Automated seizure detection from electroencephalography (EEG) would improve the quality of patient care while reducing medical costs, but achieving reliably high performance across patients has proven difficult. Convolutional Neural Networks (CNNs) show promise in addressing this problem, but they are limited by a lack of large labeled training datasets. We propose using imperfect but plentiful archived annotations to train CNNs for automated, real-time EEG seizure detection across patients. While these weak annotations indicate possible seizures with precision scores as low as 0.37, they are commonly produced in large volumes within existing clinical workflows by a mixed group of technicians, fellows, students, and board-certified epileptologists. We find that CNNs trained using such weak annotations achieve Area Under the Receiver Operating Characteristic curve (AUROC) values of 0.93 and 0.94 for pediatric and adult seizure onset detection, respectively. Compared to currently deployed clinical software, our model provides a 31% increase (18 points) in F1-score for pediatric patients and a 17% increase (11 points) for adult patients. These results demonstrate that weak annotations, which are sustainably collected via existing clinical workflows, can be leveraged to produce clinically useful seizure detection models.

Labeling training datasets has become a key barrier to building medical machine learning models. One strategy is to generate training labels programmatically, for example by applying natural language processing pipelines to text reports associated with imaging studies. We propose cross-modal data programming, which generalizes this intuitive strategy in a theoretically-grounded way that enables simpler, clinician-driven input, reduces required labeling time, and improves with additional unlabeled data. In this approach, clinicians generate training labels for models defined over a target modality (e.g. images or time series) by writing rules over an auxiliary modality (e.g. text reports). The resulting technical challenge consists of estimating the accuracies and correlations of these rules; we extend a recent unsupervised generative modeling technique to handle this cross-modal setting in a provably consistent way. Across four applications in radiography, computed tomography, and electroencephalography, and using only several hours of clinician time, our approach matches or exceeds the efficacy of physician-months of hand-labeling with statistical significance, demonstrating a fundamentally faster and more flexible way of building machine learning models in medicine.Modern machine learning approaches have achieved impressive empirical successes on diverse clinical tasks that include predicting cancer prognosis from digital pathology, 1, 2 classifying skin lesions from dermatoscopy, 3 characterizing retinopathy from fundus photographs, 4 detecting intracranial hemorrhage through computed tomography, 5, 6 and performing automated interpretation of chest radiographs. 7,8 Remarkably, these applications typically build on standardized reference neural network architectures 9 supported in professionally-maintained open source frameworks, 10, 11 suggesting that model design is no longer a major barrier to entry in medical machine learning. However, each of these application successes was predicated on a not-so-hidden cost: massive hand-labeled training datasets, often produced through years of institutional investment and expert clinician labeling time, at a cost of hundreds of thousands of dollars per task or more. 4,12 In addition to being extremely costly, these training sets are inflexible: given a new classification schema, imaging system, patient population, or other change in the data distribution or modeling task, the training set generally needs to be relabeled from scratch. These factors suggest 1

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Automated seizure detection and classification from electroencephalography (EEG) can greatly improve the diagnosis and treatment of seizures. While prior studies mainly used convolutional neural networks (CNNs) that assume image-like structure in EEG signals or spectrograms, this modeling choice does not reflect the natural geometry of or connectivity between EEG electrodes. In this study, identifying seizure regions compared to an existing CNN. In summary, our graph-based modeling approach integrates domain knowledge about EEG, sets a new state-of-the-art for seizure detection and classification on a large public dataset (5,499 EEG files), and provides better ability to identify seizure regions.

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Machine learning models that achieve high overall accuracy often make systematic errors on important subsets (or slices) of data. Identifying underperforming slices is particularly challenging when working with high-dimensional inputs (e.g. images, audio), where important slices are often unlabeled. In order to address this issue, recent studies have proposed automated slice discovery methods (SDMs), which leverage learned model representations to mine input data for slices on which a model performs poorly. To be useful to a practitioner, these methods must identify slices that are both underperforming and coherent (i.e. united by a human-understandable concept). However, no quantitative evaluation framework currently exists for rigorously assessing SDMs with respect to these criteria. Additionally, prior qualitative evaluations have shown that SDMs often identify slices that are incoherent. In this work, we address these challenges by first designing a principled evaluation framework that enables a quantitative comparison of SDMs across 1,235 slice discovery settings in three input domains (natural images, medical images, and time-series data). Then, motivated by the recent development of powerful cross-modal representation learning approaches, we present Domino, an SDM that leverages cross-modal embeddings and a novel error-aware mixture model to discover and describe coherent slices. We find that Domino accurately identifies 36% of the 1,235 slices in our framework -a 12 percentage point improvement over prior methods. Further, Domino is the first SDM that can provide natural language descriptions of identified slices, correctly generating the exact name of the slice in 35% of settings.

PurposeThe purpose of this paper is to develop a simple deterministic model that quantifies previously adopted preventive measures driven by the trend of the reported number of deaths in both Italy and India. In addition, the authors forecast the spread based on some selected quantified preventive measures. The optimal exiting policy is derived using the inverse dynamics of the model. Furthermore, the model developed by the authors is dependent on the daily number of deaths; as such, it is sensitive to the death rate but remains insensitive to trends in deaths.Design/methodology/approachIn the wake of COVID-19, policymakers and health professionals realized the limitations and shortcomings of current healthcare systems and pandemic response policies. The need to revise global and national pandemic response mechanisms has been thrust into the public spotlight. To this end, the authors devise an approach to identify the most suitable governmental non-pharmaceutical intervention (NPI) policies, previously adopted in a community, country or region that serve as the foundation for most pandemic strategies.FindingsLeveraging Italy, the authors compare the aftermath by considering three scenarios: (a) recently adopted preventive measures, (b) strictest preventive measures previously adopted, and (c) the optimal exiting policy. In comparison to the second scenario, the authors estimate about twice the number of recoveries and deaths within five months under the first scenario and about 80 times more under the optimal scenario. Whereas in India, the authors applied one scenario of recently adopted preventative measures to showcase the rapid turnaround of their model. According to the new timeline, almost 90% of all deaths in India could have been prevented if the policies implemented in April 2021 were put in place three months prior, i.e. in January 2021.Originality/valueThe novelty of the proposed approach is in the use of inverse dynamics of a simple deterministic model that allows capturing the trend of contact rate as a function of adopted NPIs, regardless of pandemic type.