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The application of machine learning (ML) to address population health challenges has received much less attention than its application in the clinical setting. One such challenge is addressing disparities in early childhood cognitive development-a complex public health issue rooted in the social determinants of health, exacerbated by inequity, characterised by intergenerational transmission, and which will continue unabated without novel approaches to address it. Early life, the period of optimal neuroplasticity, presents a window of opportunity for early intervention to improve cognitive development. Unfortunately for many, this window will be missed, and intervention may never occur or occur only when overt signs of cognitive delay manifest. In this review, we explore the potential value of ML and big data analysis in the early identification of children at risk for poor cognitive outcome, an area where there is an apparent dearth of research. We compare and contrast traditional statistical methods with ML approaches, provide examples of how ML has been used to date in the field of neurodevelopmental disorders, and present a discussion of the opportunities and risks associated with its use at a population level. The review concludes by highlighting potential directions for future research in this area. IMPACT: To date, the application of machine learning to address population health challenges in paediatrics lags behind other clinical applications. This review provides an overview of the public health challenge we face in addressing disparities in childhood cognitive development and focuses on the cornerstone of early intervention. Recent advances in our ability to collect large volumes of data, and in analytic capabilities, provide a potential opportunity to improve current practices in this field. This review explores the potential role of machine learning and big data analysis in the early identification of children at risk for poor cognitive outcomes., (© 2022. The Author(s).)

Competing Interests: The authors report no conflicts of interest.

Background: Segmentation of skin lesions remains essential in histological diagnosis and skin cancer surveillance. Recent advances in deep learning have paved the way for greater improvements in medical imaging. The Hybrid Residual Networks (ResUNet) model, supplemented with Ant Colony Optimization (ACO), represents the synergy of these improvements aimed at improving the efficiency and effectiveness of skin lesion diagnosis. Objective: This paper seeks to evaluate the effectiveness of the Hybrid ResUNet model for skin lesion classification and assess its impact on optimizing ACO performance to bridge the gap between computational efficiency and clinical utility. Methods: The study used a deep learning design on a complex dataset that included a variety of skin lesions. The method includes training a Hybrid ResUNet model with standard parameters and fine-tuning using ACO for hyperparameter optimization. Performance was evaluated using traditional metrics such as accuracy, dice coefficient, and Jaccard index compared with existing models such as residual network (ResNet) and U-Net. Results: The proposed hybrid ResUNet model exhibited excellent classification accuracy, reflected in the noticeable improvement in all evaluated metrics. His ability to describe complex lesions was particularly outstanding, improving diagnostic accuracy. Our experimental results demonstrate that the proposed Hybrid ResUNet model outperforms existing state-of-the-art methods, achieving an accuracy of 95.8%, a Dice coefficient of 93.1%, and a Jaccard index of 87.5. Conclusion: The addition of ResUNet to ACO in the proposed Hybrid ResUNet model significantly improves the classification of skin lesions. This integration goes beyond traditional paradigms and demonstrates a viable strategy for deploying AI-powered tools in clinical settings. Future work: Future investigations will focus on increasing the version's abilities by using multi-modal imaging information, experimenting with alternative optimization algorithms, and comparing real-world medical applicability. There is also a promising scope for enhancing computational performance and exploring the model's interpretability for more clinical adoption. [ABSTRACT FROM AUTHOR]

It is expected that machine learning algorithms will enable better diagnosis, prognosis, and treatment in psychiatry. A central argument for deploying algorithmic methods in clinical decision-making in psychiatry is that they may enable not only faster and more accurate clinical judgments but also that they may provide a more objective foundation for clinical decisions. This article argues that the outputs of algorithms are never objective in the sense of being unaffected by human values and possibly biased choices. And it suggests that the best way to approach this is to ensure awareness of and transparency about the ethical trade-offs that must be made when developing an algorithm for mental health. [ABSTRACT FROM AUTHOR]

Safefy-critical domains often employ autonomous agents which follow a sequential decision-making setup, whereby the agent follows a policy to dictate the appropriate action at each step. AI-practitioners often employ reinforcement learning algorithms to allow an agent to find the best policy. However, sequential systems often lack clear and immediate signs of wrong actions, with consequences visible only in hindsight, making it difficult to humans to understand system failure. In reinforcement learning, this is referred to as the credit assignment problem. To effectively collaborate with an autonomous system, particularly in a safety-critical setting, explanations should enable a user to better understand the policy of the agent and predict system behavior so that users are cognizant of potential failures and these failures can be diagnosed and mitigated. However, humans are diverse and have innate biases or preferences which may enhance or impair the utility of a policy explanation of a sequential agent. Therefore, in this paper, we designed and conducted human-subjects experiment to identify the factors which influence the perceived usability with the objective usefulness of policy explanations for reinforcement learning agents in a sequential setting. Our study had two factors: the modality of policy explanation shown to the user (Tree, Text, Modified Text, and Programs) and the "first impression" of the agent, i.e., whether the user saw the agent succeed or fail in the introductory calibration video. Our findings characterize a preference-performance tradeoff wherein participants perceived languagebased policy explanations to be significantly more useable; however, participants were better able to objectively predict the agent's behavior when provided an explanation in the form of a decision tree. Our results demonstrate that user-specific factors, such as computer science experience (p < 0.05), and situational factors, such as watching agent crash (p < 0.05), can significantly impact the perception and usefulness of the explanation. This research provides key insights to alleviate prevalent issues regarding innappropriate compliance and reliance, which are exponentially more detrimental in safety-critical settings, providing a path forward for XAI developers for future work on policy-explanations. [ABSTRACT FROM AUTHOR]

This paper focuses on the use of local Explainable Artificial Intelligence (XAI) methods, particularly the Local Rule-Based Explanations (LORE) technique, within healthcare and medical settings. It emphasizes the critical role of interpretability and transparency in AI systems for diagnosing diseases, predicting patient outcomes, and creating personalized treatment plans. While acknowledging the complexities and inherent trade-offs between interpretability and model performance, our work underscores the significance of local XAI methods in enhancing decision-making processes in healthcare. By providing granular, case-specific insights, local XAI methods like LORE enhance physicians' and patients' understanding of machine learning models and their outcome. Our paper reviews significant contributions to local XAI in healthcare, highlighting its potential to improve clinical decision making, ensure fairness, and comply with regulatory standards. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) represents a revolutionary fusion of computer science and human-like problem-solving capabilities. In medicine, AI promises transformative changes, automating medical documentation, streamlining health insurance processes, and enhancing medical image analysis. The rising prevalence of mental illness across the world underscores the need for AI in psychiatry, where innovative approaches, such as speech analysis and real-time mental health assessments, are emerging. However, challenges loom. AI's performance in radiology remains inconsistent. Biased training data, workflow disruptions, and a lack of validation standards pose hurdles. Speech recognition systems suffer from word errors, impacting clinical notes' accuracy. The black-box nature of AI algorithms and their opacity in clinical settings require attention, particularly in safeguarding patient safety. Establishing guidelines for responsible AI use in mental health, addressing confidentiality, and handling critical situations is crucial. In conclusion, while AI holds immense promise in revolutionizing psychiatry and medicine, recognizing and addressing its challenges is imperative for its responsible and effective integration into clinical practice. [ABSTRACT FROM AUTHOR]

Coronaviruses have affected the lives of people around the world. Increasingly, studies have indicated that the virus is mutating and becoming more contagious. Hence, the pressing priority is to swiftly and accurately predict patient outcomes. In addition, physicians and patients increasingly need interpretability when building machine models in healthcare. We propose an interpretable machine framework(KISM) that can diagnose and prognose patients based on blood test datasets. First, we use k-nearest neighbors, isolated forests, and SMOTE to pre-process the original blood test datasets. Seven machine learning tools Support Vector Machine, Extra Tree, Random Forest, Gradient Boosting Decision Tree, eXtreme Gradient Boosting, Logistic Regression, and ensemble learning were then used to diagnose and predict COVID-19. In addition, we used SHAP and scikit-learn post-hoc interpretability to report feature importance, allowing healthcare professionals and artificial intelligence models to interact to suggest biomarkers that some doctors may have missed. The 10-fold cross-validation of two public datasets shows that the performance of KISM is better than that of the current state-of-the-art methods. In the diagnostic COVID-19 task, an AUC value of 0.9869 and an accuracy of 0.9787 were obtained, and ultimately Leukocytes, platelets, and Proteina C reativa mg/dL were found to be the most indicative biomarkers for the diagnosis of COVID-19. An AUC value of 0.9949 and an accuracy of 0.9677 were obtained in the prognostic COVID-19 task and Age, LYMPH, and WBC were found to be the most indicative biomarkers for identifying the severity of the patient. [ABSTRACT FROM AUTHOR]

Wound infections are a major problem worldwide, both for the healthcare system and for patients affected. Currently available diagnostic methods to determine the responsible germs are time-consuming and costly. Wound infections are mostly caused by various bacteria, which in turn produce volatile organic compounds. From clinical experience, we know that depending on the bacteria involved, a specific odor impression can be expected. For this reason, we hypothesized that electronic noses, i.e., non-invasive electronic sensors for the detection of volatile organic compounds, are applicable for diagnostic purposes. By providing a comprehensive overview of the state-of-research, we tested our hypothesis. In particular, we addressed three overarching questions: 1) which sensor technologies are suitable for the diagnosis of wound infections and why? 2) how must the (biological) sample be prepared and presented to the measurement system? 3) which machine learning methods and algorithms have already proven successful for the classification of microorganisms? The corresponding articles have critically been reviewed and are discussed particularly in the context of their potential for clinical diagnostics. In summary, it can already be stated today that the use of electronic noses for the detection of bacteria in wound infections is a very interesting, fast and non-invasive method. However, reliable clinical studies are still missing and further research is necessary. [ABSTRACT FROM AUTHOR]

With the onset of pandemics and accrescent stress among people, heart disease has become one of the leading contributors to premature deaths worldwide. Early prognosis of this disorder is the most viable strategy for increasing the prospects of individuals' survival. Numerous methods exploiting machine learning algorithms for heart disease prediction have been reported in the literature, but they all suffer from overfitting problems. Conspicuously, to improve the prediction accuracy, in this research work, an efficient meta‐heuristic‐based feature selection technique, namely NSGA‐II, is employed. The proposed solution aims to reduce the feature set and thus improve the prediction accuracy supported by intelligent machine learning models. The presented classifier is trained and validated using a comprehensive heart disease dataset by utilizing NSGA‐II selected features with 10‐fold cross‐validation. For performance validation, the results of the proposed model are compared with the state‐of‐the‐art machine learning algorithms, such as a k‐nearest neighbour, support vector machine, Bayesian belief networks, random forest, and naive bayes. The simulation results highlight the improved performance of the proposed model with NSGA‐II and achieve a high prediction accuracy of 97.32%. Furthermore, results of sensitivity (92.84%), specificity (92.60%), precision (91.25%), and F‐measure (92.17%) prove the utility of the proposed approach for heart disease prediction over all other variants. [ABSTRACT FROM AUTHOR]

Machine learning models are incorporated in different fields and disciplines in which some of them require a high level of accountability and transparency, for example, the healthcare sector. With the General Data Protection Regulation (GDPR), the importance for plausibility and verifiability of the predictions made by machine learning models has become essential. A widely used category of explanation techniques attempts to explain models' predictions by quantifying the importance score of each input feature. However, summarizing such scores to provide human-interpretable explanations is challenging. Another category of explanation techniques focuses on learning a domain representation in terms of high-level human-understandable concepts and then utilizing them to explain predictions. These explanations are hampered by how concepts are constructed, which is not intrinsically interpretable. To this end, we propose Concept-based Local Explanations with Feedback (CLEF), a novel local model agnostic explanation framework for learning a set of high-level transparent concept definitions in high-dimensional tabular data that uses clinician-labeled concepts rather than raw features. CLEF maps the raw input features to high-level intuitive concepts and then decompose the evidence of prediction of the instance being explained into concepts. In addition, the proposed framework generates counterfactual explanations, suggesting the minimum changes in the instance's concept based explanation that will lead to a different prediction. We demonstrate with simulated user feedback on predicting the risk of mortality. Such direct feedback is more effective than other techniques, that rely on hand-labelled or automatically extracted concepts, in learning concepts that align with ground truth concept definitions. [ABSTRACT FROM AUTHOR]

The deep learning methods for various disease prediction tasks have become very effective and even surpass human experts. However, the lack of interpretability and medical expertise limits its clinical application. This paper combines knowledge representation learning and deep learning methods, and a disease prediction model is constructed. The model initially constructs the relationship graph between the physical indicator and the test value based on the normal range of human physical examination index. And the human physical examination index for testing value by knowledge representation learning model is encoded. Then, the patient physical examination data is represented as a vector and input into a deep learning model built with self-attention mechanism and convolutional neural network to implement disease prediction. The experimental results show that the model which is used in diabetes prediction yields an accuracy of 97.18% and the recall of 87.55%, which outperforms other machine learning methods (e.g., lasso, ridge, support vector machine, random forest, and XGBoost). Compared with the best performing random forest method, the recall is increased by 5.34%, respectively. Therefore, it can be concluded that the application of medical knowledge into deep learning through knowledge representation learning can be used in diabetes prediction for the purpose of early detection and assisting diagnosis. [ABSTRACT FROM AUTHOR]

While a growing number of machine learning (ML) systems have been deployed in clinical settings with the promise of improving patient care, many have struggled to gain adoption and realize this promise. Based on a qualitative analysis of coded interviews with clinicians who use an ML-based system for sepsis, we found that, rather than viewing the system as a surrogate for their clinical judgment, clinicians perceived themselves as partnering with the technology. Our findings suggest that, even without a deep understanding of machine learning, clinicians can build trust with an ML system through experience, expert endorsement and validation, and systems designed to accommodate clinicians' autonomy and support them across their entire workflow. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases (CVDs) are one of the most fatal disease groups worldwide. Electrocardiogram (ECG) is a widely used tool for automatically detecting cardiac abnormalities, thereby helping to control and manage CVDs. To encourage more multidisciplinary researches, PhysioNet/Computing in Cardiology Challenge 2020 (Challenge 2020) provided a public platform involving multi-center databases and automatic evaluations for ECG classification tasks. As a result, 41 teams successfully submitted their solutions and were qualified for rankings. Although Challenge 2020 was a success, there has been no in-depth methodological meta-analysis of these solutions, making it difficult for researchers to benefit from the solutions and results. In this study, we aim to systematically review the 41 solutions in terms of data processing, feature engineering, model architecture, and training strategy. For each perspective, we visualize and statistically analyze the effectiveness of the common techniques, and discuss the methodological advantages and disadvantages. Finally, we summarize five practical lessons based on the aforementioned analysis: (1) Data augmentation should be employed and adapted to specific scenarios; (2) Combining different features can improve performance; (3) A hybrid design of different types of deep neural networks (DNNs) is better than using a single type; (4) The use of end-to-end architectures should depend on the task being solved; (5) Multiple models are better than one. We expect that our meta-analysis will help accelerate the research related to ECG classification based on machine-learning models. [ABSTRACT FROM AUTHOR]

Chronic exertional compartment syndrome (CECS) is a condition occurring most frequently in the lower limbs and often requires corrective surgery to alleviate symptoms. Amongst military personnel, the success rates of this surgery can be as low as 20%, presenting a challenge in determining whether surgery is worthwhile. In this study, the data of 132 fasciotomies for CECS was analysed and using combinatorial feature selection methods, coupled with input from clinicians, identified a set of key clinical features contributing to the occupational outcomes of surgery. Features were utilised to develop a machine learning model for predicting return-to-work outcomes 12-months post-surgery. An AUC of 0.85 ± 0.08 was achieved using a linear-SVM, trained using 6 features (height, mean arterial pressure, pre-surgical score on the exercise-induced leg pain questionnaire, time from initial presentation to surgery, and whether a patient had received a prior surgery for CECS). To facilitate trust and transparency, interrogation strategies were used to identify reasons why certain patients were misclassified, using instance hardness measures. Model interrogation revealed that patient difficulty was associated with an overlap in the clinical characteristics of surgical outcomes, which was best handled by XGBoost and SVM-based models. The methodology was compiled into a machine learning framework, termed AITIA, which can be applied to other clinical problems. AITIA extends the typical machine learning pipeline, integrating the proposed interrogation strategy, allowing to user to reason and decide whether to trust the developed model based on the sensibility of its decision-making. [ABSTRACT FROM AUTHOR]