Early detection of cardiac dysfunction through routine screening is vital for diagnosing cardiovascular diseases. An important metric of cardiac function is the left ventricular ejection fraction (EF), where lower EF is associated with cardiomyopathy. Echocardiography is a popular diagnostic tool in cardiology, with ultrasound being a low-cost, real-time, and non-ionizing technology. However, human assessment of echocardiograms for calculating EF is time-consuming and expertise-demanding, raising the need for an automated approach. In this work, we propose using the M(otion)-mode of echocardiograms for estimating the EF and classifying cardiomyopathy. We generate multiple artificial M-mode images from a single echocardiogram and combine them using off-the-shelf model architectures. Additionally, we extend contrastive learning (CL) to cardiac imaging to learn meaningful representations from exploiting structures in unlabeled data allowing the model to achieve high accuracy, even with limited annotations. Our experiments show that the supervised setting converges with only ten modes and is comparable to the baseline method while bypassing its cumbersome training process and being computationally much more efficient. Furthermore, CL using M-mode images is helpful for limited data scenarios, such as having labels for only 200 patients, which is common in medical applications.

Ece Özkan Elsen and Thomas M. Sutter, Yurong Hu, Sebastian Balzer, Julia E. Vogt

GCPR 2023

01.09.2023

LinkCode

Appendicitis is among the most frequent reasons for pediatric abdominal surgeries. With recent advances in machine learning, data-driven decision support could help clinicians diagnose and manage patients while reducing the number of non-critical surgeries. However, previous decision support systems for appendicitis have focused on clinical, laboratory, scoring, and computed tomography data and have ignored the use of abdominal ultrasound, despite its noninvasive nature and widespread availability. In this work, we present interpretable machine learning models for predicting the diagnosis, management and severity of suspected appendicitis using ultrasound images. To this end, our approach utilizes concept bottleneck models (CBM) that facilitate interpretation and interaction with high-level concepts that are understandable to clinicians. Furthermore, we extend CBMs to prediction problems with multiple views and incomplete concept sets. Our models were trained on a dataset comprising 579 pediatric patients with 1709 ultrasound images accompanied by clinical and laboratory data. Results show that our proposed method enables clinicians to utilize a human-understandable and intervenable predictive model without compromising performance or requiring time-consuming image annotation when deployed.

Ricards Marcinkevics, Patricia Reis Wolfertstetter, Ugne Klimiene, Kieran Chin-Cheong, Alyssia Paschke, Julia Zerres, Markus Denzinger, David Niederberger, Sven Wellmann, Ece Özkan Elsen, Christian Knorr, Julia E. Vogt

Workshop on Machine Learning for Multimodal Healthcare Data, Co-located with ICML 2023

29.07.2023

Abstract Ante-hoc interpretability has become the holy grail of explainable artificial intelligence for high-stakes domains such as healthcare; however, this notion is elusive, lacks a widely-accepted definition and depends on the operational context. It can refer to predictive models whose structure adheres to domain-specific constraints, or ones that are inherently transparent. The latter conceptualisation assumes observers who judge this quality, whereas the former presupposes them to have technical and domain expertise (thus alienating other groups of explainees). Additionally, the distinction between ante-hoc interpretability and the less desirable post-hoc explainability, which refers to methods that construct a separate explanatory model, is vague given that transparent predictive models may still require (post-)processing to yield suitable explanatory insights. Ante-hoc interpretability is thus an overloaded concept that comprises a range of implicit properties, which we unpack in this paper to better understand what is needed for its safe deployment across high-stakes domains. To this end, we outline modelling and explaining desiderata that allow us to navigate its distinct realisations in view of the envisaged application and audience.

Kacper Sokol, Julia E. Vogt

Workshop on Interpretable ML in Healthcare at 2023 International Conference on Machine Learning (ICML)

28.07.2023

LinkDOI

Counterfactual explanations are the de facto standard when tasked with interpreting decisions of (opaque) predictive models. Their generation is often subject to algorithmic and domain-specific constraints – such as density-based feasibility for the former and attribute (im)mutability or directionality of change for the latter – that aim to maximise their real-life utility. In addition to desiderata with respect to the counterfactual instance itself, the existence of a viable path connecting it with the factual data point, known as algorithmic recourse, has become an important technical consideration. While both of these requirements ensure that the steps of the journey as well as its destination are admissible, current literature neglects the multiplicity of such counterfactual paths. To address this shortcoming we introduce the novel concept of explanatory multiverse that encompasses all the possible counterfactual journeys and shows how to navigate, reason about and compare the geometry of these paths – their affinity, branching, divergence and possible future convergence – with two methods: vector spaces and graphs. Implementing this (interactive) explanatory process grants explainees more agency by allowing them to select counterfactuals based on the properties of the journey leading to them in addition to their absolute differences.

Kacper Sokol, Edward Small, Yueqing Xuan

Workshop on Counterfactuals in Minds and Machines at 2023 International Conference on Machine Learning (ICML)

28.07.2023

LinkDOI

Alexander Immer, Christoph Schultheiss, Julia E. Vogt, Bernhard Schölkopf, Peter Bühlmann, Alexander Marx

Proceedings of the 40th International Conference on Machine Learning, ICML 2023

04.07.2023

LinkCode