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Imon Banerjee

Publications and source records attributed to Imon Banerjee.

At least 37 records · Page 2Linked to original sources

Novel AI-Based Quantification of Breast Arterial Calcification to Predict Cardiovascular Risk

Women are underdiagnosed and undertreated for cardiovascular disease. Automatic quantification of breast arterial calcification on screening mammography can identify women at risk for cardiovascular disease and enable earlier treatment and management of disease. In this retrospective study of 116,135 women from two healthcare systems, a transformer-based neural network quantified BAC severity (no BAC, mild, moderate, and severe) on screening mammograms. Outcomes included major adverse cardiovascular events (MACE) and all-cause mortality. BAC severity was independently associated with MACE after adjusting for cardiovascular risk factors, with increasing hazard ratios from mild (HR 1.18-1.22), moderate (HR 1.38-1.47), to severe BAC (HR 2.03-2.22) across datasets (all p<0.001). This association remained significant across all age groups, with even mild BAC indicating increased risk in women under 50. BAC remained an independent predictor when analyzed alongside ASCVD risk scores, showing significant associations with myocardial infarction, stroke, heart failure, and mortality (all p<0.005). Automated BAC quantification enables opportunistic cardiovascular risk assessment during routine mammography without additional radiation or cost. This approach provides value beyond traditional risk factors, particularly in younger women, offering potential for early CVD risk stratification in the millions of women undergoing annual mammography.

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Benchmark on Peer Review Toxic Detection: A Challenging Task with a New Dataset

Peer review is crucial for advancing and improving science through constructive criticism. However, toxic feedback can discourage authors and hinder scientific progress. This work explores an important but underexplored area: detecting toxicity in peer reviews. We first define toxicity in peer reviews across four distinct categories and curate a dataset of peer reviews from the OpenReview platform, annotated by human experts according to these definitions. Leveraging this dataset, we benchmark a variety of models, including a dedicated toxicity detection model, a sentiment analysis model, several open-source large language models (LLMs), and two closed-source LLMs. Our experiments explore the impact of different prompt granularities, from coarse to fine-grained instructions, on model performance. Notably, state-of-the-art LLMs like GPT-4 exhibit low alignment with human judgments under simple prompts but achieve improved alignment with detailed instructions. Moreover, the model's confidence score is a good indicator of better alignment with human judgments. For example, GPT-4 achieves a Cohen's Kappa score of 0.56 with human judgments, which increases to 0.63 when using only predictions with a confidence score higher than 95%. Overall, our dataset and benchmarks underscore the need for continued research to enhance toxicity detection capabilities of LLMs. By addressing this issue, our work aims to contribute to a healthy and responsible environment for constructive academic discourse and scientific collaboration.

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Unsupervised Hybrid framework for ANomaly Detection (HAND) -- applied to Screening Mammogram

Out-of-distribution (OOD) detection is crucial for enhancing the generalization of AI models used in mammogram screening. Given the challenge of limited prior knowledge about OOD samples in external datasets, unsupervised generative learning is a preferable solution which trains the model to discern the normal characteristics of in-distribution (ID) data. The hypothesis is that during inference, the model aims to reconstruct ID samples accurately, while OOD samples exhibit poorer reconstruction due to their divergence from normality. Inspired by state-of-the-art (SOTA) hybrid architectures combining CNNs and transformers, we developed a novel backbone - HAND, for detecting OOD from large-scale digital screening mammogram studies. To boost the learning efficiency, we incorporated synthetic OOD samples and a parallel discriminator in the latent space to distinguish between ID and OOD samples. Gradient reversal to the OOD reconstruction loss penalizes the model for learning OOD reconstructions. An anomaly score is computed by weighting the reconstruction and discriminator loss. On internal RSNA mammogram held-out test and external Mayo clinic hand-curated dataset, the proposed HAND model outperformed encoder-based and GAN-based baselines, and interestingly, it also outperformed the hybrid CNN+transformer baselines. Therefore, the proposed HAND pipeline offers an automated efficient computational solution for domain-specific quality checks in external screening mammograms, yielding actionable insights without direct exposure to the private medical imaging data.

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Knowledge-grounded Adaptation Strategy for Vision-language Models: Building Unique Case-set for Screening Mammograms for Residents Training

A visual-language model (VLM) pre-trained on natural images and text pairs poses a significant barrier when applied to medical contexts due to domain shift. Yet, adapting or fine-tuning these VLMs for medical use presents considerable hurdles, including domain misalignment, limited access to extensive datasets, and high-class imbalances. Hence, there is a pressing need for strategies to effectively adapt these VLMs to the medical domain, as such adaptations would prove immensely valuable in healthcare applications. In this study, we propose a framework designed to adeptly tailor VLMs to the medical domain, employing selective sampling and hard-negative mining techniques for enhanced performance in retrieval tasks. We validate the efficacy of our proposed approach by implementing it across two distinct VLMs: the in-domain VLM (MedCLIP) and out-of-domain VLMs (ALBEF). We assess the performance of these models both in their original off-the-shelf state and after undergoing our proposed training strategies, using two extensive datasets containing mammograms and their corresponding reports. Our evaluation spans zero-shot, few-shot, and supervised scenarios. Through our approach, we observe a notable enhancement in Recall@K performance for the image-text retrieval task.

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Assessing Empathy in Large Language Models with Real-World Physician-Patient Interactions

The integration of Large Language Models (LLMs) into the healthcare domain has the potential to significantly enhance patient care and support through the development of empathetic, patient-facing chatbots. This study investigates an intriguing question Can ChatGPT respond with a greater degree of empathy than those typically offered by physicians? To answer this question, we collect a de-identified dataset of patient messages and physician responses from Mayo Clinic and generate alternative replies using ChatGPT. Our analyses incorporate novel empathy ranking evaluation (EMRank) involving both automated metrics and human assessments to gauge the empathy level of responses. Our findings indicate that LLM-powered chatbots have the potential to surpass human physicians in delivering empathetic communication, suggesting a promising avenue for enhancing patient care and reducing professional burnout. The study not only highlights the importance of empathy in patient interactions but also proposes a set of effective automatic empathy ranking metrics, paving the way for the broader adoption of LLMs in healthcare.

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Hierarchical Classification System for Breast Cancer Specimen Report (HCSBC) -- an end-to-end model for characterizing severity and diagnosis

Automated classification of cancer pathology reports can extract information from unstructured reports and categorize each report into structured diagnosis and severity categories. Thus, such system can reduce the burden for populating tumor registries, help registration for clinical trial as well as developing large dataset for deep learning model development using true pathologic ground truth. However, the content of breast pathology reports can be difficult for categorize due to the high linguistic variability in content and wide variety of potential diagnoses >50. Existing NLP models are primarily focused on developing classifier for primary breast cancer types (e.g. IDC, DCIS, ILC) and tumor characteristics, and ignore the rare diagnosis of cancer subtypes. We then developed a hierarchical hybrid transformer-based pipeline (59 labels) - Hierarchical Classification System for Breast Cancer Specimen Report (HCSBC), which utilizes the potential of the transformer context-preserving NLP technique and compared our model to several state of the art ML and DL models. We trained the model on the EUH data and evaluated our model's performance on two external datasets - MGH and Mayo Clinic. We publicly release the code and a live application under Huggingface spaces repository

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Multivariate Analysis on Performance Gaps of Artificial Intelligence Models in Screening Mammography

Although deep learning models for abnormality classification can perform well in screening mammography, the demographic, imaging, and clinical characteristics associated with increased risk of model failure remain unclear. This retrospective study uses the Emory BrEast Imaging Dataset(EMBED) containing mammograms from 115931 patients imaged at Emory Healthcare between 2013-2020, with BI-RADS assessment, region of interest coordinates for abnormalities, imaging features, pathologic outcomes, and patient demographics. Multiple deep learning models were trained to distinguish between abnormal tissue patches and randomly selected normal tissue patches from screening mammograms. We assessed model performance by subgroups defined by age, race, pathologic outcome, tissue density, and imaging characteristics and investigated their associations with false negatives (FN) and false positives (FP). We also performed multivariate logistic regression to control for confounding between subgroups. The top-performing model, ResNet152V2, achieved accuracy of 92.6%(95%CI=92.0-93.2%), and AUC 0.975(95%CI=0.972-0.978). Before controlling for confounding, nearly all subgroups showed statistically significant differences in model performance. However, after controlling for confounding, we found lower FN risk associates with Other race(RR=0.828;p=.050), biopsy-proven benign lesions(RR=0.927;p=.011), and mass(RR=0.921;p=.010) or asymmetry(RR=0.854;p=.040); higher FN risk associates with architectural distortion (RR=1.037;p<.001). Higher FP risk associates to BI-RADS density C(RR=1.891;p<.001) and D(RR=2.486;p<.001). Our results demonstrate subgroup analysis is important in mammogram classifier performance evaluation, and controlling for confounding between subgroups elucidates the true associations between variables and model failure. These results can help guide developing future breast cancer detection models.

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Generalizable Natural Language Processing Framework for Migraine Reporting from Social Media

Migraine is a high-prevalence and disabling neurological disorder. However, information migraine management in real-world settings could be limited to traditional health information sources. In this paper, we (i) verify that there is substantial migraine-related chatter available on social media (Twitter and Reddit), self-reported by migraine sufferers; (ii) develop a platform-independent text classification system for automatically detecting self-reported migraine-related posts, and (iii) conduct analyses of the self-reported posts to assess the utility of social media for studying this problem. We manually annotated 5750 Twitter posts and 302 Reddit posts. Our system achieved an F1 score of 0.90 on Twitter and 0.93 on Reddit. Analysis of information posted by our 'migraine cohort' revealed the presence of a plethora of relevant information about migraine therapies and patient sentiments associated with them. Our study forms the foundation for conducting an in-depth analysis of migraine-related information using social media data.

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Meta Sparse Principal Component Analysis

We study the meta-learning for support (i.e. the set of non-zero entries) recovery in high-dimensional Principal Component Analysis. We reduce the sufficient sample complexity in a novel task with the information that is learned from auxiliary tasks. We assume each task to be a different random Principal Component (PC) matrix with a possibly different support and that the support union of the PC matrices is small. We then pool the data from all the tasks to execute an improper estimation of a single PC matrix by maximising the $l_1$-regularised predictive covariance to establish that with high probability the true support union can be recovered provided a sufficient number of tasks $m$ and a sufficient number of samples $ O\left(\frac{\log(p)}{m}\right)$ for each task, for $p$-dimensional vectors. Then, for a novel task, we prove that the maximisation of the $l_1$-regularised predictive covariance with the additional constraint that the support is a subset of the estimated support union could reduce the sufficient sample complexity of successful support recovery to $O(\log |J|)$, where $J$ is the support union recovered from the auxiliary tasks. Typically, $|J|$ would be much less than $p$ for sparse matrices. Finally, we demonstrate the validity of our experiments through numerical simulations.

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Augmenting Vision Language Pretraining by Learning Codebook with Visual Semantics

Language modality within the vision language pretraining framework is innately discretized, endowing each word in the language vocabulary a semantic meaning. In contrast, visual modality is inherently continuous and high-dimensional, which potentially prohibits the alignment as well as fusion between vision and language modalities. We therefore propose to "discretize" the visual representation by joint learning a codebook that imbues each visual token a semantic. We then utilize these discretized visual semantics as self-supervised ground-truths for building our Masked Image Modeling objective, a counterpart of Masked Language Modeling which proves successful for language models. To optimize the codebook, we extend the formulation of VQ-VAE which gives a theoretic guarantee. Experiments validate the effectiveness of our approach across common vision-language benchmarks.

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Advances in Prediction of Readmission Rates Using Long Term Short Term Memory Networks on Healthcare Insurance Data

30-day hospital readmission is a long standing medical problem that affects patients' morbidity and mortality and costs billions of dollars annually. Recently, machine learning models have been created to predict risk of inpatient readmission for patients with specific diseases, however no model exists to predict this risk across all patients. We developed a bi-directional Long Short Term Memory (LSTM) Network that is able to use readily available insurance data (inpatient visits, outpatient visits, and drug prescriptions) to predict 30 day re-admission for any admitted patient, regardless of reason. The top-performing model achieved an ROC AUC of 0.763 (0.011) when using historical, inpatient, and post-discharge data. The LSTM model significantly outperformed a baseline random forest classifier, indicating that understanding the sequence of events is important for model prediction. Incorporation of 30-days of historical data also significantly improved model performance compared to inpatient data alone, indicating that a patients clinical history prior to admission, including outpatient visits and pharmacy data is a strong contributor to readmission. Our results demonstrate that a machine learning model is able to predict risk of inpatient readmission with reasonable accuracy for all patients using structured insurance billing data. Because billing data or equivalent surrogates can be extracted from sites, such a model could be deployed to identify patients at risk for readmission before they are discharged, or to assign more robust follow up (closer follow up, home health, mailed medications) to at-risk patients after discharge.

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PathologyBERT -- Pre-trained Vs. A New Transformer Language Model for Pathology Domain

Pathology text mining is a challenging task given the reporting variability and constant new findings in cancer sub-type definitions. However, successful text mining of a large pathology database can play a critical role to advance 'big data' cancer research like similarity-based treatment selection, case identification, prognostication, surveillance, clinical trial screening, risk stratification, and many others. While there is a growing interest in developing language models for more specific clinical domains, no pathology-specific language space exist to support the rapid data-mining development in pathology space. In literature, a few approaches fine-tuned general transformer models on specialized corpora while maintaining the original tokenizer, but in fields requiring specialized terminology, these models often fail to perform adequately. We propose PathologyBERT - a pre-trained masked language model which was trained on 347,173 histopathology specimen reports and publicly released in the Huggingface repository. Our comprehensive experiments demonstrate that pre-training of transformer model on pathology corpora yields performance improvements on Natural Language Understanding (NLU) and Breast Cancer Diagnose Classification when compared to nonspecific language models.

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Multimodal spatiotemporal graph neural networks for improved prediction of 30-day all-cause hospital readmission

Measures to predict 30-day readmission are considered an important quality factor for hospitals as accurate predictions can reduce the overall cost of care by identifying high risk patients before they are discharged. While recent deep learning-based studies have shown promising empirical results on readmission prediction, several limitations exist that may hinder widespread clinical utility, such as (a) only patients with certain conditions are considered, (b) existing approaches do not leverage data temporality, (c) individual admissions are assumed independent of each other, which is unrealistic, (d) prior studies are usually limited to single source of data and single center data. To address these limitations, we propose a multimodal, modality-agnostic spatiotemporal graph neural network (MM-STGNN) for prediction of 30-day all-cause hospital readmission that fuses multimodal in-patient longitudinal data. By training and evaluating our methods using longitudinal chest radiographs and electronic health records from two independent centers, we demonstrate that MM-STGNN achieves AUROC of 0.79 on both primary and external datasets. Furthermore, MM-STGNN significantly outperforms the current clinical reference standard, LACE+ score (AUROC=0.61), on the primary dataset. For subset populations of patients with heart and vascular disease, our model also outperforms baselines on predicting 30-day readmission (e.g., 3.7 point improvement in AUROC in patients with heart disease). Lastly, qualitative model interpretability analysis indicates that while patients' primary diagnoses were not explicitly used to train the model, node features crucial for model prediction directly reflect patients' primary diagnoses. Importantly, our MM-STGNN is agnostic to node feature modalities and could be utilized to integrate multimodal data for triaging patients in various downstream resource allocation tasks.

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OSCARS: An Outlier-Sensitive Content-Based Radiography Retrieval System

Improving the retrieval relevance on noisy datasets is an emerging need for the curation of a large-scale clean dataset in the medical domain. While existing methods can be applied for class-wise retrieval (aka. inter-class), they cannot distinguish the granularity of likeness within the same class (aka. intra-class). The problem is exacerbated on medical external datasets, where noisy samples of the same class are treated equally during training. Our goal is to identify both intra/inter-class similarities for fine-grained retrieval. To achieve this, we propose an Outlier-Sensitive Content-based rAdiologhy Retrieval System (OSCARS), consisting of two steps. First, we train an outlier detector on a clean internal dataset in an unsupervised manner. Then we use the trained detector to generate the anomaly scores on the external dataset, whose distribution will be used to bin intra-class variations. Second, we propose a quadruplet (a, p, nintra, ninter) sampling strategy, where intra-class negatives nintra are sampled from bins of the same class other than the bin anchor a belongs to, while niner are randomly sampled from inter-classes. We suggest a weighted metric learning objective to balance the intra and inter-class feature learning. We experimented on two representative public radiography datasets. Experiments show the effectiveness of our approach. The training and evaluation code can be found in https://github.com/XiaoyuanGuo/oscars.

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The EMory BrEast imaging Dataset (EMBED): A Racially Diverse, Granular Dataset of 3.5M Screening and Diagnostic Mammograms

Developing and validating artificial intelligence models in medical imaging requires datasets that are large, granular, and diverse. To date, the majority of publicly available breast imaging datasets lack in one or more of these areas. Models trained on these data may therefore underperform on patient populations or pathologies that have not previously been encountered. The EMory BrEast imaging Dataset (EMBED) addresses these gaps by providing 3650,000 2D and DBT screening and diagnostic mammograms for 116,000 women divided equally between White and African American patients. The dataset also contains 40,000 annotated lesions linked to structured imaging descriptors and 61 ground truth pathologic outcomes grouped into six severity classes. Our goal is to share this dataset with research partners to aid in development and validation of breast AI models that will serve all patients fairly and help decrease bias in medical AI.

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CVAD: A generic medical anomaly detector based on Cascade VAE

Detecting out-of-distribution (OOD) samples in medical imaging plays an important role for downstream medical diagnosis. However, existing OOD detectors are demonstrated on natural images composed of inter-classes and have difficulty generalizing to medical images. The key issue is the granularity of OOD data in the medical domain, where intra-class OOD samples are predominant. We focus on the generalizability of OOD detection for medical images and propose a self-supervised Cascade Variational autoencoder-based Anomaly Detector (CVAD). We use a variational autoencoders' cascade architecture, which combines latent representation at multiple scales, before being fed to a discriminator to distinguish the OOD data from the in-distribution (ID) data. Finally, both the reconstruction error and the OOD probability predicted by the binary discriminator are used to determine the anomalies. We compare the performance with the state-of-the-art deep learning models to demonstrate our model's efficacy on various open-access medical imaging datasets for both intra- and inter-class OOD. Further extensive results on datasets including common natural datasets show our model's effectiveness and generalizability. The code is available at https://github.com/XiaoyuanGuo/CVAD.

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Margin-Aware Intra-Class Novelty Identification for Medical Images

Traditional anomaly detection methods focus on detecting inter-class variations while medical image novelty identification is inherently an intra-class detection problem. For example, a machine learning model trained with normal chest X-ray and common lung abnormalities, is expected to discover and flag idiopathic pulmonary fibrosis which a rare lung disease and unseen by the model during training. The nuances from intra-class variations and lack of relevant training data in medical image analysis pose great challenges for existing anomaly detection methods. To tackle the challenges, we propose a hybrid model - Transformation-based Embedding learning for Novelty Detection (TEND) which without any out-of-distribution training data, performs novelty identification by combining both autoencoder-based and classifier-based method. With a pre-trained autoencoder as image feature extractor, TEND learns to discriminate the feature embeddings of in-distribution data from the transformed counterparts as fake out-of-distribution inputs. To enhance the separation, a distance objective is optimized to enforce a margin between the two classes. Extensive experimental results on both natural image datasets and medical image datasets are presented and our method out-performs state-of-the-art approaches.

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MedShift: identifying shift data for medical dataset curation

To curate a high-quality dataset, identifying data variance between the internal and external sources is a fundamental and crucial step. However, methods to detect shift or variance in data have not been significantly researched. Challenges to this are the lack of effective approaches to learn dense representation of a dataset and difficulties of sharing private data across medical institutions. To overcome the problems, we propose a unified pipeline called MedShift to detect the top-level shift samples and thus facilitate the medical curation. Given an internal dataset A as the base source, we first train anomaly detectors for each class of dataset A to learn internal distributions in an unsupervised way. Second, without exchanging data across sources, we run the trained anomaly detectors on an external dataset B for each class. The data samples with high anomaly scores are identified as shift data. To quantify the shiftness of the external dataset, we cluster B's data into groups class-wise based on the obtained scores. We then train a multi-class classifier on A and measure the shiftness with the classifier's performance variance on B by gradually dropping the group with the largest anomaly score for each class. Additionally, we adapt a dataset quality metric to help inspect the distribution differences for multiple medical sources. We verify the efficacy of MedShift with musculoskeletal radiographs (MURA) and chest X-rays datasets from more than one external source. Experiments show our proposed shift data detection pipeline can be beneficial for medical centers to curate high-quality datasets more efficiently. An interface introduction video to visualize our results is available at https://youtu.be/V3BF0P1sxQE.

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