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Folkert W. Asselbergs

Publications and source records attributed to Folkert W. Asselbergs.

4 recordsLinked to original sources

Leveraging Cardiac Imaging to Improve ECG-Based Detection of Chagas Disease in Resource-Constrained Settings

Chagas disease is a major cause of cardiomyopathy in Latin America. Cardiac magnetic resonance (CMR) imaging can characterize its structural abnormalities, but scanners and expert readers remain scarce in endemic regions. Electrocardiography (ECG) is inexpensive and widely available, yet structural disease must be inferred indirectly from electrical signals. We propose to transfer CMR-derived structural knowledge to ECG through contrastive pre-training. Using 63,193 paired ECG-CMR examinations from the UK Biobank, we align an ECG encoder with a clinically grounded CMR embedding space using an asymmetric InfoNCE objective. Despite seeing no Chagas cases during pre-training, the resulting representation improves ECG-based Chagas detection. Across CODE-15% and SaMi-Trop, a frozen linear probe achieves an AUROC of 0.851 and sensitivity at the top 5% of predicted risk (Top5%-TPR) of 0.427 in five-fold cross-validation, compared with 0.827 and 0.377 for an unaligned ECG-FM baseline. On the PhysioNet/CinC 2025 Challenge test set, our model obtains the highest AUROC on SaMi-Trop-3 and the best ELSA-Brasil challenge score among the three top-performing methods, indicating that imaging-supervised ECG representations can generalize to populations and settings beyond the pre-training distribution.

cs.LG↗

Enhancing Transparency and Traceability in Healthcare AI: The AI Product Passport

Objective: To develop the AI Product Passport, a standards-based framework improving transparency, traceability, and compliance in healthcare AI via lifecycle-based documentation. Materials and Methods: The AI Product Passport was developed within the AI4HF project, focusing on heart failure AI tools. We analyzed regulatory frameworks (EU AI Act, FDA guidelines) and existing standards to design a relational data model capturing metadata across AI lifecycle phases: study definition, dataset preparation, model generation/evaluation, deployment/monitoring, and passport generation. MLOps/ModelOps concepts were integrated for operational relevance. Co-creation involved feedback from AI4HF consortium and a Lisbon workshop with 21 diverse stakeholders, evaluated via Mentimeter polls. The open-source platform was implemented with Python libraries for automated provenance tracking. Results: The AI Product Passport was designed based on existing standards and methods with well-defined lifecycle management and role-based access. Its implementation is a web-based platform with a relational data model supporting auditable documentation. It generates machine- and human-readable reports, customizable for stakeholders. It aligns with FUTURE-AI principles (Fairness, Universality, Traceability, Usability, Robustness, Explainability), ensuring fairness, traceability, and usability. Exported passports detail model purpose, data provenance, performance, and deployment context. GitHub-hosted backend/frontend codebases enhance accessibility. Discussion and Conclusion: The AI Product Passport addresses transparency gaps in healthcare AI, meeting regulatory and ethical demands. Its open-source nature and alignment with standards foster trust and adaptability. Future enhancements include FAIR data principles and FHIR integration for improved interoperability, promoting responsible AI deployment.

cs.CY↗

Interpretable phenotyping of Heart Failure patients with Dutch discharge letters

Objective: Heart failure (HF) patients present with diverse phenotypes affecting treatment and prognosis. This study evaluates models for phenotyping HF patients based on left ventricular ejection fraction (LVEF) classes, using structured and unstructured data, assessing performance and interpretability. Materials and Methods: The study analyzes all HF hospitalizations at both Amsterdam UMC hospitals (AMC and VUmc) from 2015 to 2023 (33,105 hospitalizations, 16,334 patients). Data from AMC were used for model training, and from VUmc for external validation. The dataset was unlabelled and included tabular clinical measurements and discharge letters. Silver labels for LVEF classes were generated by combining diagnosis codes, echocardiography results, and textual mentions. Gold labels were manually annotated for 300 patients for testing. Multiple Transformer-based (black-box) and Aug-Linear (white-box) models were trained and compared with baselines on structured and unstructured data. To evaluate interpretability, two clinicians annotated 20 discharge letters by highlighting information they considered relevant for LVEF classification. These were compared to SHAP and LIME explanations from black-box models and the inherent explanations of Aug-Linear models. Results: BERT-based and Aug-Linear models, using discharge letters alone, achieved the highest classification results (AUC=0.84 for BERT, 0.81 for Aug-Linear on external validation), outperforming baselines. Aug-Linear explanations aligned more closely with clinicians' explanations than post-hoc explanations on black-box models. Conclusions: Discharge letters emerged as the most informative source for phenotyping HF patients. Aug-Linear models matched black-box performance while providing clinician-aligned interpretability, supporting their use in transparent clinical decision-making.

cs.CL↗

Multimodal Learning for Cardiovascular Risk Prediction using EHR Data

Electronic health records (EHRs) contain structured and unstructured data of significant clinical and research value. Various machine learning approaches have been developed to employ information in EHRs for risk prediction. The majority of these attempts, however, focus on structured EHR fields and lose the vast amount of information in the unstructured texts. To exploit the potential information captured in EHRs, in this study we propose a multimodal recurrent neural network model for cardiovascular risk prediction that integrates both medical texts and structured clinical information. The proposed multimodal bidirectional long short-term memory (BiLSTM) model concatenates word embeddings to classical clinical predictors before applying them to a final fully connected neural network. In the experiments, we compare performance of different deep neural network (DNN) architectures including convolutional neural network and long short-term memory in scenarios of using clinical variables and chest X-ray radiology reports. Evaluated on a data set of real world patients with manifest vascular disease or at high-risk for cardiovascular disease, the proposed BiLSTM model demonstrates state-of-the-art performance and outperforms other DNN baseline architectures.

cs.LG↗