Expert-augmented automated machine learning optimizes hemodynamic predictors of spinal cord injury outcome.

Journal: PloS one
Published Date:

Abstract

Artificial intelligence and machine learning (AI/ML) is becoming increasingly more accessible to biomedical researchers with significant potential to transform biomedicine through optimization of highly-accurate predictive models and enabling better understanding of disease biology. Automated machine learning (AutoML) in particular is positioned to democratize artificial intelligence (AI) by reducing the amount of human input and ML expertise needed. However, successful translation of AI/ML in biomedicine requires moving beyond optimizing only for prediction accuracy and towards establishing reproducible clinical and biological inferences. This is especially challenging for clinical studies on rare disorders where the smaller patient cohorts and corresponding sample size is an obstacle for reproducible modeling results. Here, we present a model-agnostic framework to reinforce AutoML using strategies and tools of explainable and reproducible AI, including novel metrics to assess model reproducibility. The framework enables clinicians to interpret AutoML-generated models for clinical and biological verifiability and consequently integrate domain expertise during model development. We applied the framework towards spinal cord injury prognostication to optimize the intraoperative hemodynamic range during injury-related surgery and additionally identified a strong detrimental relationship between intraoperative hypertension and patient outcome. Furthermore, our analysis captured how evolving clinical practices such as faster time-to-surgery and blood pressure management affect clinical model development. Altogether, we illustrate how expert-augmented AutoML improves inferential reproducibility for biomedical discovery and can ultimately build trust in AI processes towards effective clinical integration.

Authors

  • Austin Chou
    Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco (UCSF), San Francisco, California, United States of America.
  • Abel Torres-EspĂ­n
    Brain and Spinal Injury Center, Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
  • Nikos Kyritsis
    Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco (UCSF), San Francisco, California, United States of America.
  • J Russell Huie
    Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco (UCSF), San Francisco, California, United States of America.
  • Sarah Khatry
    DataRobot, Inc., Boston, Massachusetts, United States of America.
  • Jeremy Funk
    DataRobot, Inc., Boston, Massachusetts, United States of America.
  • Jennifer Hay
    DataRobot, Inc., Boston, Massachusetts, United States of America.
  • Andrew Lofgreen
    DataRobot, Inc., Boston, Massachusetts, United States of America.
  • Rajiv Shah
    DataRobot, Inc., Boston, Massachusetts, United States of America.
  • Chandler McCann
    DataRobot, Inc., Boston, Massachusetts, United States of America.
  • Lisa U Pascual
    Orthopedic Trauma Institute, Department of Orthopedic Surgery, University of California, San Francisco (UCSF), San Francisco, California, United States of America.
  • Edilberto Amorim
    Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, USA. Electronic address: edilbertoamorim@gmail.com.
  • Philip R Weinstein
    Department of Neurological Surgery, University of California, San Francisco (UCSF), San Francisco, California, United States of America.
  • Geoffrey T Manley
    Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco (UCSF), San Francisco, California, United States of America.
  • Sanjay S Dhall
    Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco (UCSF), San Francisco, California, United States of America.
  • Jonathan Z Pan
    Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco (UCSF), San Francisco, California, United States of America.
  • Jacqueline C Bresnahan
    Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco (UCSF), San Francisco, California, United States of America.
  • Michael S Beattie
    Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco (UCSF), San Francisco, California, United States of America.
  • William D Whetstone
    Department of Emergency Medicine, University of California, San Francisco, San Francisco, California, USA.
  • Adam R Ferguson
    Brain and Spinal Injury Center (BASIC), Department of Neurological Surgery, University of California, San Francisco; San Francisco Veterans Affairs Medical Center, San Francisco, CA 94143.