Data diversity is critical to success when training deep learning models. Medical imaging data sets are often imbalanced as pathologic findings are generally rare, which introduces significant challenges when training deep learning models. In this work, we propose a method to generate synthetic abnormal MRI images with brain tumors by training a generative adversarial network using two publicly available data sets of brain MRI. We demonstrate two unique benefits that the synthetic images provide. First, we illustrate improved performance on tumor segmentation by leveraging the synthetic images as a form of data augmentation. Second, we demonstrate the value of generative models as an anonymization tool, achieving comparable tumor segmentation results when trained on the synthetic data versus when trained on real subject data. Together, these results offer a potential solution to two of the largest challenges facing machine learning in medical imaging, namely the small incidence of pathological findings, and the restrictions around sharing of patient data.
There is an increasing interest in developing artificial intelligence (AI) systems to process and interpret electronic health records (EHRs). Natural language processing (NLP) powered by pretrained language models is the key technology for medical AI systems utilizing clinical narratives. However, there are few clinical language models, the largest of which trained in the clinical domain is comparatively small at 110 million parameters (compared with billions of parameters in the general domain). It is not clear how large clinical language models with billions of parameters can help medical AI systems utilize unstructured EHRs. In this study, we develop from scratch a large clinical language model—GatorTron—using >90 billion words of text (including >82 billion words of de-identified clinical text) and systematically evaluate it on five clinical NLP tasks including clinical concept extraction, medical relation extraction, semantic textual similarity, natural language inference (NLI), and medical question answering (MQA). We examine how (1) scaling up the number of parameters and (2) scaling up the size of the training data could benefit these NLP tasks. GatorTron models scale up the clinical language model from 110 million to 8.9 billion parameters and improve five clinical NLP tasks (e.g., 9.6% and 9.5% improvement in accuracy for NLI and MQA), which can be applied to medical AI systems to improve healthcare delivery. The GatorTron models are publicly available at: https://catalog.ngc.nvidia.com/orgs/nvidia/teams/clara/models/gatortron_og.
With the advent of artificial intelligence (AI) across many fields and subspecialties, there are considerable expectations for transformative impact. However, there are also concerns regarding the potential abuse of AI. Many scientists have been worried about the dangers of AI leading to "biased" conclusions, in part because of the enthusiasm of the inventor or overenthusiasm among the general public. Here, though, we consider some scenarios in which people may intend to cause potential errors within data sets of analyzed information, resulting in incorrect conclusions and leading to potential problems with patient care and outcomes.A generative adversarial network (GAN) is a recently developed deeplearning model aimed at creating new images. It simultaneously trains a generator and a discriminator network, which serves to generate artificial images and to discriminate real from artificial images, respectively. We have recently described how GANs can produce artificial images of people and audio content that fool the recipient into believing that they are authentic. As applied to medical imaging, GANs can generate synthetic images that can alter lesion size, location, and transpose abnormalities onto normal examinations (Fig. 1) [1]. GANs have the potential to improve image quality, reduce radiation dose, augment data for training algorithms,
There is an increasing interest in developing massive-size deep learning models in natural language processing (NLP) - the key technology to extract patient information from unstructured electronic health records (EHRs). However, there are limited studies exploring large language models in the clinical domain; the current largest clinical NLP model was trained with 110 million parameters (compared with 175 billion parameters in the general domain). It is not clear how large-size NLP models can help machines understand patients' clinical information from unstructured EHRs. In this study, we developed a large clinical transformer model - GatorTron - using >90 billion words of text and evaluated it on 5 clinical NLP tasks including clinical concept extraction, relation extraction, semantic textual similarity, natural language inference, and medical question answering. GatorTron is now the largest transformer model in the clinical domain that scaled up from the previous 110 million to 8.9 billion parameters and achieved state-of-the-art performance on the 5 clinical NLP tasks targeting various healthcare information documented in EHRs. GatorTron models perform better in understanding and utilizing patient information from clinical narratives in ways that can be applied to improvements in healthcare delivery and patient outcomes.
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