This application is based upon and claims the benefit of priority from Japanese Patent Application No. 2021-181131, filed Nov. 5, 2021, the entire contents of which are incorporated herein by reference.
Embodiments described herein relate generally to medical information processing apparatus and method.
Semi- or full automation of job operations using machine learning models is expected to improve the efficiency of job operations that require high-level expertise by specialists. As work criteria of such job operations are left to the judgement of a person who conducts the job operation, such job operations are called personalized job operations. In the medical field, typical examples of job personalization are jobs related to medical decision making such as image diagnosis and determination of examination protocols. In supporting personalized job operations using machine learning, it is difficult to accurately add correct answer labels because of factors such as the operator’s skill and the situation at the time a correct answer label is added, and for this reason, the accuracy of prediction by a machine learning model may be deteriorated.
A medical information processing apparatus according to the embodiment has a processing circuitry. The processing circuitry adds a correct answer label used for training a decision making model, which is a machine learning model used for decision making in the medical field, in accordance with an operator’s input instruction. The processing circuitry collects status data indicating a status of the operator while doing the work of adding the correct answer label. The processing circuitry trains a reliability level determination model, which is a machine learning model which accepts status data and outputs a reliability level of the correct answer label, based on the status data and the correct answer label. The processing circuitry obtains input data of the decision making model. The processing circuitry trains the decision making model which accepts the input data and outputs output data that is data indicating a result of the decision making, based on the input data, the correct answer label, and the reliability level.
An embodiment of the medical information processing apparatus and method will be described in detail below with reference to the accompanying drawings.
The medical information processing apparatus 2 generates a machine learning model used for medical decision making (hereinafter, a “decision making model”) and a machine learning model for determining a reliability level of a correct answer label (hereinafter a “reliability level determination model”).
The decision making model 31 and the trained decision making model 35 are a network having an input layer for inputting input data 32, hidden layers for converting input data 32 into output data 36, and an output layer for outputting output data 36. It suffices that there is at least one hidden layer. The decision making model 31 and the trained decision making model 35 are a multi-class classification model that outputs a probability of a corresponding class of multiple classes relating to a decision making result as the output data 36. For example, in the case of medical decision making for image diagnosis, a disease is placed as a class; in the case of medical decision making for determining an examination protocol, on the other hand, an examination protocol is placed as a class.
The reliability level determination model 41 and the trained reliability level determination model 44 are a neural network having an input layer for inputting the status data 42, hidden layers for converting the status data 42 into the reliability level 45, and an output layer for outputting the reliability level 45. It suffices that there is at least one hidden layer. The reliability level determination model 41 and the trained reliability level determination model 44 are a multi-class classification model that outputs a probability of a corresponding class of multiple classes relating to a decision making result as the reliability level 45. Specific tasks of the reliability level determination model 41 and the trained reliability level determination model 44 are set in accordance with those of the decision making model 31 and the trained decision making model 35. For example, if the tasks of the decision making model 31 and the trained decision making model 35 are medical decision making for image diagnosis, the tasks of the reliability level determination model 41 and the trained reliability level determination model 44 are also medical decision making for the image diagnosis; on the other hand, if the tasks of the decision making model 31 and the trained decision making model 35 are medical decision making for determining an examination protocol, the tasks of the reliability level determination model 41 and the trained reliability level determination model 44 are also medical decision making for determining an examination protocol.
As shown in
The processing circuitry 21 includes processors such as a CPU (central processing unit) and a GPU (graphics processing unit). The processing circuitry 21 executes a medical information processing program to realize an obtainment function 211, an addition function 212, a collection function 213, a first learning function 214, a reliability level calculation function 215, a second learning function 216, and a display controlling function 217, etc. Note that the embodiment is not limited to the case in which the respective functions 211 to 217 are realized by single processing circuitry. Processing circuitry may be composed by combining a plurality of independent processors, and the respective processors may execute programs, thereby realizing the functions 211 to 217. The functions 211 to 217 may be respective modularized program constituting a consensus making support program or separate programs. These programs are stored in the storage apparatus 22.
By the realization of the obtainment function 211, the processing circuitry 21 obtains various information items. For example, the processing circuitry 21 obtains input data of medical decision making. The input data of medical decision making is used for training a decision making model. The input data of medical decision making can be obtained from a medical information system, such as a hospital information system (HIS) or a radiology information system (RIS), etc.
Through realization of the addition function 212, the processing circuitry 21 adds a correct answer label in accordance with an operator’s instruction that is input via the medical device terminal 3. The correct answer label is used for training a reliability level determination model and a decision making model.
By the realization of the collection function 213, the processing circuitry 21 acquires various information items. For example, the processing circuitry 21 collects status data indicating an operator’s status while doing the work of adding a correct answer label.
Through realization of the first learning function 214, the processing circuitry 21 trains, based on the status data and the correct answer label, a reliability level determination model which accepts the status data and outputs a reliability level of the correct answer label.
Through realization of the reliability level calculation function 215, the processing circuitry 21 calculates a reliability level of a correct answer label based on the trained reliability level determination model.
Through realization of the second learning function 216, the processing circuitry 21 trains the decision making model which accepts the input data and outputs output data that is data indicating a result of the decision making, based on the input data of medical decision making, the correct answer label, and the reliability level.
Through realization of the display controlling function 217, the processing circuitry 21 display various information on the display device 25 and/or the medical device terminal 3. For example, the processing circuitry 21 display a reliability level obtained by the reliability level calculation function 215, etc, on the display device 25 and/or the medical device terminal 3.
The storage apparatus 22 is a ROM (read only memory), a RAM (random access memory), an HDD (Hard Disk Drive), an SSD (Solid State Drive), or an integrated circuit storage device, etc. storing various types of information. The storage apparatus 22 may be not only the above-listed memory devices, but also a driver that writes and reads various types of information to and from, for example, a portable storage medium such as a compact disc (CD), a digital versatile disc (DVD), a flash memory, or a semiconductor memory. The storage apparatus 22 may be provided in another computer connected via a network.
The input device 23 accepts various kinds of input operations from an operator, converts the accepted input operations to electric signals, and outputs the electric signals to the processing circuitry 21. Specifically, the input device 23 is connected to an input device, such as a mouse, a keyboard, a trackball, a switch, a button, a joystick, a touch pad, or a touch panel display. The input device 23 outputs to the processing circuitry 21 an electrical signal corresponding to an input operation on the input device. The input device 23 may be an input device provided in another computer connected via a network or the like.
The communication device 24 is an interface for sending and receiving various types of information to and from other computers, such as the medical device terminal 3, etc. included in the medical information processing system 1.
The display device 25 displays various types of information through the display controlling function 217 of the processing circuitry 21. For the display device 25, for example, a liquid crystal display (LCD), a cathode ray tube (CRT) display, an organic electro luminescence display (OELD), a plasma display, or any other display can be used as appropriate. A projector may be used as the display device 25.
Next, an operation example of the medical information processing apparatus 2 is described. In the description hereinafter, assume that a task of the decision making model is determining an examination protocol. A decision making model that determines an examination protocol will be hereinafter called an “examination protocol classification model”.
After step S1, the processing circuitry 21, through the realization of the display controlling function 217, displays a working screen for examination protocol determination (step S2). In step S2, the processing circuitry 21 displays the working screen with a predetermined layout.
After step S2, the processing circuitry 21 adds a correct answer label through the implementation of the addition function 212 (step S3). In step S3, the processing circuitry 21 adds a correct answer label on the working screen displayed in step S2, in accordance with an operator’s instruction that is input via the input device 23 and/or the medical device terminal 3. As a correct answer label, an examination protocol is added. At the time of adding a correct answer label, the processing circuitry 21 collects status data indicating a status of the operator while doing the work of the adding a correct answer label, through the implementation of the collection function 213. The processing circuitry 21 collects, as status data, data relating to operator’s operations, lines of sight, speech, and/or facial expressions that reflect a process of the operator’s decision making at the time of adding a correct answer label.
At the time of an operator adding a correct answer label, the processing circuitry 21 collects an event log 62 that can be obtained through the working screen 61 that occurs during a process of determining a correct answer label by the operator. The event log 62 is raw data relating to the status data. As an example, an operation log of a screen operation by an operator via the input device 23 and a log of an operator’s line of sight on the working screen 61 are collected as event logs 62.
As shown in
The event logs 62 are recorded for each targeted patient. Specifically, the events of selecting a targeted patient to adding a correct answer label, in other words pressing the confirmation button, are collected as a single event log 62 relating to the target patient. The speech log, which is a log relating to an operator’s speech, and/or a facial expression log, which is a log relating to an operator’s facial expression, may be collected as an event log 62. It suffices that a speech log is collected by performing speech recognition on audio signals collected by a microphone and converting the signals into text information. It suffices that a facial expression log is collected by analyzing an operator’s facial expression reflected on an image taken by an optical camera.
After event logs 62 relating to the target patient are collected, the processing circuitry 21 generates status data 63 based on the event logs 62. The status data 63 has determination time information and reference items as an example. The determination time information is time relating to a time required for the work of adding a correct answer label. More specifically, it is an elapsed time from the time when the target patient is selected to the time when the confirmation button of an examination protocol is pressed. The reference item is information relating to a display item that the operator looks at in the examination data. More specifically, information of a location of acquisition relating to the event name “looking”. The status data 63 relating to the target patient is stored in the storage apparatus 22. A combination of the status data 63 relating to the target patient and the correct solution label is stored as a single training sample in the storage apparatus 22.
The determination time may be fragmented according to reference items when it is recorded. For example, x seconds from a selection of a patient to checking of patient information, y seconds from checking of patient information to confirmation of a protocol. The attention level may be converted into a numerical value. For example, three seconds for determining whether to use a contrast agent, ten seconds to refer to a diagnosed disease name, three times of checking (rechecking) a use of a contrast agent in a single diagnosis session.
After step S3, the processing circuitry 21 determines whether or not the training of the reliability level determination model should be started through realization of the first learning function 214 (step S4). In step S4, the processing circuitry 21 determines whether or not the number of collected training samples has reached the number required to train the reliability level determination model. If the number of collected training samples is less than the required number, the training of the reliability level determination model is not started, and steps S1 through S3 are repeated for another patient.
Then, if the number of collected training samples has reached the required number, and it is determined that training of the reliability level determination model is to be started (Yes in step S4), the processing circuitry 21 trains the reliability level determination model based on status data and the correct answer label through a realization of the first learning function 214 (step S5).
As described above, by training the reliability level determination model 71 based on supervised learning in which the status data 72 is input and the correct answer label 73 is used as a teacher, the reliability level determination model 71 learns a correlation between the status data 72 and the correct answer label 73. Herein, the correlation between the status data 72 and the correct answer label 73 is explained.
After step S5, the processing circuitry 21 calculates a reliability level from the status data, using the trained reliability level determination mode, through realization of the reliability level calculation function 215 (step S6).
In step S6, the processing circuitry 21 calculates a reliability level for status data of each target patient. The reliability level is registered in the reliability level database being associated with the status data.
After step S6, the processing circuitry 21 trains the examination protocol classification model based on the input data and the correct answer label through realization of the second learning function 216 (step S7). The input data is data input to the examination protocol classification model and is a part of the examination data. In other words, the input data is data of items for which a correlation can be acknowledged between the item and the examination protocol in the examination data. The items of the input data are predetermined. Assume that the input data is associated with the status data, the correct answer label, and the reliability level through an ID, etc.
In the training process, the processing circuitry 21 calculates an output obtained by performing forward propagation computation (hereinafter, a “model output”) on the input data 122 that is input to the examination protocol classification model 121, and the processing circuitry 21 calculates an error between the model output and the correct answer label 73, and updates the learning parameter by optimizing the error by, for example, stochastic gradient descent. The learning parameter is optimized by repeating the updating calculation using a plurality of training samples in such a manner that the error is minimized.
Herein, the error is expressed by a loss function L(T,p,w) wherein T is a correct answer label, p is a model output, and w is a reliability level of the correct answer label T, as represented by Expression (1) below. The subscript k indicates a training sample number.
As represented by Expression (1), the loss function L (T,p,w) is defined by a total sum of cross entropy indicating an error between a correct answer label T weighted by a reliability level w and a model output p over the plurality of training samples. As an example, in the case of the training samples shown in
After step S7, the medical information processing according to the first embodiment is finished.
The above-described flow of the medical information processing is an example, and the present embodiment is not limited to this. In the foregoing description the processing circuitry 21 successively performs the training of the reliability level determination model (S5) and the training of the examination protocol classification model (S7); however, for example, the training of the examination protocol classification model (S7) may be performed after a predetermined length of time, for example a few days, a few weeks, or a few months, of the training of the reliability level determination model (S5). The reliability level determination model (S5) and the training of the examination protocol classification model (S7) may not be necessarily performed by the same medical information processing apparatus 2 and may be performed by separate medical information processing apparatuses. The plurality of training samples (correct answer label and status data) are not necessarily collected by the same medical information processing apparatus 2 and may be collected by separate medical information processing apparatuses.
According to the foregoing embodiment, the medical information processing apparatus 2 has the addition function 212, the collection function 213, the first learning function 214, the obtainment function 211, and the second learning function 216. The addition function 212 adds a correct answer label used for training a decision making model, which is a machine learning model used for decision making by health care provision, in accordance with an operator’s input instruction. The collection function 213 collects status data indicating a status of the operator while doing the work of adding a correct answer label. The first learning function 214 trains a reliability level determination model, which is a machine learning model to which status data is input and which outputs a reliability level of the correct answer label, based on the status data and the correct answer label. The obtainment function 211 obtains input data of the decision making model. The second learning function 216 trains the decision making model to which the input data is input and which outputs output data that is data indicating a result of the decision making, based on the input data, the correct answer label, and the reliability level.
According to the above structure, it is possible to evaluate the reliability level of each correct answer level based on the status data indicating an operator’s status while doing the work adding a correct answer label. Since the decision making model is trained based on a correct answer label evaluated with a reasonable reliability level, a correct answer label having a low reliability level does not contribute to the training; it is thus possible to increase prediction accuracy of the decision making model.
The foregoing medical information processing is merely an example, and the present embodiment is not limited to this example and can be modified in various ways.
In the above-described example, the reliability level determination model is trained based on status data and a correct answer label. However, the present embodiment is not limited thereto. Hereinafter, training of the reliability level determination model according to Modification 1 is described.
During the training process, the processing circuitry 21 calculates a predicted label obtained by inputting the status data 142 and the ability data 143 to the reliability level determination model 141 and performing forward propagation computation, calculates an error between the prediction label and the correct answer label 144, and updates a training parameter in accordance with an optimization method, such as stochastic gradient descent. The learning parameter is optimized by repeating the updating calculation using a plurality of training samples in such a manner that the error is minimized. A trained reliability level determination model is generated by allocating the optimized learning parameter to the machine learning model. With the above training method, a reliability level determination model to which status data and ability data are input and which outputs a reliability level can be generated. The reliability level is used as a weight in the training of the examination protocol classification model, similarly to the above-described example.
Hereinafter, training of the reliability level determination model according to Modification 2 is described.
A freshness level is a time at which the operator adds a correct answer label. The later the time is, the higher the freshness level is. The higher the freshness level is, the higher the reliability level is. The confidence level indicates a degree of subjective confidence felt by an operator toward a correct answer label added by himself/herself or when he/she adds a label. The confidence level is input by an operator after a correct answer label is added. For example, if the operator is aware that he/she took some time to add a correct answer label, a lower confidence level is assigned compared to that assigned to an operator who is aware that he/she did not take very much time. The higher the confidence level is, the higher the reliability level is. The quality indicates the quality of information which is referred to when a correct answer label is added. For example, if an annotation is added to a medical image as a correct answer label, it is information regarding a quality of the medical image. As quality, an image format of a medical image, a presence/absence of artifacts in a medical image, a difference in SNR, and an imaging condition are used. A required time is a difference between an optimal value of a preset required time (determination time) and an actual required time (determination time) or a score based on the difference.
During the training process, the processing circuitry 21 calculates a predicted label obtained by inputting the status data 162, the ability data 163, and the additional data 164 to the reliability level determination model 161 and performing forward propagation computation, calculates an error between the prediction label and the correct answer label 165, and updates a training parameter in accordance with an optimization method, such as stochastic gradient descent. The learning parameter is optimized by repeating the updating calculation using a plurality of training samples in such a manner that the error is minimized. A trained reliability level determination model is generated by allocating the optimized learning parameter to the machine learning model. With the above training method, a reliability level determination model to which the status data 162, the ability data 163, and the additional data 164 are input and which outputs a reliability level can be generated. The reliability level is used as a weight in the training of the examination protocol classification model, similarly to the above-described example.
By training a reliability level determination model using additional data in addition to the status data and the ability data, it is expected that the accuracy of the reliability level is improved compared to Modification 2.
In the foregoing various examples, the reliability level that is output from the reliability level determination model is used as a weight in the training of the decision making model, such as an examination protocol classification model, etc. However, the present embodiment is not limited thereto. The processing circuitry 21 according to Modification 3 displays a reliability level. Hereinafter, the display of a reliability level is explained.
Suppose that the decision making model according to Modification 3 is an image diagnosis model to which a medical image is input and which outputs an annotation indicating a disease candidate area. An annotation is included in a correct answer label. More specifically, the imaging model is a multi-class classification model that outputs a probability of a disease candidate for each unit area such as a pixel. The image diagnosis model outputs the probability of each disease candidate in each unit area, and outputs a disease candidate with the highest probability. The processing circuitry 21 retains a color table defining a correspondence between a disease candidate and a color value, determines a disease candidate with a highest probability for each unit area, and displays the unit area with a color value corresponding to the disease candidate. A set of unit areas each displayed with a color value corresponding to a disease candidate constitutes an annotation.
An annotation is used as a correct answer label in order to train an image diagnosis model; however, similarly to the forgoing example, the operator adds the annotation. The reliability level determination model according to Modification 3 is trained based on status data relating to the time when an annotation is added and an annotation, and state data is input to the model and the model outputs a reliability level of each unit area. The processing circuitry 21 causes the display device 25 to display a medical image on which a reliability level is overlaid.
Typically, the display screen 170 is observed by the operator who added the annotation 173. By displaying the annotation 173 with color coding in accordance with a reliability level, it is possible to easily check the reliability level for each area of the annotation 173. For example, it is possible to prompt an operator to review the annotation for the area where the reliability level is low.
The correspondence between the reliability level and the color value may be designed freely at request. In the example shown in
As shown in
The display of the reliability level is not limited to a case where the decision making model is an image diagnosis model; any type of model, such as an examination protocol classification model can be used.
According to at least one of the above-explained embodiments, it is possible to improve an accuracy in prediction by a machine learning model.
The term “processor” used in the above explanation indicates, for example, a circuit, such as a CPU, a GPU, or an Application Specific Integrated Circuit (ASIC), and a programmable logic device (for example, a simple programmable logic device (SPLD), a complex programmable logic device (CPLD), and a field programmable gate array (FPGA)). The processor realizes its function by reading and executing the program stored in the storage circuitry. The program may be directly incorporated into the circuit of the processor instead of being stored in the storage circuit. In this case, the processor implements the function by reading and executing the program incorporated into the circuit. The function corresponding to the program may be implemented by a combination of logic circuits instead of executing the program. The processors described in connection with the above embodiments are not limited to single-circuit processors; a plurality of independent processors may be integrated into a single processor that implements the functions of the processors. Furthermore, a plurality of constituent elements shown in
While certain embodiments have been described, these embodiments have been presented by way of example only, and are not intended to limit the scope of the inventions. Indeed, the novel embodiments described herein may be embodied in a variety of other forms; furthermore, various omissions, substitutions and changes in the form of the embodiments described herein may be made without departing from the spirit of the inventions. The accompanying claims and their equivalents are intended to cover such forms or modifications as would fall within the scope and spirit of the inventions.
Regarding the foregoing embodiment, the appendage of the following is discloses as one aspect and selective features of the invention.
A medical information processing apparatus comprising processing circuitry configured to:
The processing circuitry may collect, as the status data, data relating to operator’s operations, lines of sight, speeches, and/or facial expressions that reflect a process of an operator’s decision making at the time of doing the work.
The processing circuitry may collect, as data relating to the line of sight, reference item data, which is data relating to an item that the line of sight of the operator focuses on among various items displayed on a display screen for the work of addition.
The processing circuitry may collect, as the reference item data, an identifier of a reference item on which the operator’s line of sight focuses.
The processing circuitry may collect ability data, which is data relating to an ability of the operator, and train the reliability level determination model which accepts the status data and the ability data, and outputs the reliability level based on the status data, the ability data, and the correct answer label.
The processing circuitry may further collect additional data, which is data relating to a freshness level, a confidence level, a quality, and/or a required time, and train the reliability level determination model which accepts the status data, the ability data, and the additional data and outputs the reliability level based on the status data, the ability data, the additional data, and the correct answer label.
The reliability level determination model may be a multi-class classification model that outputs the probability of each of multiple classes relating to a result of the decision making as the reliability level.
The processing circuitry may train the decision making model by minimizing a loss function.
The loss function may include an error between an output of the decision making model and the correct answer label weighted by the reliability level.
The processing circuitry may display the reliability level via a display device.
The decision making may be an addition of annotation of a disease candidate area to a medical image. The processing circuitry may display the annotation with a color value according to the reliability level.
The correspondence between the reliability level and the color value may be set in accordance with a difficulty level of the addition of the annotation.
A medical information processing method comprising:
Number | Date | Country | Kind |
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2021-181131 | Nov 2021 | JP | national |