Digital pathology is on the verge of becoming a mainstream option for routine diagnostics. Faster whole slide image scanning has paved the way for this development, but implementation on a large scale is challenging on technical, logistical, and financial levels. Comparative studies have published reassuring data on safety and feasibility, but implementation experiences highlight the need for training and the knowledge of pitfalls. Up to half of the pathologists are reluctant to sign out reports on only digital slides and are concerned about reporting without the tool that has represented their profession since its beginning. Guidelines by international pathology organizations aim to safeguard histology in the digital realm, from image acquisition over the setup of work-stations to long-term image archiving, but must be considered a starting point only. Cost-efficiency analyses and occupational health issues need to be addressed comprehensively. Image analysis is blended into the traditional work-flow, and the approval of artificial intelligence for routine diagnostics starts to challenge human evaluation as the gold standard. Here we discuss experiences from past digital pathology implementations, future possibilities through the addition of artificial intelligence, technical and occupational health challenges, and possible changes to the pathologist’s profession.
Deriving interpretable prognostic features from deep-learning-based prognostic histopathology models remains a challenge. In this study, we developed a deep learning system (DLS) for predicting disease-specific survival for stage II and III colorectal cancer using 3652 cases (27,300 slides). When evaluated on two validation datasets containing 1239 cases (9340 slides) and 738 cases (7140 slides), respectively, the DLS achieved a 5-year disease-specific survival AUC of 0.70 (95% CI: 0.66–0.73) and 0.69 (95% CI: 0.64–0.72), and added significant predictive value to a set of nine clinicopathologic features. To interpret the DLS, we explored the ability of different human-interpretable features to explain the variance in DLS scores. We observed that clinicopathologic features such as T-category, N-category, and grade explained a small fraction of the variance in DLS scores (R2 = 18% in both validation sets). Next, we generated human-interpretable histologic features by clustering embeddings from a deep-learning-based image-similarity model and showed that they explained the majority of the variance (R2 of 73–80%). Furthermore, the clustering-derived feature most strongly associated with high DLS scores was also highly prognostic in isolation. With a distinct visual appearance (poorly differentiated tumor cell clusters adjacent to adipose tissue), this feature was identified by annotators with 87.0–95.5% accuracy. Our approach can be used to explain predictions from a prognostic deep learning model and uncover potentially-novel prognostic features that can be reliably identified by people for future validation studies.
Recent advances in automatic machine learning (aML) allow solving problems without any human intervention. However, sometimes a human-in-the-loop can be beneficial in solving computationally hard problems. In this paper we provide new experimental insights on how we can improve computational intelligence by complementing it with human intelligence in an interactive machine learning approach (iML). For this purpose, we used the Ant Colony Optimization (ACO) framework, because this fosters multi-agent approaches with human agents in the loop. We propose unification between the human intelligence and interaction skills and the computational power of an artificial system. The ACO framework is used on a case study solving the Traveling Salesman Problem, because of its many practical implications, e.g. in the medical domain. We used ACO due to the fact that it is one of the best algorithms used in many applied intelligence problems. For the evaluation we used gamification, i.e. we implemented a snake-like game called Traveling Snakesman with the MAX-MIN Ant System (MMAS) in the background. We extended the MMAS-Algorithm in a way, that the human can directly interact and influence the ants. This is done by "traveling" with the snake across the graph. Each time the human travels over an ant, the current pheromone value of the edge is multiplied by 5. This manipulation has an impact on the ant's behavior (the probability that this edge is taken by the ant increases). The results show that the humans performing one tour through the graphs have a significant impact on the shortest path found by the MMAS. Consequently, our experiment demonstrates that in our case human intelligence can positively influence machine intelligence. To the best of our knowledge this is the first study of this kind.
Part 1: The International Cross Domain Conference (CD-ARES 2016)International audienceMost Machine Learning (ML) researchers focus on automatic Machine Learning (aML) where great advances have been made, for example, in speech recognition, recommender systems, or autonomous vehicles. Automatic approaches greatly benefit from the availability of “big data”. However, sometimes, for example in health informatics, we are confronted not a small number of data sets or rare events, and with complex problems where aML-approaches fail or deliver unsatisfactory results. Here, interactive Machine Learning (iML) may be of help and the “human-in-the-loop” approach may be beneficial in solving computationally hard problems, where human expertise can help to reduce an exponential search space through heuristics.In this paper, experiments are discussed which help to evaluate the effectiveness of the iML-“human-in-the-loop” approach, particularly in opening the “black box”, thereby enabling a human to directly and indirectly manipulating and interacting with an algorithm. For this purpose, we selected the Ant Colony Optimization (ACO) framework, and use it on the Traveling Salesman Problem (TSP) which is of high importance in solving many practical problems in health informatics, e.g. in the study of proteins
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