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Nov 19

ALR$^2$: A Retrieve-then-Reason Framework for Long-context Question Answering

The context window of large language models (LLMs) has been extended significantly in recent years. However, while the context length that the LLM can process has grown, the capability of the model to accurately reason over that context degrades noticeably. This occurs because modern LLMs often become overwhelmed by the vast amount of information in the context; when answering questions, the model must identify and reason over relevant evidence sparsely distributed throughout the text. To alleviate the challenge of long-context reasoning, we develop a retrieve-then-reason framework, enabling LLMs to reason over relevant evidence collected during an intermediate retrieval step. We find that modern LLMs struggle to accurately retrieve relevant facts and instead, often hallucinate "retrieved facts", resulting in flawed reasoning and the production of incorrect answers. To address these issues, we introduce ALR^2, a method that augments the long-context reasoning capability of LLMs via an explicit two-stage procedure, i.e., aligning LLMs with the objectives of both retrieval and reasoning. We demonstrate the efficacy of ALR^2 for mitigating performance degradation in long-context reasoning tasks. Through extensive experiments on long-context QA benchmarks, we find our method to outperform competitive baselines by large margins, achieving at least 8.4 and 7.9 EM gains on the long-context versions of HotpotQA and SQuAD datasets, respectively.

  • 8 authors
·
Oct 4, 2024

MagicGUI: A Foundational Mobile GUI Agent with Scalable Data Pipeline and Reinforcement Fine-tuning

This paper presents MagicGUI, a foundational mobile GUI agent designed to address critical challenges in perception, grounding, and reasoning within real-world mobile GUI environments. The framework is underpinned by following six key components: (1) a comprehensive and accurate dataset, constructed via the scalable GUI Data Pipeline, which aggregates the largest and most diverse GUI-centric multimodal data to date from open-source repositories, automated crawling, and targeted manual annotation; (2) enhanced perception and grounding capabilities, facilitating fine-grained multimodal alignment for UI element referencing, grounding, and screen comprehension; (3) a comprehensive and unified action space, encompassing both fundamental UI operations and complex interactive intents to support human-agent interactions; (4) planning-oriented reasoning mechanisms that enable the model to decompose complex user instructions into sequential actions with explicit intermediate meta-paln reasoning; (5) an iterative two-stage training procedure, combining large-scale continue pre-training on 7.8M samples with reinforcement fine-tuning utilizing a spatially enhanced composite reward and dual filtering strategy; and (6) competitive performance on both the proprietary Magic-RICH benchmark and over a dozen public benchmarks, achieving superior performance across GUI perception and agent tasks, while demonstrating robust generalization and real-world deployment potential in practical mobile GUI scenarios, as detailed in Figure 1.

  • 24 authors
·
Jul 19

PitVis-2023 Challenge: Workflow Recognition in videos of Endoscopic Pituitary Surgery

The field of computer vision applied to videos of minimally invasive surgery is ever-growing. Workflow recognition pertains to the automated recognition of various aspects of a surgery: including which surgical steps are performed; and which surgical instruments are used. This information can later be used to assist clinicians when learning the surgery; during live surgery; and when writing operation notes. The Pituitary Vision (PitVis) 2023 Challenge tasks the community to step and instrument recognition in videos of endoscopic pituitary surgery. This is a unique task when compared to other minimally invasive surgeries due to the smaller working space, which limits and distorts vision; and higher frequency of instrument and step switching, which requires more precise model predictions. Participants were provided with 25-videos, with results presented at the MICCAI-2023 conference as part of the Endoscopic Vision 2023 Challenge in Vancouver, Canada, on 08-Oct-2023. There were 18-submissions from 9-teams across 6-countries, using a variety of deep learning models. A commonality between the top performing models was incorporating spatio-temporal and multi-task methods, with greater than 50% and 10% macro-F1-score improvement over purely spacial single-task models in step and instrument recognition respectively. The PitVis-2023 Challenge therefore demonstrates state-of-the-art computer vision models in minimally invasive surgery are transferable to a new dataset, with surgery specific techniques used to enhance performance, progressing the field further. Benchmark results are provided in the paper, and the dataset is publicly available at: https://doi.org/10.5522/04/26531686.

  • 32 authors
·
Sep 2, 2024

SuPRA: Surgical Phase Recognition and Anticipation for Intra-Operative Planning

Intra-operative recognition of surgical phases holds significant potential for enhancing real-time contextual awareness in the operating room. However, we argue that online recognition, while beneficial, primarily lends itself to post-operative video analysis due to its limited direct impact on the actual surgical decisions and actions during ongoing procedures. In contrast, we contend that the prediction and anticipation of surgical phases are inherently more valuable for intra-operative assistance, as they can meaningfully influence a surgeon's immediate and long-term planning by providing foresight into future steps. To address this gap, we propose a dual approach that simultaneously recognises the current surgical phase and predicts upcoming ones, thus offering comprehensive intra-operative assistance and guidance on the expected remaining workflow. Our novel method, Surgical Phase Recognition and Anticipation (SuPRA), leverages past and current information for accurate intra-operative phase recognition while using future segments for phase prediction. This unified approach challenges conventional frameworks that treat these objectives separately. We have validated SuPRA on two reputed datasets, Cholec80 and AutoLaparo21, where it demonstrated state-of-the-art performance with recognition accuracies of 91.8% and 79.3%, respectively. Additionally, we introduce and evaluate our model using new segment-level evaluation metrics, namely Edit and F1 Overlap scores, for a more temporal assessment of segment classification. In conclusion, SuPRA presents a new multi-task approach that paves the way for improved intra-operative assistance through surgical phase recognition and prediction of future events.

  • 5 authors
·
Mar 10, 2024

Preserving Tumor Volumes for Unsupervised Medical Image Registration

Medical image registration is a critical task that estimates the spatial correspondence between pairs of images. However, current traditional and deep-learning-based methods rely on similarity measures to generate a deforming field, which often results in disproportionate volume changes in dissimilar regions, especially in tumor regions. These changes can significantly alter the tumor size and underlying anatomy, which limits the practical use of image registration in clinical diagnosis. To address this issue, we have formulated image registration with tumors as a constraint problem that preserves tumor volumes while maximizing image similarity in other normal regions. Our proposed strategy involves a two-stage process. In the first stage, we use similarity-based registration to identify potential tumor regions by their volume change, generating a soft tumor mask accordingly. In the second stage, we propose a volume-preserving registration with a novel adaptive volume-preserving loss that penalizes the change in size adaptively based on the masks calculated from the previous stage. Our approach balances image similarity and volume preservation in different regions, i.e., normal and tumor regions, by using soft tumor masks to adjust the imposition of volume-preserving loss on each one. This ensures that the tumor volume is preserved during the registration process. We have evaluated our strategy on various datasets and network architectures, demonstrating that our method successfully preserves the tumor volume while achieving comparable registration results with state-of-the-art methods. Our codes is available at: https://dddraxxx.github.io/Volume-Preserving-Registration/.

  • 5 authors
·
Sep 18, 2023

HecVL: Hierarchical Video-Language Pretraining for Zero-shot Surgical Phase Recognition

Natural language could play an important role in developing generalist surgical models by providing a broad source of supervision from raw texts. This flexible form of supervision can enable the model's transferability across datasets and tasks as natural language can be used to reference learned visual concepts or describe new ones. In this work, we present HecVL, a novel hierarchical video-language pretraining approach for building a generalist surgical model. Specifically, we construct a hierarchical video-text paired dataset by pairing the surgical lecture video with three hierarchical levels of texts: at clip-level, atomic actions using transcribed audio texts; at phase-level, conceptual text summaries; and at video-level, overall abstract text of the surgical procedure. Then, we propose a novel fine-to-coarse contrastive learning framework that learns separate embedding spaces for the three video-text hierarchies using a single model. By disentangling embedding spaces of different hierarchical levels, the learned multi-modal representations encode short-term and long-term surgical concepts in the same model. Thanks to the injected textual semantics, we demonstrate that the HecVL approach can enable zero-shot surgical phase recognition without any human annotation. Furthermore, we show that the same HecVL model for surgical phase recognition can be transferred across different surgical procedures and medical centers. The code is available at https://github.com/CAMMA-public/SurgVLP

  • 4 authors
·
May 16, 2024

SingleInsert: Inserting New Concepts from a Single Image into Text-to-Image Models for Flexible Editing

Recent progress in text-to-image (T2I) models enables high-quality image generation with flexible textual control. To utilize the abundant visual priors in the off-the-shelf T2I models, a series of methods try to invert an image to proper embedding that aligns with the semantic space of the T2I model. However, these image-to-text (I2T) inversion methods typically need multiple source images containing the same concept or struggle with the imbalance between editing flexibility and visual fidelity. In this work, we point out that the critical problem lies in the foreground-background entanglement when learning an intended concept, and propose a simple and effective baseline for single-image I2T inversion, named SingleInsert. SingleInsert adopts a two-stage scheme. In the first stage, we regulate the learned embedding to concentrate on the foreground area without being associated with the irrelevant background. In the second stage, we finetune the T2I model for better visual resemblance and devise a semantic loss to prevent the language drift problem. With the proposed techniques, SingleInsert excels in single concept generation with high visual fidelity while allowing flexible editing. Additionally, SingleInsert can perform single-image novel view synthesis and multiple concepts composition without requiring joint training. To facilitate evaluation, we design an editing prompt list and introduce a metric named Editing Success Rate (ESR) for quantitative assessment of editing flexibility. Our project page is: https://jarrentwu1031.github.io/SingleInsert-web/

  • 5 authors
·
Oct 12, 2023

Multi-Stage Cable Routing through Hierarchical Imitation Learning

We study the problem of learning to perform multi-stage robotic manipulation tasks, with applications to cable routing, where the robot must route a cable through a series of clips. This setting presents challenges representative of complex multi-stage robotic manipulation scenarios: handling deformable objects, closing the loop on visual perception, and handling extended behaviors consisting of multiple steps that must be executed successfully to complete the entire task. In such settings, learning individual primitives for each stage that succeed with a high enough rate to perform a complete temporally extended task is impractical: if each stage must be completed successfully and has a non-negligible probability of failure, the likelihood of successful completion of the entire task becomes negligible. Therefore, successful controllers for such multi-stage tasks must be able to recover from failure and compensate for imperfections in low-level controllers by smartly choosing which controllers to trigger at any given time, retrying, or taking corrective action as needed. To this end, we describe an imitation learning system that uses vision-based policies trained from demonstrations at both the lower (motor control) and the upper (sequencing) level, present a system for instantiating this method to learn the cable routing task, and perform evaluations showing great performance in generalizing to very challenging clip placement variations. Supplementary videos, datasets, and code can be found at https://sites.google.com/view/cablerouting.

  • 8 authors
·
Jul 17, 2023

Non-Sequential Graph Script Induction via Multimedia Grounding

Online resources such as WikiHow compile a wide range of scripts for performing everyday tasks, which can assist models in learning to reason about procedures. However, the scripts are always presented in a linear manner, which does not reflect the flexibility displayed by people executing tasks in real life. For example, in the CrossTask Dataset, 64.5% of consecutive step pairs are also observed in the reverse order, suggesting their ordering is not fixed. In addition, each step has an average of 2.56 frequent next steps, demonstrating "branching". In this paper, we propose the new challenging task of non-sequential graph script induction, aiming to capture optional and interchangeable steps in procedural planning. To automate the induction of such graph scripts for given tasks, we propose to take advantage of loosely aligned videos of people performing the tasks. In particular, we design a multimodal framework to ground procedural videos to WikiHow textual steps and thus transform each video into an observed step path on the latent ground truth graph script. This key transformation enables us to train a script knowledge model capable of both generating explicit graph scripts for learnt tasks and predicting future steps given a partial step sequence. Our best model outperforms the strongest pure text/vision baselines by 17.52% absolute gains on F1@3 for next step prediction and 13.8% absolute gains on Acc@1 for partial sequence completion. Human evaluation shows our model outperforming the WikiHow linear baseline by 48.76% absolute gains in capturing sequential and non-sequential step relationships.

  • 7 authors
·
May 27, 2023

Zero-Shot Dual-Path Integration Framework for Open-Vocabulary 3D Instance Segmentation

Open-vocabulary 3D instance segmentation transcends traditional closed-vocabulary methods by enabling the identification of both previously seen and unseen objects in real-world scenarios. It leverages a dual-modality approach, utilizing both 3D point clouds and 2D multi-view images to generate class-agnostic object mask proposals. Previous efforts predominantly focused on enhancing 3D mask proposal models; consequently, the information that could come from 2D association to 3D was not fully exploited. This bias towards 3D data, while effective for familiar indoor objects, limits the system's adaptability to new and varied object types, where 2D models offer greater utility. Addressing this gap, we introduce Zero-Shot Dual-Path Integration Framework that equally values the contributions of both 3D and 2D modalities. Our framework comprises three components: 3D pathway, 2D pathway, and Dual-Path Integration. 3D pathway generates spatially accurate class-agnostic mask proposals of common indoor objects from 3D point cloud data using a pre-trained 3D model, while 2D pathway utilizes pre-trained open-vocabulary instance segmentation model to identify a diverse array of object proposals from multi-view RGB-D images. In Dual-Path Integration, our Conditional Integration process, which operates in two stages, filters and merges the proposals from both pathways adaptively. This process harmonizes output proposals to enhance segmentation capabilities. Our framework, utilizing pre-trained models in a zero-shot manner, is model-agnostic and demonstrates superior performance on both seen and unseen data, as evidenced by comprehensive evaluations on the ScanNet200 and qualitative results on ARKitScenes datasets.

  • 6 authors
·
Aug 16, 2024

PI-RADS v2 Compliant Automated Segmentation of Prostate Zones Using co-training Motivated Multi-task Dual-Path CNN

The detailed images produced by Magnetic Resonance Imaging (MRI) provide life-critical information for the diagnosis and treatment of prostate cancer. To provide standardized acquisition, interpretation and usage of the complex MRI images, the PI-RADS v2 guideline was proposed. An automated segmentation following the guideline facilitates consistent and precise lesion detection, staging and treatment. The guideline recommends a division of the prostate into four zones, PZ (peripheral zone), TZ (transition zone), DPU (distal prostatic urethra) and AFS (anterior fibromuscular stroma). Not every zone shares a boundary with the others and is present in every slice. Further, the representations captured by a single model might not suffice for all zones. This motivated us to design a dual-branch convolutional neural network (CNN), where each branch captures the representations of the connected zones separately. Further, the representations from different branches act complementary to each other at the second stage of training, where they are fine-tuned through an unsupervised loss. The loss penalises the difference in predictions from the two branches for the same class. We also incorporate multi-task learning in our framework to further improve the segmentation accuracy. The proposed approach improves the segmentation accuracy of the baseline (mean absolute symmetric distance) by 7.56%, 11.00%, 58.43% and 19.67% for PZ, TZ, DPU and AFS zones respectively.

  • 3 authors
·
Sep 22, 2023

AutoDiffusion: Training-Free Optimization of Time Steps and Architectures for Automated Diffusion Model Acceleration

Diffusion models are emerging expressive generative models, in which a large number of time steps (inference steps) are required for a single image generation. To accelerate such tedious process, reducing steps uniformly is considered as an undisputed principle of diffusion models. We consider that such a uniform assumption is not the optimal solution in practice; i.e., we can find different optimal time steps for different models. Therefore, we propose to search the optimal time steps sequence and compressed model architecture in a unified framework to achieve effective image generation for diffusion models without any further training. Specifically, we first design a unified search space that consists of all possible time steps and various architectures. Then, a two stage evolutionary algorithm is introduced to find the optimal solution in the designed search space. To further accelerate the search process, we employ FID score between generated and real samples to estimate the performance of the sampled examples. As a result, the proposed method is (i).training-free, obtaining the optimal time steps and model architecture without any training process; (ii). orthogonal to most advanced diffusion samplers and can be integrated to gain better sample quality. (iii). generalized, where the searched time steps and architectures can be directly applied on different diffusion models with the same guidance scale. Experimental results show that our method achieves excellent performance by using only a few time steps, e.g. 17.86 FID score on ImageNet 64 times 64 with only four steps, compared to 138.66 with DDIM. The code is available at https://github.com/lilijiangg/AutoDiffusion.

  • 10 authors
·
Sep 19, 2023

State-Change Learning for Prediction of Future Events in Endoscopic Videos

Surgical future prediction, driven by real-time AI analysis of surgical video, is critical for operating room safety and efficiency. It provides actionable insights into upcoming events, their timing, and risks-enabling better resource allocation, timely instrument readiness, and early warnings for complications (e.g., bleeding, bile duct injury). Despite this need, current surgical AI research focuses on understanding what is happening rather than predicting future events. Existing methods target specific tasks in isolation, lacking unified approaches that span both short-term (action triplets, events) and long-term horizons (remaining surgery duration, phase transitions). These methods rely on coarse-grained supervision while fine-grained surgical action triplets and steps remain underexplored. Furthermore, methods based only on future feature prediction struggle to generalize across different surgical contexts and procedures. We address these limits by reframing surgical future prediction as state-change learning. Rather than forecasting raw observations, our approach classifies state transitions between current and future timesteps. We introduce SurgFUTR, implementing this through a teacher-student architecture. Video clips are compressed into state representations via Sinkhorn-Knopp clustering; the teacher network learns from both current and future clips, while the student network predicts future states from current videos alone, guided by our Action Dynamics (ActDyn) module. We establish SFPBench with five prediction tasks spanning short-term (triplets, events) and long-term (remaining surgery duration, phase and step transitions) horizons. Experiments across four datasets and three procedures show consistent improvements. Cross-procedure transfer validates generalizability.

  • 4 authors
·
Oct 14

Recollection from Pensieve: Novel View Synthesis via Learning from Uncalibrated Videos

Currently almost all state-of-the-art novel view synthesis and reconstruction models rely on calibrated cameras or additional geometric priors for training. These prerequisites significantly limit their applicability to massive uncalibrated data. To alleviate this requirement and unlock the potential for self-supervised training on large-scale uncalibrated videos, we propose a novel two-stage strategy to train a view synthesis model from only raw video frames or multi-view images, without providing camera parameters or other priors. In the first stage, we learn to reconstruct the scene implicitly in a latent space without relying on any explicit 3D representation. Specifically, we predict per-frame latent camera and scene context features, and employ a view synthesis model as a proxy for explicit rendering. This pretraining stage substantially reduces the optimization complexity and encourages the network to learn the underlying 3D consistency in a self-supervised manner. The learned latent camera and implicit scene representation have a large gap compared with the real 3D world. To reduce this gap, we introduce the second stage training by explicitly predicting 3D Gaussian primitives. We additionally apply explicit Gaussian Splatting rendering loss and depth projection loss to align the learned latent representations with physically grounded 3D geometry. In this way, Stage 1 provides a strong initialization and Stage 2 enforces 3D consistency - the two stages are complementary and mutually beneficial. Extensive experiments demonstrate the effectiveness of our approach, achieving high-quality novel view synthesis and accurate camera pose estimation, compared to methods that employ supervision with calibration, pose, or depth information. The code is available at https://github.com/Dwawayu/Pensieve.

  • 3 authors
·
May 19

SG2VID: Scene Graphs Enable Fine-Grained Control for Video Synthesis

Surgical simulation plays a pivotal role in training novice surgeons, accelerating their learning curve and reducing intra-operative errors. However, conventional simulation tools fall short in providing the necessary photorealism and the variability of human anatomy. In response, current methods are shifting towards generative model-based simulators. Yet, these approaches primarily focus on using increasingly complex conditioning for precise synthesis while neglecting the fine-grained human control aspect. To address this gap, we introduce SG2VID, the first diffusion-based video model that leverages Scene Graphs for both precise video synthesis and fine-grained human control. We demonstrate SG2VID's capabilities across three public datasets featuring cataract and cholecystectomy surgery. While SG2VID outperforms previous methods both qualitatively and quantitatively, it also enables precise synthesis, providing accurate control over tool and anatomy's size and movement, entrance of new tools, as well as the overall scene layout. We qualitatively motivate how SG2VID can be used for generative augmentation and present an experiment demonstrating its ability to improve a downstream phase detection task when the training set is extended with our synthetic videos. Finally, to showcase SG2VID's ability to retain human control, we interact with the Scene Graphs to generate new video samples depicting major yet rare intra-operative irregularities.

  • 4 authors
·
Jun 3

Deep Multimodal Fusion for Surgical Feedback Classification

Quantification of real-time informal feedback delivered by an experienced surgeon to a trainee during surgery is important for skill improvements in surgical training. Such feedback in the live operating room is inherently multimodal, consisting of verbal conversations (e.g., questions and answers) as well as non-verbal elements (e.g., through visual cues like pointing to anatomic elements). In this work, we leverage a clinically-validated five-category classification of surgical feedback: "Anatomic", "Technical", "Procedural", "Praise" and "Visual Aid". We then develop a multi-label machine learning model to classify these five categories of surgical feedback from inputs of text, audio, and video modalities. The ultimate goal of our work is to help automate the annotation of real-time contextual surgical feedback at scale. Our automated classification of surgical feedback achieves AUCs ranging from 71.5 to 77.6 with the fusion improving performance by 3.1%. We also show that high-quality manual transcriptions of feedback audio from experts improve AUCs to between 76.5 and 96.2, which demonstrates a clear path toward future improvements. Empirically, we find that the Staged training strategy, with first pre-training each modality separately and then training them jointly, is more effective than training different modalities altogether. We also present intuitive findings on the importance of modalities for different feedback categories. This work offers an important first look at the feasibility of automated classification of real-world live surgical feedback based on text, audio, and video modalities.

  • 8 authors
·
Dec 5, 2023

SurgWound-Bench: A Benchmark for Surgical Wound Diagnosis

Surgical site infection (SSI) is one of the most common and costly healthcare-associated infections and and surgical wound care remains a significant clinical challenge in preventing SSIs and improving patient outcomes. While recent studies have explored the use of deep learning for preliminary surgical wound screening, progress has been hindered by concerns over data privacy and the high costs associated with expert annotation. Currently, no publicly available dataset or benchmark encompasses various types of surgical wounds, resulting in the absence of an open-source Surgical-Wound screening tool. To address this gap: (1) we present SurgWound, the first open-source dataset featuring a diverse array of surgical wound types. It contains 697 surgical wound images annotated by 3 professional surgeons with eight fine-grained clinical attributes. (2) Based on SurgWound, we introduce the first benchmark for surgical wound diagnosis, which includes visual question answering (VQA) and report generation tasks to comprehensively evaluate model performance. (3) Furthermore, we propose a three-stage learning framework, WoundQwen, for surgical wound diagnosis. In the first stage, we employ five independent MLLMs to accurately predict specific surgical wound characteristics. In the second stage, these predictions serve as additional knowledge inputs to two MLLMs responsible for diagnosing outcomes, which assess infection risk and guide subsequent interventions. In the third stage, we train a MLLM that integrates the diagnostic results from the previous two stages to produce a comprehensive report. This three-stage framework can analyze detailed surgical wound characteristics and provide subsequent instructions to patients based on surgical images, paving the way for personalized wound care, timely intervention, and improved patient outcomes.

  • 9 authors
·
Aug 20

A study of a deterministic model for meningitis epidemic

A compartmental deterministic model that allows (1) immunity from two stages of infection and carriage, and (2) disease induced death, is used in studying the dynamics of meningitis epidemic process in a closed population. It allows for difference in the transmission rate of infection to a susceptible by a carrier and an infective. It is generalized to allow a proportion ({\phi}) of those susceptibles infected to progress directly to infectives in stage I. Both models are used in this study. The threshold conditions for the spread of carrier and infectives in stage I are derived for the two models. Sensitivity analysis is performed on the reproductive number derived from the next generation matrix. The case-carrier ratio profile for various parameters and threshold values are shown. So also are the graphs of the total number ever infected as influenced by {\epsilon} and {\phi}. The infection transmission rate (eta), the odds in favor of a carrier, over an infective, in transmitting an infection to a susceptible ({\epsilon}) and the carrier conversion rate ({\phi}) to an infective in stage I, are identified as key parameters that should be subject of attention for any control intervention strategy. The case-carrier ratio profiles provide evidence of a critical case-carrier ratio attained before the number of reported cases grows to an epidemic level. They also provide visual evidence of epidemiological context, in this case, epidemic incidence (in later part of dry season) and endemic incidence (during rainy season). Results from total proportion ever infected suggest that the model, in which {\phi}=0 obtained, can adequately represent, in essence, the generalized model for this study.

  • 2 authors
·
Mar 31, 2023

Improving Prototypical Parts Abstraction for Case-Based Reasoning Explanations Designed for the Kidney Stone Type Recognition

The in-vivo identification of the kidney stone types during an ureteroscopy would be a major medical advance in urology, as it could reduce the time of the tedious renal calculi extraction process, while diminishing infection risks. Furthermore, such an automated procedure would make possible to prescribe anti-recurrence treatments immediately. Nowadays, only few experienced urologists are able to recognize the kidney stone types in the images of the videos displayed on a screen during the endoscopy. Thus, several deep learning (DL) models have recently been proposed to automatically recognize the kidney stone types using ureteroscopic images. However, these DL models are of black box nature whicl limits their applicability in clinical settings. This contribution proposes a case-based reasoning DL model which uses prototypical parts (PPs) and generates local and global descriptors. The PPs encode for each class (i.e., kidney stone type) visual feature information (hue, saturation, intensity and textures) similar to that used by biologists. The PPs are optimally generated due a new loss function used during the model training. Moreover, the local and global descriptors of PPs allow to explain the decisions ("what" information, "where in the images") in an understandable way for biologists and urologists. The proposed DL model has been tested on a database including images of the six most widespread kidney stone types. The overall average classification accuracy was 90.37. When comparing this results with that of the eight other DL models of the kidney stone state-of-the-art, it can be seen that the valuable gain in explanability was not reached at the expense of accuracy which was even slightly increased with respect to that (88.2) of the best method of the literature. These promising and interpretable results also encourage urologists to put their trust in AI-based solutions.

  • 8 authors
·
Sep 19, 2024

Model-free Approach to Evaluate a Censored Intermediate Outcome as a Surrogate for Overall Survival

Clinical trials or studies oftentimes require long-term and/or costly follow-up of participants to evaluate a novel treatment/drug/vaccine. There has been increasing interest in the past few decades in using short-term surrogate outcomes as a replacement of the primary outcome i.e., in using the surrogate outcome, which can potentially be observed sooner, to make inference about the treatment effect on the long-term primary outcome. Very few of the available statistical methods to evaluate a surrogate are applicable to settings where both the surrogate and the primary outcome are time-to-event outcomes subject to censoring. Methods that can handle this setting tend to require parametric assumptions or be limited to assessing only the restricted mean survival time. In this paper, we propose a non-parametric approach to evaluate a censored surrogate outcome, such as time to progression, when the primary outcome is also a censored time-to-event outcome, such as time to death, and the treatment effect of interest is the difference in overall survival. Specifically, we define the proportion of the treatment effect on the primary outcome that is explained (PTE) by the censored surrogate outcome in this context, and estimate this proportion by defining and deriving an optimal transformation of the surrogate information. Our approach provides the added advantage of relaxed assumptions to guarantee that the true PTE is within (0,1), along with being model-free. Finite sample performance of our estimators are illustrated via extensive simulation studies and a real data application examining progression-free survival as a surrogate for overall survival for patients with metastatic colorectal cancer.

  • 4 authors
·
Dec 18, 2024