Machine Learning in Medicine - Cookbook Two

Machine learning refers to a series of processes in which a computer finds rules from a vast amount of data. With recent advances in computer technology and the availability of a wide variety of health data, machine learning has rapidly developed and been applied in medical research. Currently, there are three types of machine learning: supervised, unsupervised, and reinforcement learning. In medical research, supervised learning is commonly used for diagnoses and prognoses, while unsupervised learning is used for phenotyping a disease, and reinforcement learning for maximizing favorable results, such as optimization of total patients' waiting time in the emergency department. The present article focuses on the concept and application of supervised learning in medicine, the most commonly used machine learning approach in medicine, and provides a brief explanation of four algorithms widely used for prediction (random forests, gradient-boosted decision tree, support vector machine, and neural network). Among these algorithms, the neural network has further developed into deep learning algorithms to solve more complex tasks. Along with simple classification problems, deep learning is commonly used to process medical imaging, such as retinal fundus photographs for diabetic retinopathy diagnosis. Although machine learning can bring new insights into medicine by processing a vast amount of data that are often beyond human capacity, algorithms can also fail when domain knowledge is neglected. The combination of algorithms and human cognitive ability is a key to the successful application of machine learning in medicine.

Artificial intelligence has been applied in wildfire science and management since the 1990s, with early applications including neural networks and expert systems. Since then, the field has rapidly progressed congruently with the wide adoption of machine learning (ML) methods in the environmental sciences. Here, we present a scoping review of ML applications in wildfire science and management. Our overall objective is to improve awareness of ML methods among wildfire researchers and managers, as well as illustrate the diverse and challenging range of problems in wildfire science available to ML data scientists. To that end, we first present an overview of popular ML approaches used in wildfire science to date and then review the use of ML in wildfire science as broadly categorized into six problem domains, including (i) fuels characterization, fire detection, and mapping; (ii) fire weather and climate change; (iii) fire occurrence, susceptibility, and risk; (iv) fire behavior prediction; (v) fire effects; and (vi) fire management. Furthermore, we discuss the advantages and limitations of various ML approaches relating to data size, computational requirements, generalizability, and interpretability, as well as identify opportunities for future advances in the science and management of wildfires within a data science context. In total, to the end of 2019, we identified 300 relevant publications in which the most frequently used ML methods across problem domains included random forests, MaxEnt, artificial neural networks, decision trees, support vector machines, and genetic algorithms. As such, there exists opportunities to apply more current ML methods — including deep learning and agent-based learning — in the wildfire sciences, especially in instances involving very large multivariate datasets. We must recognize, however, that despite the ability of ML models to learn on their own, expertise in wildfire science is necessary to ensure realistic modelling of fire processes across multiple scales, while the complexity of some ML methods such as deep learning requires a dedicated and sophisticated knowledge of their application. Finally, we stress that the wildfire research and management communities play an active role in providing relevant, high-quality, and freely available wildfire data for use by practitioners of ML methods.

Background: Medicine is becoming an increasingly data-centred discipline and, beyond classical statistical approaches, artificial intelligence (AI) and, in particular, machine learning (ML) are attracting much interest for the analysis of medical data. It has been argued that AI is experiencing a fast process of commodification. This characterization correctly reflects the current process of industrialization of AI and its reach into society. Therefore, societal issues related to the use of AI and ML should not be ignored any longer and certainly not in the medical domain. These societal issues may take many forms, but they all entail the design of models from a human-centred perspective, incorporating human-relevant requirements and constraints. In this brief paper, we discuss a number of specific issues affecting the use of AI and ML in medicine, such as fairness, privacy and anonymity, explainability and interpretability, but also some broader societal issues, such as ethics and legislation. We reckon that all of these are relevant aspects to consider in order to achieve the objective of fostering acceptance of AI- and ML-based technologies, as well as to comply with an evolving legislation concerning the impact of digital technologies on ethically and privacy sensitive matters. Our specific goal here is to reflect on how all these topics affect medical applications of AI and ML. This paper includes some of the contents of the “2nd Meeting of Science and Dialysis: Artificial Intelligence,” organized in the Bellvitge University Hospital, Barcelona, Spain. Summary and Key Messages: AI and ML are attracting much interest from the medical community as key approaches to knowledge extraction from data. These approaches are increasingly colonizing ambits of social impact, such as medicine and healthcare. Issues of social relevance with an impact on medicine and healthcare include (although they are not limited to) fairness, explainability, privacy, ethics and legislation.

A dose deposition matrix (DDM) prediction method using several voxel features and a machine learning (ML) approach is proposed for plan optimization in radiation therapy. Head and lung cases with the inhomogeneous medium are used as training and testing data. The prediction model is a cascade forward backprop neural network where the input is the features of the voxel, including 1) voxel to body surface distance along the beamlet axis, 2) voxel to beamlet axis distance, 3) voxel density, 4) heterogeneity corrected voxel to body surface distance, 5) heterogeneity corrected voxel to beamlet axis, and (6) the dose of voxel obtained from the pencil beam (PB) algorithm. The output is the predicted voxel dose corresponding to a beamlet. The predicted DDM was used for plan optimization (ML method) and compared with the dose of MC-based plan optimization (MC method) and the dose of pencil beam-based plan optimization (PB method). The mean absolute error (MAE) value was calculated for full volume relative to the dose of the MC method to evaluate the overall dose performance of the final plan. For patient with head tumor, the ML method achieves MAE value 0.49 × 10-4 and PB has MAE 1.86 × 10-4. For patient with lung tumor, the ML method has MAE 1.42 × 10-4 and PB has MAE 3.72 × 10-4. The maximum percentage difference in PTV dose coverage (D98) between ML and MC methods is no more than 1.2% for patient with head tumor, while the difference is larger than 10% using the PB method. For patient with lung tumor, the maximum percentage difference in PTV dose coverage (D98) between ML and MC methods is no more than 2.1%, while the difference is larger than 16% using the PB method. In this work, a reliable DDM prediction method is established for plan optimization by applying several voxel features and the ML approach. The results show that the ML method based on voxel features can obtain plans comparable to the MC method and is better than the PB method in achieving accurate dose to the patient, which is helpful for rapid plan optimization and accurate dose calculation. Establishment of a new machine learning method based on the relationship between the voxel and beamlet features for dose deposition matrix prediction in radiation therapy.

BackgroundFollowing visible successes on a wide range of predictive tasks, machine learning techniques are attracting substantial interest from medical researchers and clinicians. We address the need for capacity development in this area by providing a conceptual introduction to machine learning alongside a practical guide to developing and evaluating predictive algorithms using freely-available open source software and public domain data.MethodsWe demonstrate the use of machine learning techniques by developing three predictive models for cancer diagnosis using descriptions of nuclei sampled from breast masses. These algorithms include regularized General Linear Model regression (GLMs), Support Vector Machines (SVMs) with a radial basis function kernel, and single-layer Artificial Neural Networks. The publicly-available dataset describing the breast mass samples (N=683) was randomly split into evaluation (n=456) and validation (n=227) samples.We trained algorithms on data from the evaluation sample before they were used to predict the diagnostic outcome in the validation dataset. We compared the predictions made on the validation datasets with the real-world diagnostic decisions to calculate the accuracy, sensitivity, and specificity of the three models. We explored the use of averaging and voting ensembles to improve predictive performance. We provide a step-by-step guide to developing algorithms using the open-source R statistical programming environment.ResultsThe trained algorithms were able to classify cell nuclei with high accuracy (.94 -.96), sensitivity (.97 -.99), and specificity (.85 -.94). Maximum accuracy (.96) and area under the curve (.97) was achieved using the SVM algorithm. Prediction performance increased marginally (accuracy =.97, sensitivity =.99, specificity =.95) when algorithms were arranged into a voting ensemble.ConclusionsWe use a straightforward example to demonstrate the theory and practice of machine learning for clinicians and medical researchers. The principals which we demonstrate here can be readily applied to other complex tasks including natural language processing and image recognition.

Parameter importance assessment improves efficacy of machine learning methods for predicting snow avalanche sites in Leh-Manali Highway, India

P125. Development of a novel ensemble machine learning algorithm for prediction of complications and readmission after anterior cervical spinal fusion

Developing Theory Using Machine Learning Methods

How Magic a Bullet Is Machine Learning for Credit Analysis? An Exploration with FinTech Lending Data

Machine learning is a novel discipline concerned with the analysis of large and multiple variables data. It involves computationally intensive methods, like factor analysis, cluster analysis, and discriminant analysis. It is currently mainly the domain of computer scientists, and is already commonly used in social sciences, marketing research, operational research and applied sciences. It is virtually unused in clinical research. This is probably due to the traditional belief of clinicians in clinical trials where multiple variables are equally balanced by the randomization process and are not further taken into account. In contrast, modern computer data files often involve hundreds of variables like genes and other laboratory values, and computationally intensive methods are required. This book was written as a hand-hold presentation accessible to clinicians, and as a must-read publication for those new to the methods.

Machine learning guided design of functional materials with targeted properties

Machine learning (ML) methods are attracting considerable attention among academics in the field of finance. However, it is commonly believed that ML has not transformed the asset management industry to the same extent as other sectors. This survey focuses on the ML methods and empirical results available in the literature that matter most for active portfolio management. ML has asset management applications for signal generation, portfolio construction, and trade execution, and promising findings have been reported. Reinforcement learning (RL), in particular, is expected to play a more significant role in the industry. Nevertheless, the performance of a sample of active exchange-traded funds (ETF) that use ML in their investments tends to be mixed. Overall, ML techniques show great promise for active portfolio management, but investors should be cautioned against their main potential pitfalls. 
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Background Safety issues for fluoroquinolones have been provided by regulatory agencies. This study was conducted to identify signals of fluoroquinolones reported in the Korea Adverse Event Reporting System (KAERS) using tree-based machine learning (ML) methods. Research design and methods All adverse events (AEs) associated with the target drugs reported in the KAERS from 2013 to 2017 were matched with drug label information. A dataset containing label-positive and -negative AEs was arbitrarily divided into training and test sets. Decision tree, random forest (RF), bagging, and gradient boosting machine (GBM) were fitted on the training set with hyperparameters tuned using five-fold cross-validation and applied to the test set. The ML method with the highest area under the curve (AUC) scores was selected as the final ML model. Results Bagging was selected as the final ML model for gemifloxacin (AUC score: 1) and levofloxacin (AUC: 0.9987). RF was selected in ciprofloxacin, moxifloxacin, and ofloxacin (AUC scores: 0.9859, 0.9974, and 0.9999 respectively). We found that the final ML methods detected additional signals that were not detected using the disproportionality analysis (DPA) methods. Conclusions The bagging-or-RF-based ML methods performed better than DPA and detected novel AE signals previously unidentified using the DPA methods.

PurposeInjuries are common in sports and can have significant physical, psychological and financial consequences. Machine learning (ML) methods could be used to improve injury prediction and allow proper approaches to injury prevention. The aim of our study was therefore to perform a systematic review of ML methods in sport injury prediction and prevention.MethodsA search of the PubMed database was performed on March 24th 2020. Eligible articles included original studies investigating the role of ML for sport injury prediction and prevention. Two independent reviewers screened articles, assessed eligibility, risk of bias and extracted data. Methodological quality and risk of bias were determined by the Newcastle–Ottawa Scale. Study quality was evaluated using the GRADE working group methodology.ResultsEleven out of 249 studies met inclusion/exclusion criteria. Different ML methods were used (tree-based ensemble methods (n = 9), Support Vector Machines (n = 4), Artificial Neural Networks (n = 2)). The classification methods were facilitated by preprocessing steps (n = 5) and optimized using over- and undersampling methods (n = 6), hyperparameter tuning (n = 4), feature selection (n = 3) and dimensionality reduction (n = 1). Injury predictive performance ranged from poor (Accuracy = 52%, AUC = 0.52) to strong (AUC = 0.87, f1-score = 85%). ConclusionsCurrent ML methods can be used to identify athletes at high injury risk and be helpful to detect the most important injury risk factors. Methodological quality of the analyses was sufficient in general, but could be further improved. More effort should be put in the interpretation of the ML models.

The huge number of machine learning (ML) methods has resulted in significant information overload. Faced with an overwhelming number of ML methods, it is challenging to select appropriate ones for the given dataset and task. In general, the names of ML methods or datasets are rather condensed, thus lacking specific explanations, while the rich latent relationships between ML entities are not fully explored. In this paper, we propose a description-enhanced machine learning knowledge graph-based approach - DEKR - to help recommend appropriate ML methods for given ML datasets. The proposed knowledge graph (KG) not only includes the connections between entities but also contains the descriptions of the dataset and method entities. DEKR fuses the structural information with the description information of entities in the knowledge graph. It is a deep hybrid recommendation framework, which incorporates the knowledge graph-based and text-based methods, overcoming the limitations of previous knowledge graph-based recommendation systems that ignore the description information. There are two key components of DEKR: 1) a graph neural network aggregating information from multi-order neighbors with attention to enrich the seed (i.e. dataset or method) node's own representation, and 2) a deep collaborative filtering network based on the description text to obtain the linear and nonlinear interactions of description features. Through extensive experiments, we demonstrated the efficiency of DEKR, which outperforms the current state-of-the-art baselines by a large margin.