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Applications/Health

Li-wei Lehman, Benjamin Moody, Harsh Deep, Feng Wu, Hasan Saeed, Lucas McCullum, Diane Perry, Tristan Struja, Qiao Li, Gari Clifford 等

False arrhythmia alarms in intensive care units (ICUs) are a continuing problem despite considerable effort from industrial and academic algorithm developers. Of all life-threatening arrhythmias, ventricular tachycardia (VT) stands out as the most challenging arrhythmia to detect reliably. We introduce a new annotated VT alarm database, VTaC (Ventricular Tachycardia annotated alarms from ICUs) consisting of over 5,000 waveform recordings with VT alarms triggered by bedside monitors in the ICU. Each VT alarm waveform in the dataset has been labeled by at least two independent human expert annotators. The dataset encompasses data collected from ICUs in two major US hospitals and includes data from three leading bedside monitor manufacturers, providing a diverse and representative collection of alarm waveform data. Each waveform recording comprises at least two electrocardiogram (ECG) leads and one or more pulsatile waveforms, such as photoplethysmogram (PPG or PLETH) and arterial blood pressure (ABP) waveforms. We demonstrate the utility of this new benchmark dataset for the task of false arrhythmia alarm reduction, and present performance of multiple machine learning approaches, including conventional supervised machine learning, deep learning, semi-supervised learning, and generative approaches for the task of VT false alarm reduction.

Applications/Health

Qing Wu, Lixuan Chen, Ce Wang, Hongjiang Wei, S. Kevin Zhou, Jingyi Yu, Yuyao Zhang

Emerging neural reconstruction techniques based on tomography (e.g., NeRF, NeAT, and NeRP) have started showing unique capabilities in medical imaging. In this work, we present a novel Polychromatic neural representation (Polyner) to tackle the challenging problem of CT imaging when metallic implants exist within the human body. CT metal artifacts arise from the drastic variation of metal's attenuation coefficients at various energy levels of the X-ray spectrum, leading to a nonlinear metal effect in CT measurements. Recovering CT images from metal-affected measurements hence poses a complicated nonlinear inverse problem where empirical models adopted in previous metal artifact reduction (MAR) approaches lead to signal loss and strongly aliased reconstructions. Polyner instead models the MAR problem from a nonlinear inverse problem perspective. Specifically, we first derive a polychromatic forward model to accurately simulate the nonlinear CT acquisition process. Then, we incorporate our forward model into the implicit neural representation to accomplish reconstruction. Lastly, we adopt a regularizer to preserve the physical properties of the CT images across different energy levels while effectively constraining the solution space. Our Polyner is an unsupervised method and does not require any external training data. Experimenting with multiple datasets shows that our Polyner achieves comparable or better performance than supervised methods on in-domain datasets while demonstrating significant performance improvements on out-of-domain datasets. To the best of our knowledge, our Polyner is the first unsupervised MAR method that outperforms its supervised counterparts. The code for this work is available at: https://github.com/iwuqing/Polyner.

Applications/Health

Stav Belogolovsky, Ido Greenberg, Danny Eytan, Shie Mannor

Dosing models often use differential equations to model biological dynamics. Neural differential equations in particular can learn to predict the derivative of a process, which permits predictions at irregular points of time. However, this temporal flexibility often comes with a high sensitivity to noise, whereas medical problems often present high noise and limited data. Moreover, medical dosing models must generalize reliably over individual patients and changing treatment policies. To address these challenges, we introduce the Neural Eigen Stochastic Differential Equation algorithm (NESDE). NESDE provides individualized modeling (using a hypernetwork over patient-level parameters); generalization to new treatment policies (using decoupled control); tunable expressiveness according to the noise level (using piecewise linearity); and fast, continuous, closed-form prediction (using spectral representation). We demonstrate the robustness of NESDE in both synthetic and real medical problems, and use the learned dynamics to publish simulated medical gym environments.

Applications/Health

Seongsu Bae, Daeun Kyung, Jaehee Ryu, Eunbyeol Cho, Gyubok Lee, Sunjun Kweon, Jungwoo Oh, Lei Ji, Eric Chang, Tackeun Kim 等

Electronic Health Records (EHRs), which contain patients' medical histories in various multi-modal formats, often overlook the potential for joint reasoning across imaging and table modalities underexplored in current EHR Question Answering (QA) systems. In this paper, we introduce EHRXQA, a novel multi-modal question answering dataset combining structured EHRs and chest X-ray images. To develop our dataset, we first construct two uni-modal resources: 1) The MIMIC- CXR-VQA dataset, our newly created medical visual question answering (VQA) benchmark, specifically designed to augment the imaging modality in EHR QA, and 2) EHRSQL (MIMIC-IV), a refashioned version of a previously established table-based EHR QA dataset. By integrating these two uni-modal resources, we successfully construct a multi-modal EHR QA dataset that necessitates both uni-modal and cross-modal reasoning. To address the unique challenges of multi-modal questions within EHRs, we propose a NeuralSQL-based strategy equipped with an external VQA API. This pioneering endeavor enhances engagement with multi-modal EHR sources and we believe that our dataset can catalyze advances in real-world medical scenarios such as clinical decision-making and research. EHRXQA is available at https://github.com/baeseongsu/ehrxqa.

Applications/Health

Jungwoo Oh, Gyubok Lee, Seongsu Bae, Joon-myoung Kwon, Edward Choi

Question answering (QA) in the field of healthcare has received much attention due to significant advancements in natural language processing. However, existing healthcare QA datasets primarily focus on medical images, clinical notes, or structured electronic health record tables. This leaves the vast potential of combining electrocardiogram (ECG) data with these systems largely untapped. To address this gap, we present ECG-QA, the first QA dataset specifically designed for ECG analysis. The dataset comprises a total of 70 question templates that cover a wide range of clinically relevant ECG topics, each validated by an ECG expert to ensure their clinical utility. As a result, our dataset includes diverse ECG interpretation questions, including those that require a comparative analysis of two different ECGs. In addition, we have conducted numerous experiments to provide valuable insights for future research directions. We believe that ECG-QA will serve as a valuable resource for the development of intelligent QA systems capable of assisting clinicians in ECG interpretations.

Applications/Health

Chenyu You, Weicheng Dai, Yifei Min, Fenglin Liu, David Clifton, S. Kevin Zhou, Lawrence Staib, James Duncan

For medical image segmentation, contrastive learning is the dominant practice to improve the quality of visual representations by contrasting semantically similar and dissimilar pairs of samples. This is enabled by the observation that without accessing ground truth labels, negative examples with truly dissimilar anatomical features, if sampled, can significantly improve the performance. In reality, however, these samples may come from similar anatomical features and the models may struggle to distinguish the minority tail-class samples, making the tail classes more prone to misclassification, both of which typically lead to model collapse. In this paper, we propose $\texttt{ARCO}$, a semi-supervised contrastive learning (CL) framework with stratified group theory for medical image segmentation. In particular, we first propose building $\texttt{ARCO}$ through the concept of variance-reduced estimation, and show that certain variance-reduction techniques are particularly beneficial in pixel/voxel-level segmentation tasks with extremely limited labels. Furthermore, we theoretically prove these sampling techniques are universal in variance reduction. Finally, we experimentally validate our approaches on eight benchmarks, i.e., five 2D/3D medical and three semantic segmentation datasets, with different label settings, and our methods consistently outperform state-of-the-art semi-supervised methods. Additionally, we augment the CL frameworks with these sampling techniques and demonstrate significant gains over previous methods. We believe our work is an important step towards semi-supervised medical image segmentation by quantifying the limitation of current self-supervision objectives for accomplishing such challenging safety-critical tasks.

Applications/Health

Zhenbang Wu, Huaxiu Yao, David Liebovitz, Jimeng Sun

Deep learning models have been widely used to assist doctors with clinical decision-making. However, these models often encounter a significant performance drop when applied to data that differs from the distribution they were trained on. This challenge is known as the domain shift problem. Existing domain generalization algorithms attempt to address this problem by assuming the availability of domain IDs and training a single model to handle all domains. However, in healthcare settings, patients can be classified into numerous latent domains, where the actual domain categorizations are unknown. Furthermore, each patient domain exhibits distinct clinical characteristics, making it sub-optimal to train a single model for all domains. To overcome these limitations, we propose SLGD, a self-learning framework that iteratively discovers decoupled domains and trains personalized classifiers for each decoupled domain. We evaluate the generalizability of SLGD across spatial and temporal data distribution shifts on two real-world public EHR datasets: eICU and MIMIC-IV. Our results show that SLGD achieves up to 11% improvement in the AUPRC score over the best baseline.

Applications/Health

Çağlar Hızlı, ST John, Anne Juuti, Tuure Saarinen, Kirsi Pietiläinen, Pekka Marttinen

Deciding on an appropriate intervention requires a causal model of a treatment, the outcome, and potential mediators. Causal mediation analysis lets us distinguish between direct and indirect effects of the intervention, but has mostly been studied in a static setting. In healthcare, data come in the form of complex, irregularly sampled time-series, with dynamic interdependencies between a treatment, outcomes, and mediators across time. Existing approaches to dynamic causal mediation analysis are limited to regular measurement intervals, simple parametric models, and disregard long-range mediator--outcome interactions. To address these limitations, we propose a non-parametric mediator--outcome model where the mediator is assumed to be a temporal point process that interacts with the outcome process. With this model, we estimate the direct and indirect effects of an external intervention on the outcome, showing how each of these affects the whole future trajectory. We demonstrate on semi-synthetic data that our method can accurately estimate direct and indirect effects. On real-world healthcare data, our model infers clinically meaningful direct and indirect effect trajectories for blood glucose after a surgery.

Applications/Health

Alfredo De Goyeneche Macaya, Shreya Ramachandran, Ke Wang, Ekin Karasan, Joseph Y. Cheng, Stella X. Yu, Michael Lustig

Magnetic Resonance Imaging (MRI) is a powerful medical imaging modality that offers diagnostic information without harmful ionizing radiation. Unlike optical imaging, MRI sequentially samples the spatial Fourier domain (k-space) of the image. Measurements are collected in multiple shots, or readouts, and in each shot, data along a smooth trajectory is sampled.Conventional MRI data acquisition relies on sampling k-space row-by-row in short intervals, which is slow and inefficient. More efficient, non-Cartesian sampling trajectories (e.g., Spirals) use longer data readout intervals, but are more susceptible to magnetic field inhomogeneities, leading to off-resonance artifacts. Spiral trajectories cause off-resonance blurring in the image, and the mathematics of this blurring resembles that of optical blurring, where magnetic field variation corresponds to depth and readout duration to aperture size. Off-resonance blurring is a system issue with a physics-based, accurate forward model. We present a physics-informed deep learning framework for off-resonance correction in MRI, which is trained exclusively on synthetic, noise-like data with representative marginal statistics. Our approach allows for fat/water separation and is compatible with parallel imaging acceleration. Through end-to-end training using synthetic randomized data (i.e., noise-like images, coil sensitivities, field maps), we train the network to reverse off-resonance effects across diverse anatomies and contrasts without retraining. We demonstrate the effectiveness of our approach through results on phantom and in-vivo data. This work has the potential to facilitate the clinical adoption of non-Cartesian sampling trajectories, enabling efficient, rapid, and motion-robust MRI scans. Code is publicly available at: https://github.com/mikgroup/ResoNet.

Applications/Health

Mahesh Shakya, Bishesh Khanal

Various deep learning models have been proposed for 3D bone shape reconstruction from two orthogonal (biplanar) X-ray images.However, it is unclear how these models compare against each other since they are evaluated on different anatomy, cohort and (often privately held) datasets.Moreover, the impact of the commonly optimized image-based segmentation metrics such as dice score on the estimation of clinical parameters relevant in 2D-3D bone shape reconstruction is not well known.To move closer toward clinical translation, we propose a benchmarking framework that evaluates tasks relevant to real-world clinical scenarios, including reconstruction of fractured bones, bones with implants, robustness to population shift, and error in estimating clinical parameters.Our open-source platform provides reference implementations of 8 models (many of whose implementations were not publicly available), APIs to easily collect and preprocess 6 public datasets, and the implementation of automatic clinical parameter and landmark extraction methods. We present an extensive evaluation of 8 2D-3D models on equal footing using 6 public datasets comprising images for four different anatomies.Our results show that attention-based methods that capture global spatial relationships tend to perform better across all anatomies and datasets; performance on clinically relevant subgroups may be overestimated without disaggregated reporting; ribs are substantially more difficult to reconstruct compared to femur, hip and spine; and the dice score improvement does not always bring corresponding improvement in the automatic estimation of clinically relevant parameters.

Applications/Health

Junling Liu, Peilin Zhou, Yining Hua, Dading Chong, Zhongyu Tian, Andrew Liu, Helin Wang, Chenyu You, Zhenhua Guo, LEI ZHU 等

Recent advancements in large language models (LLMs) have transformed the field of question answering (QA). However, evaluating LLMs in the medical field is challenging due to the lack of standardized and comprehensive datasets. To address this gap, we introduce CMExam, sourced from the Chinese National Medical Licensing Examination. CMExam consists of 60K+ multiple-choice questions for standardized and objective evaluations, as well as solution explanations for model reasoning evaluation in an open-ended manner. For in-depth analyses of LLMs, we invited medical professionals to label five additional question-wise annotations, including disease groups, clinical departments, medical disciplines, areas of competency, and question difficulty levels. Alongside the dataset, we further conducted thorough experiments with representative LLMs and QA algorithms on CMExam. The results show that GPT-4 had the best accuracy of 61.6% and a weighted F1 score of 0.617. These results highlight a great disparity when compared to human accuracy, which stood at 71.6%. For explanation tasks, while LLMs could generate relevant reasoning and demonstrate improved performance after finetuning, they fall short of a desired standard, indicating ample room for improvement. To the best of our knowledge, CMExam is the first Chinese medical exam dataset to provide comprehensive medical annotations. The experiments and findings of LLM evaluation also provide valuable insights into the challenges and potential solutions in developing Chinese medical QA systems and LLM evaluation pipelines.

Applications/Health

Xin Liu, Girish Narayanswamy, Akshay Paruchuri, Xiaoyu Zhang, Jiankai Tang, Yuzhe Zhang, Roni Sengupta, Shwetak Patel, Yuntao Wang, Daniel McDuff

Camera-based physiological measurement is a fast growing field of computer vision. Remote photoplethysmography (rPPG) utilizes imaging devices (e.g., cameras) to measure the peripheral blood volume pulse (BVP) via photoplethysmography, and enables cardiac measurement via webcams and smartphones. However, the task is non-trivial with important pre-processing, modeling and post-processing steps required to obtain state-of-the-art results. Replication of results and benchmarking of new models is critical for scientific progress; however, as with many other applications of deep learning, reliable codebases are not easy to find or use. We present a comprehensive toolbox, rPPG-Toolbox, unsupervised and supervised rPPG models with support for public benchmark datasets, data augmentation and systematic evaluation: https://github.com/ubicomplab/rPPG-Toolbox.

Applications/Health

Michael Wornow, Rahul Thapa, Ethan Steinberg, Jason Fries, Nigam Shah

While the general machine learning (ML) community has benefited from public datasets, tasks, and models, the progress of ML in healthcare has been hampered by a lack of such shared assets. The success of foundation models creates new challenges for healthcare ML by requiring access to shared pretrained models to validate performance benefits. We help address these challenges through three contributions. First, we publish a new dataset, EHRSHOT, which contains de-identified structured data from the electronic health records (EHRs) of 6,739 patients from Stanford Medicine. Unlike MIMIC-III/IV and other popular EHR datasets, EHRSHOT is longitudinal and not restricted to ICU/ED patients. Second, we publish the weights of CLMBR-T-base, a 141M parameter clinical foundation model pretrained on the structured EHR data of 2.57M patients. We are one of the first to fully release such a model for coded EHR data; in contrast, most prior models released for clinical data (e.g. GatorTron, ClinicalBERT) only work with unstructured text and cannot process the rich, structured data within an EHR. We provide an end-to-end pipeline for the community to validate and build upon its performance. Third, we define 15 few-shot clinical prediction tasks, enabling evaluation of foundation models on benefits such as sample efficiency and task adaptation. Our model and dataset are available via a research data use agreement from here: https://stanfordaimi.azurewebsites.net/. Code to reproduce our results is available here: https://github.com/som-shahlab/ehrshot-benchmark.

Applications/Health

Zhongwei Wan, Che Liu, Mi Zhang, Jie Fu, Benyou Wang, Sibo Cheng, Lei Ma, César Quilodrán-Casas, Rossella Arcucci

The scarcity of data presents a critical obstacle to the efficacy of medical vision-language pre-training (VLP). A potential solution lies in the combination of datasets from various language communities.Nevertheless, the main challenge stems from the complexity of integrating diverse syntax and semantics, language-specific medical terminology, and culture-specific implicit knowledge. Therefore, one crucial aspect to consider is the presence of community bias caused by different languages.This paper presents a novel framework named Unifying Cross-Lingual Medical Vision-Language Pre-Training (\textbf{Med-UniC}), designed to integrate multi-modal medical data from the two most prevalent languages, English and Spanish. Specifically, we propose \textbf{C}ross-lingual \textbf{T}ext Alignment \textbf{R}egularization (\textbf{CTR}) to explicitly unify cross-lingual semantic representations of medical reports originating from diverse language communities. \textbf{CTR} is optimized through latent language disentanglement, rendering our optimization objective to not depend on negative samples, thereby significantly mitigating the bias from determining positive-negative sample pairs within analogous medical reports. Furthermore, it ensures that the cross-lingual representation is not biased toward any specific language community.\textbf{Med-UniC} reaches superior performance across 5 medical image tasks and 10 datasets encompassing over 30 diseases, offering a versatile framework for unifying multi-modal medical data within diverse linguistic communities.The experimental outcomes highlight the presence of community bias in cross-lingual VLP. Reducing this bias enhances the performance not only in vision-language tasks but also in uni-modal visual tasks.

Applications/Health

Chunyuan Li, Cliff Wong, Sheng Zhang, Naoto Usuyama, Haotian Liu, Jianwei Yang, Tristan Naumann, Hoifung Poon, Jianfeng Gao

Conversational generative AI has demonstrated remarkable promise for empowering biomedical practitioners, but current investigations focus on unimodal text. Multimodal conversational AI has seen rapid progress by leveraging billions of image-text pairs from the public web, but such general-domain vision-language models still lack sophistication in understanding and conversing about biomedical images. In this paper, we propose a cost-efficient approach for training a vision-language conversational assistant that can answer open-ended research questions of biomedical images. The key idea is to leverage a large-scale, broad-coverage biomedical figure-caption dataset extracted from PubMed Central, use GPT-4 to self-instruct open-ended instruction-following data from the captions, and then fine-tune a large general-domain vision-language model using a novel curriculum learning method. Specifically, the model first learns to align biomedical vocabulary using the figure-caption pairs as is, then learns to master open-ended conversational semantics using GPT-4 generated instruction-following data, broadly mimicking how a layperson gradually acquires biomedical knowledge. This enables us to train a Large Language and Vision Assistant for BioMedicine (LLaVA-Med) in less than 15 hours (with eight A100s). LLaVA-Med exhibits excellent multimodal conversational capability and can follow open-ended instruction to assist with inquiries about a biomedical image. On three standard biomedical visual question answering datasets, LLaVA-Med outperforms previous supervised state-of-the-art on certain metrics. To facilitate biomedical multimodal research, we will release our instruction-following data and the LLaVA-Med model.

Applications/Health

Shih-Cheng Huang, Zepeng Huo, Ethan Steinberg, Chia-Chun Chiang, Curtis Langlotz, Matthew Lungren, Serena Yeung, Nigam Shah, Jason Fries

Synthesizing information from various data sources plays a crucial role in the practice of modern medicine. Current applications of artificial intelligence in medicine often focus on single-modality data due to a lack of publicly available, multimodal medical datasets. To address this limitation, we introduce INSPECT, which contains de-identified longitudinal records from a large cohort of pulmonary embolism (PE) patients, along with ground truth labels for multiple outcomes. INSPECT contains data from 19,402 patients, including CT images, sections of radiology reports, and structured electronic health record (EHR) data (including demographics, diagnoses, procedures, and vitals). Using our provided dataset, we develop and release a benchmark for evaluating several baseline modeling approaches on a variety of important PE related tasks. We evaluate image-only, EHR-only, and fused models. Trained models and the de-identified dataset are made available for non-commercial use under a data use agreement. To the best our knowledge, INSPECT is the largest multimodal dataset for enabling reproducible research on strategies for integrating 3D medical imaging and EHR data.

Applications/Health

Juanma Zambrano Chaves, Nandita Bhaskhar, Maayane Attias, Jean-Benoit Delbrouck, Daniel Rubin, Andreas Loening, Curtis Langlotz, Akshay Chaudhari

The radiology report is the main form of communication between radiologists and other clinicians. Prior work in natural language processing in radiology reports has shown the value of developing methods tailored for individual tasks such as identifying reports with critical results or disease detection. Meanwhile, English and biomedical natural language understanding benchmarks such as the General Language Understanding and Evaluation as well as Biomedical Language Understanding and Reasoning Benchmark have motivated the development of models that can be easily adapted to address many tasks in those domains. Here, we characterize the radiology report as a distinct domain and introduce RaLEs, the Radiology Language Evaluations, as a benchmark for natural language understanding and generation in radiology. RaLEs is comprised of seven natural language understanding and generation evaluations including the extraction of anatomical and disease entities and their relations, procedure selection, and report summarization. We characterize the performance of models designed for the general, biomedical, clinical and radiology domains across these tasks. We find that advances in the general and biomedical domains do not necessarily translate to radiology, and that improved models from the general domain can perform comparably to smaller clinical-specific models. The limited performance of existing pre-trained models on RaLEs highlights the opportunity to improve domain-specific self-supervised models for natural language processing in radiology. We propose RaLEs as a benchmark to promote and track the development of such domain-specific radiology language models.

Applications/Health

Wenwen Zhang, Arvin Tashakori, Zenan Jiang, Amir Servati, Harishkumar Narayana, Saeid Soltanian, Rou Yi Yeap, Menghan Ma, Lauren Toy, Peyman Servati

The kinematics of human movements and locomotion are closely linked to the activation and contractions of muscles. To investigate this, we present a multimodal dataset with benchmarks collected using a novel pair of Intelligent Knee Sleeves (Texavie MarsWear Knee Sleeves) for human pose estimation. Our system utilizes synchronized datasets that comprise time-series data from the Knee Sleeves and the corresponding ground truth labels from visualized motion capture camera system. We employ these to generate 3D human models solely based on the wearable data of individuals performing different activities. We demonstrate the effectiveness of this camera-free system and machine learning algorithms in the assessment of various movements and exercises, including extension to unseen exercises and individuals. The results show an average error of 7.21 degrees across all eight lower body joints when compared to the ground truth, indicating the effectiveness and reliability of the Knee Sleeve system for the prediction of different lower body joints beyond knees. The results enable human pose estimation in a seamless manner without being limited by visual occlusion or the field of view of cameras. Our results show the potential of multimodal wearable sensing in a variety of applications from home fitness to sports, healthcare, and physical rehabilitation focusing on pose and movement estimation.

Applications/Health

Hava Chaptoukaev, Valeriya Strizhkova, Michele Panariello, Bianca Dalpaos, Aglind Reka, Valeria Manera, Susanne Thümmler, Esma ISMAILOVA, Nicholas W., francois bremond 等

StressID is a new dataset specifically designed for stress identification fromunimodal and multimodal data. It contains videos of facial expressions, audiorecordings, and physiological signals. The video and audio recordings are acquiredusing an RGB camera with an integrated microphone. The physiological datais composed of electrocardiography (ECG), electrodermal activity (EDA), andrespiration signals that are recorded and monitored using a wearable device. Thisexperimental setup ensures a synchronized and high-quality multimodal data col-lection. Different stress-inducing stimuli, such as emotional video clips, cognitivetasks including mathematical or comprehension exercises, and public speakingscenarios, are designed to trigger a diverse range of emotional responses. Thefinal dataset consists of recordings from 65 participants who performed 11 tasks,as well as their ratings of perceived relaxation, stress, arousal, and valence levels.StressID is one of the largest datasets for stress identification that features threedifferent sources of data and varied classes of stimuli, representing more than39 hours of annotated data in total. StressID offers baseline models for stressclassification including a cleaning, feature extraction, and classification phase foreach modality. Additionally, we provide multimodal predictive models combiningvideo, audio, and physiological inputs. The data and the code for the baselines areavailable at https://project.inria.fr/stressid/.

Applications/Health

Emma Chen, Aman Kansal, Julie Chen, Boyang Tom Jin, Julia Reisler, David Kim, Pranav Rajpurkar

We propose the Multimodal Clinical Benchmark for Emergency Care (MC-BEC), a comprehensive benchmark for evaluating foundation models in Emergency Medicine using a dataset of 100K+ continuously monitored Emergency Department visits from 2020-2022. MC-BEC focuses on clinically relevant prediction tasks at timescales from minutes to days, including predicting patient decompensation, disposition, and emergency department (ED) revisit, and includes a standardized evaluation framework with train-test splits and evaluation metrics. The multimodal dataset includes a wide range of detailed clinical data, including triage information, prior diagnoses and medications, continuously measured vital signs, electrocardiogram and photoplethysmograph waveforms, orders placed and medications administered throughout the visit, free-text reports of imaging studies, and information on ED diagnosis, disposition, and subsequent revisits. We provide performance baselines for each prediction task to enable the evaluation of multimodal, multitask models. We believe that MC-BEC will encourage researchers to develop more effective, generalizable, and accessible foundation models for multimodal clinical data.