Building Multimodal Clinical Decision Support Systems Using Artificial Intelligence

Healthcare analytics is a branch of data science that examines underlying patterns in healthcare data in order to identify ways in which clinical care can be improved - in terms of patient care, cost optimization, and hospital management. Towards this end, Clinical Decision Support Systems (CDSS) have received extensive research attention over the years. CDSS are intended to influence clinical decision making during patient care. CDSS can be defined as "a link between health observations and health-related knowledge that influences treatment choices by clinicians for improved healthcare delivery".A CDSS is intended to aid physicians and other health care professionals with clinical decision-making tasks based on automated analysis of patient data and other sources of information. CDSS is an evolving system with the potential for wide applicability to improve patient outcomes and healthcare resource utilization. Recent breakthroughs in healthcare analytics have seen an emerging trend in the application of artificial intelligence approaches to assist essential applications such as disease prediction, disease code assignment, disease phenotyping, and disease-related lesion segmentation. Despite the significant benefits offered by CDSSs, there are several issues that need to be overcome to achieve their full potential. There is substantial scope for improvement in terms of patient data modelling methodologies and prediction models, particularly for unstructured clinical data. This thesis discusses several approaches for developing decision support systems towards patient-centric predictive analytics on large multimodal healthcare data. Clinical data in the form of unstructured text, which is rich in patientspecific information sources, has largely remained unexplored and could be potentially used to facilitate effective CDSS development. Effective code assignment for patient clinical records in a hospital plays a significant role in the process of standardizing medical records, mainly for streamlining clinical care delivery, billing, and managing insurance claims. The current practice employed is manual coding, usually carried out by trained medical coders, making the process subjective, error-prone, inexact, and time-consuming.

This book constitutes the refereed proceedings of the Third MICCAI Workshop on Medical Content-Based Retrieval for Clinical Decision Support, MCBR-CBS 2012, held in Nice, France, in October 2012. The 10 revised full papers presented together with 2 invited talks were carefully reviewed and selected from 15 submissions. The papers are divided on several topics on image analysis of visual or multimodal medical data (X-ray, MRI, CT, echo videos, time series data), machine learning of disease correlations in visual or multimodal data, algorithms for indexing and retrieval of data from visual or multimodal medical databases, disease model-building and clinical decision support systems based on visual or multimodal analysis, algorithms for medical image retrieval or classification, systems of retrieval or classification using the ImageCLEF collection.

This book constitutes the refereed joint proceedings of the 4th International Workshop on Deep Learning in Medical Image Analysis, DLMIA 2018, and the 8th International Workshop on Multimodal Learning for Clinical Decision Support, ML-CDS 2018, held in conjunction with the 21st International Conference on Medical Imaging and Computer-Assisted Intervention, MICCAI 2018, in Granada, Spain, in September 2018. The 39 full papers presented at DLMIA 2018 and the 4 full papers presented at ML-CDS 2018 were carefully reviewed and selected from 85 submissions to DLMIA and 6 submissions to ML-CDS. The DLMIA papers focus on the design and use of deep learning methods in medical imaging. The ML-CDS papers discuss new techniques of multimodal mining/retrieval and their use in clinical decision support.

This book constitutes the refereed joint proceedings of the 10th International Workshop on Multimodal Learning for Clinical Decision Support, ML-CDS 2020, and the 9th International Workshop on Clinical Image-Based Procedures, CLIP 2020, held in conjunction with the 23rd International Conference on Medical Imaging and Computer-Assisted Intervention, MICCAI 2020, in Lima, Peru, in October 2020. The workshops were held virtually due to the COVID-19 pandemic. The 4 full papers presented at ML-CDS 2020 and the 9 full papers presented at CLIP 2020 were carefully reviewed and selected from numerous submissions to ML-CDS and 10 submissions to CLIP. The ML-CDS papers discuss machine learning on multimodal data sets for clinical decision support and treatment planning. The CLIP workshops provides a forum for work centered on specific clinical applications, including techniques and procedures based on comprehensive clinical image and other data.

This book constitutes the refereed joint proceedings of the Second International Workshop on Interpretability of Machine Intelligence in Medical Image Computing, iMIMIC 2019, and the 9th International Workshop on Multimodal Learning for Clinical Decision Support, ML-CDS 2019, held in conjunction with the 22nd International Conference on Medical Imaging and Computer-Assisted Intervention, MICCAI 2019, in Shenzhen, China, in October 2019. The 7 full papers presented at iMIMIC 2019 and the 3 full papers presented at ML-CDS 2019 were carefully reviewed and selected from 10 submissions to iMIMIC and numerous submissions to ML-CDS. The iMIMIC papers focus on introducing the challenges and opportunities related to the topic of interpretability of machine learning systems in the context of medical imaging and computer assisted intervention. The ML-CDS papers discuss machine learning on multimodal data sets for clinical decision support and treatment planning.

This book constitutes the refereed joint proceedings of the Third International Workshop on Deep Learning in Medical Image Analysis, DLMIA 2017, and the 6th International Workshop on Multimodal Learning for Clinical Decision Support, ML-CDS 2017, held in conjunction with the 20th International Conference on Medical Imaging and Computer-Assisted Intervention, MICCAI 2017, in Québec City, QC, Canada, in September 2017. The 38 full papers presented at DLMIA 2017 and the 5 full papers presented at ML-CDS 2017 were carefully reviewed and selected. The DLMIA papers focus on the design and use of deep learning methods in medical imaging. The ML-CDS papers discuss new techniques of multimodal mining/retrieval and their use in clinical decision support.

This book constitutes the refereed joint proceedings of the 11th International Workshop on Multimodal Learning for Clinical Decision Support, ML-CDS 2021, held in conjunction with the 24th International Conference on Medical Imaging and Computer-Assisted Intervention, MICCAI 2021, in Strasbourg, France, in October 2021. The workshop was held virtually due to the COVID-19 pandemic. The 10 full papers presented at ML-CDS 2021 were carefully reviewed and selected from numerous submissions. The ML-CDS papers discuss machine learning on multimodal data sets for clinical decision support and treatment planning.

Decision support systems (DSS) have evolved over the past four decades from theoretical concepts into real world computerized applications. DSS architecture contains three key components: knowledge base, computerized model, and user interface. DSS simulate cognitive decision-making functions of humans based on artificial intelligence methodologies (including expert systems, data mining, machine learning, connectionism, logistical reasoning, etc.) in order to perform decision support functions. The applications of DSS cover many domains, ranging from aviation monitoring, transportation safety, clinical diagnosis, weather forecast, business management to internet search strategy. By combining knowledge bases with inference rules, DSS are able to provide suggestions to end users to improve decisions and outcomes. This book is written as a textbook so that it can be used in formal courses examining decision support systems. It may be used by both undergraduate and graduate students from diverse computer-related fields. It will also be of value to established professionals as a text for self-study or for reference.