Explaining deep neural networks for knowledge discovery in electrocardiogram analysis.

Journal: Scientific reports
PMID:

Abstract

Deep learning-based tools may annotate and interpret medical data more quickly, consistently, and accurately than medical doctors. However, as medical doctors are ultimately responsible for clinical decision-making, any deep learning-based prediction should be accompanied by an explanation that a human can understand. We present an approach called electrocardiogram gradient class activation map (ECGradCAM), which is used to generate attention maps and explain the reasoning behind deep learning-based decision-making in ECG analysis. Attention maps may be used in the clinic to aid diagnosis, discover new medical knowledge, and identify novel features and characteristics of medical tests. In this paper, we showcase how ECGradCAM attention maps can unmask how a novel deep learning model measures both amplitudes and intervals in 12-lead electrocardiograms, and we show an example of how attention maps may be used to develop novel ECG features.

Authors

  • Steven A Hicks
    SimulaMet, Oslo, Norway.
  • Jonas L Isaksen
    University of Copenhagen, 2200, Copenhagen N, Denmark.
  • Vajira Thambawita
    SimulaMet, Oslo, Norway.
  • Jonas Ghouse
    University of Copenhagen, 2200, Copenhagen N, Denmark.
  • Gustav Ahlberg
    University of Copenhagen, 2200, Copenhagen N, Denmark.
  • Allan Linneberg
    Center for Clinical Research and Prevention, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark.
  • Niels Grarup
    University of Copenhagen, 2200, Copenhagen N, Denmark.
  • Inga Strümke
    SimulaMet, 0167, Oslo, Norway.
  • Christina Ellervik
    University of Copenhagen, 2200, Copenhagen N, Denmark.
  • Morten Salling Olesen
    University of Copenhagen, 2200, Copenhagen N, Denmark.
  • Torben Hansen
    Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Claus Graff
    Aalborg University, 9220, Aalborg Ø, Denmark.
  • Niels-Henrik Holstein-Rathlou
    University of Copenhagen, 2200, Copenhagen N, Denmark.
  • Pål Halvorsen
    Center for Digital Engineering Simula Metropolitan, Fornebu 1364, Norway.
  • Mary M Maleckar
    Simula Research Laboratory, 1364, Fornebu, Norway.
  • Michael A Riegler
    SimulaMet, Oslo, Norway.
  • Jørgen K Kanters
    University of Copenhagen, 2200, Copenhagen N, Denmark.