A digital mask to safeguard patient privacy.

Journal: Nature medicine
Published Date: Sep 15, 2022

Abstract

The storage of facial images in medical records poses privacy risks due to the sensitive nature of the personal biometric information that can be extracted from such images. To minimize these risks, we developed a new technology, called the digital mask (DM), which is based on three-dimensional reconstruction and deep-learning algorithms to irreversibly erase identifiable features, while retaining disease-relevant features needed for diagnosis. In a prospective clinical study to evaluate the technology for diagnosis of ocular conditions, we found very high diagnostic consistency between the use of original and reconstructed facial videos (κ ≥ 0.845 for strabismus, ptosis and nystagmus, and κ = 0.801 for thyroid-associated orbitopathy) and comparable diagnostic accuracy (P ≥ 0.131 for all ocular conditions tested) was observed. Identity removal validation using multiple-choice questions showed that compared to image cropping, the DM could much more effectively remove identity attributes from facial images. We further confirmed the ability of the DM to evade recognition systems using artificial intelligence-powered re-identification algorithms. Moreover, use of the DM increased the willingness of patients with ocular conditions to provide their facial images as health information during medical treatment. These results indicate the potential of the DM algorithm to protect the privacy of patients' facial images in an era of rapid adoption of digital health technologies.

Authors

  • Yahan Yang
    University of Pennsylvania, Philadelphia, PA.
  • Junfeng Lyu
    School of Software and BNRist, Tsinghua University, Beijing, China.
  • Ruixin Wang
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
  • Quan Wen
    School of Software and BNRist, Tsinghua University, Beijing, China.
  • Lanqin Zhao
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, China.
  • Wenben Chen
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China.
  • Shaowei Bi
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Jie Meng
    School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu, China.
  • Keli Mao
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Yu Xiao
    Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, the Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
  • Yingying Liang
    Department of Ophthalmology, Guangdong Provincial People's Hospital; Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
  • Danqi Zeng
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Zijing Du
    Department of Ophthalmology, Guangdong Provincial People's Hospital; Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
  • Yuxuan Wu
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Tingxin Cui
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
  • Lixue Liu
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Wai Cheng Iao
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Xiaoyan Li
    Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China.
  • Carol Y Cheung
    Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China. Electronic address: carolcheung@cuhk.edu.hk.
  • Jianhua Zhou
    Department of Ultrasound, Sun Yat-sen University Cancer centre, State Key Laboratory of Oncology in South China, Collaborative Innovation centre for Cancer Medicine, Guangzhou, China.
  • Youjin Hu
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Lai Wei
  • Iat Fan Lai
    Ophthalmic Center, Kiang Wu Hospital, Macau, China.
  • Xinping Yu
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Jingchang Chen
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Zhonghao Wang
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Zhen Mao
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Huijing Ye
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Wei Xiao
    Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhenjiang Province, China.
  • Huasheng Yang
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Danping Huang
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Xiaoming Lin
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Wei-Shi Zheng
    School of Information Science and Technology, Sun Yat-sen University, Guangzhou 510006, China; Guangdong Province Key Laboratory of Computational Science, Guangzhou 510275, China. Electronic address: wszheng@ieee.org.
  • Ruixuan Wang
    School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, P. R. China. wangruix5@mail.sysu.edu.cn.
  • Patrick Yu-Wai-Man
    From the Singapore National Eye Center (D.M., D.T., S.S., C.-Y.C., T.Y.W.), Singapore Eye Research Institute (D.M., R.P.N., D.T., C.V., S.S., C.-Y.C., T.Y.W.), Duke-NUS Medical School (D.M., R.P.N., D.T., S.S., C.-Y.C., T.Y.W.), Institute of High Performance Computing, Agency for Science, Technology, and Research (J.Z., X.X., Y.L.), and Yong Loo Lin School of Medicine, National University of Singapore (S.S., T.Y.W.) - all in Singapore; Farabi Eye Hospital, Tehran University of Medical Science, Tehran, Iran (M.A.F.); the Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, and the Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal (P.F.); the Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (K.V.); the Eye Center, Medical Center, University of Freiburg, Freiburg (W.A.L.), and the Department of Ophthalmology, Ruprecht Karl University of Heidelberg, Mannheim (J.B.J.) - both in Germany; IRCCS Istituto delle Scienze Neurologiche di Bologna, Unità Operativa Complessa Clinica Neurologica, and Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy (C.L.M.); the Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Hong Kong (C.Y.C.), and Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou (H.Y.) - both in China; the Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Glostrup, Denmark (S.H.); the Department of Ophthalmology, University Hospital of Grenoble-Alpes, and Grenoble-Alpes University, HP2 Laboratory, INSERM Unité 1042, Grenoble (C.C.), Service d'Ophtalmologie, Unité Rétine-Uvéites-Neuro-Ophtalmologie, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux (M.-B.R.), the Department of Ophthalmology, Lille Catholic Hospital, Lille Catholic University, and INSERM Unité 1171, Lille (T.T.H.C.), the Department of Ophthalmology, University Hospital Angers, Angers (P.G.), and Rothschild Foundation Hospital, Paris (C.C.-V.) - all in France; the Department of Clinical Neurosciences, Geneva University Hospital, Geneva (N.S.); the Department of Neurology, SUNY Upstate Medical University, Syracuse, NY (L.J.M.); the American Eye Center, Mandaluyong City, Philippines (R.K.); Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, University College London, London (P.Y.-W.-M.), and Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals, and Cambridge Centre for Brain Repair and Medical Research Council Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge (P.Y.-W.-M.) - all in the United Kingdom; the Save Sight Institute, Faculty of Health and Medicine, University of Sydney, Sydney (C.L.F.); the Department of Ophthalmology and Neurology, Mayo Clinic, Rochester, MN (J.J.C.); the Department of Neuro-ophthalmology, Sankara Nethralaya, Medical Research Foundation, Chennai, India (S.A.); the Departments of Ophthalmology, Neurology, and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore (N.R.M.); and the Departments of Ophthalmology and Neurology, Emory University School of Medicine, Atlanta (N.J.N., V.B.).
  • Feng Xu
    Orthopedics Department of the First Affiliated Hospital of Tsinghua University, Beijing, China.
  • Qionghai Dai
  • Haotian Lin
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou.

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