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Federated learning (FL) is a method used for training artificial intelligence models with data from multiple sources while maintaining data anonymity, thus removing many barriers to data sharing. Here we used data from 20 institutes across the globe to train a FL model, called EXAM (electronic medical record (EMR) chest X-ray AI model), that predicts the future oxygen requirements of symptomatic patients with COVID-19 using inputs of vital signs, laboratory data and chest X-rays. EXAM achieved an average area under the curve (AUC) >0.92 for predicting outcomes at 24 and 72 h from the time of initial presentation to the emergency room, and it provided 16% improvement in average AUC measured across all participating sites and an average increase in generalizability of 38% when compared with models trained at a single site using that site’s data. For prediction of mechanical ventilation treatment or death at 24 h at the largest independent test site, EXAM achieved a sensitivity of 0.950 and specificity of 0.882. In this study, FL facilitated rapid data science collaboration without data exchange and generated a model that generalized across heterogeneous, unharmonized datasets for prediction of clinical outcomes in patients with COVID-19, setting the stage for the broader use of FL in healthcare. Federated learning, a method for training artificial intelligence algorithms that protects data privacy, was used to predict future oxygen requirements of symptomatic patients with COVID-19 using data from 20 different institutes across the globe.

Federated learning (FL) is a method used for training artificial intelligence models with data from multiple sources while maintaining data anonymity, thus removing many barriers to data sharing. Here we used data from 20 institutes across the globe to train a FL model, called EXAM (electronic medical record (EMR) chest X-ray AI model), that predicts the future oxygen requirements of symptomatic patients with COVID-19 using inputs of vital signs, laboratory data and chest X-rays. EXAM achieved an average area under the curve (AUC)0.92 for predicting outcomes at 24 and 72 h from the time of initial presentation to the emergency room, and it provided 16% improvement in average AUC measured across all participating sites and an average increase in generalizability of 38% when compared with models trained at a single site using that site's data. For prediction of mechanical ventilation treatment or death at 24 h at the largest independent test site, EXAM achieved a sensitivity of 0.950 and specificity of 0.882. In this study, FL facilitated rapid data science collaboration without data exchange and generated a model that generalized across heterogeneous, unharmonized datasets for prediction of clinical outcomes in patients with COVID-19, setting the stage for the broader use of FL in healthcare.

Automated detection of cancer metastases in lymph nodes has the potential to improve the assessment of prognosis for patients. To enable fair comparison between the algorithms for this purpose, we set up the CAMELYON17 challenge in conjunction with the IEEE International Symposium on Biomedical Imaging 2017 Conference in Melbourne. Over 300 participants registered on the challenge website, of which 23 teams submitted a total of 37 algorithms before the initial deadline. Participants were provided with 899 whole-slide images (WSIs) for developing their algorithms. The developed algorithms were evaluated based on the test set encompassing 100 patients and 500 WSIs. The evaluation metric used was a quadratic weighted Cohen's kappa. We discuss the algorithmic details of the 10 best pre-conference and two post-conference submissions. All these participants used convolutional neural networks in combination with pre- and postprocessing steps. Algorithms differed mostly in neural network architecture, training strategy, and pre- and postprocessing methodology. Overall, the kappa metric ranged from 0.89 to -0.13 across all submissions. The best results were obtained with pre-trained architectures such as ResNet. Confusion matrix analysis revealed that all participants struggled with reliably identifying isolated tumor cells, the smallest type of metastasis, with detection rates below 40%. Qualitative inspection of the results of the top participants showed categories of false positives, such as nerves or contamination, which could be targeted for further optimization. Last, we show that simple combinations of the top algorithms result in higher kappa metric values than any algorithm individually, with 0.93 for the best combination.

Range queries and range joins in metric spaces have applications in many areas, including GIS, computational biology, and data integration, where metric uncertain data exist in different forms, resulting from circumstances such as equipment limitations, high-throughput sequencing technologies, and privacy preservation. We represent metric uncertain data by using an object-level model and a bi-level model, respectively. Two novel indexes, the uncertain pivot B+-tree (UPB-tree) and the uncertain pivot B+-forest (UPB-forest), are proposed in order to support probabilistic range queries and range joins for a wide range of uncertain data types and similarity metrics. Both index structures use a small set of effective pivots chosen based on a newly defined criterion and employ the B+-tree(s) as the underlying index. In addition, we present efficient metric probabilistic range query and metric probabilistic range join algorithms, which utilize validation and pruning techniques based on derived probability lower and upper bounds. Extensive experiments with both real and synthetic data sets demonstrate that, compared against existing state-of-the-art indexes for metric uncertain data, the UPB-tree and the UPB-forest incur much lower construction costs, consume less storage space, and can support more efficient metric probabilistic range queries and metric probabilistic range joins.

There has been substantial recent progress on the theoretical understanding of model-free approaches to Linear Quadratic Regulator (LQR) problems. Much attention has been devoted to the special case when the goal is to drive the state close to a zero target. In this work, we consider the general case where the target is allowed to be arbitrary, which we refer to as the LQR tracking problem. We study the optimization landscape of this problem, and show that similar to the zero-target LQR problem, the LQR tracking problem also satisfies gradient dominance and local smoothness properties. This allows us to develop a zeroth-order policy gradient algorithm that achieves global convergence. We support our arguments with numerical simulations on a linear system., Comment: Modified parameterization for policy structure. Revised focus to be on optimization landscape and convergence for the LQR tracking problem

Tissue characterization has long been an important component of Computer Aided Diagnosis (CAD) systems for automatic lesion detection and further clinical planning. Motivated by the superior performance of deep learning methods on various computer vision problems, there has been increasing work applying deep learning to medical image analysis. However, the development of a robust and reliable deep learning model for computer-aided diagnosis is still highly challenging due to the combination of the high heterogeneity in the medical images and the relative lack of training samples. Specifically, annotation and labeling of the medical images is much more expensive and time-consuming than other applications and often involves manual labor from multiple domain experts. In this work, we propose a multi-stage, self-paced learning framework utilizing a convolutional neural network (CNN) to classify Computed Tomography (CT) image patches. The key contribution of this approach is that we augment the size of training samples by refining the unlabeled instances with a self-paced learning CNN. By implementing the framework on high performance computing servers including the NVIDIA DGX1 machine, we obtained the experimental result, showing that the self-pace boosted network consistently outperformed the original network even with very scarce manual labels. The performance gain indicates that applications with limited training samples such as medical image analysis can benefit from using the proposed framework.