of a consistent classification criteria in manually labeled training datasets, and the fundamental advantages of knowledge-based approaches to formalize and validate that criteria.