RESUMEN
Can one learn to diagnose COVID-19 under extreme minimal supervision? Since the outbreak of the novel COVID-19 there has been a rush for developing automatic techniques for expert-level disease identification on Chest X-ray data. In particular, the use of deep supervised learning has become the go-to paradigm. However, the performance of such models is heavily dependent on the availability of a large and representative labelled dataset. The creation of which is a heavily expensive and time consuming task, and especially imposes a great challenge for a novel disease. Semi-supervised learning has shown the ability to match the incredible performance of supervised models whilst requiring a small fraction of the labelled examples. This makes the semi supervised paradigm an attractive option for identifying COVID-19. In this work, we introduce a graph based deep semi-supervised framework for classifying COVID-19 from chest X-rays. Our framework introduces an optimisation model for graph diffusion that reinforces the natural relation among the tiny labelled set and the vast unlabelled data. We then connect the diffusion prediction output as pseudo-labels that are used in an iterative scheme in a deep net. We demonstrate, through our experiments, that our model is able to outperform the current leading supervised model with a tiny fraction of the labelled examples. Finally, we provide attention maps to accommodate the radiologist's mental model, better fitting their perceptual and cognitive abilities. These visualisation aims to assist the radiologist in judging whether the diagnostic is correct or not, and in consequence to accelerate the decision.
RESUMEN
Common lung diseases are first diagnosed using chest X-rays. Here, we show that a fully automated deep-learning pipeline for the standardization of chest X-ray images, for the visualization of lesions and for disease diagnosis can identify viral pneumonia caused by coronavirus disease 2019 (COVID-19) and assess its severity, and can also discriminate between viral pneumonia caused by COVID-19 and other types of pneumonia. The deep-learning system was developed using a heterogeneous multicentre dataset of 145,202 images, and tested retrospectively and prospectively with thousands of additional images across four patient cohorts and multiple countries. The system generalized across settings, discriminating between viral pneumonia, other types of pneumonia and the absence of disease with areas under the receiver operating characteristic curve (AUCs) of 0.94-0.98; between severe and non-severe COVID-19 with an AUC of 0.87; and between COVID-19 pneumonia and other viral or non-viral pneumonia with AUCs of 0.87-0.97. In an independent set of 440 chest X-rays, the system performed comparably to senior radiologists and improved the performance of junior radiologists. Automated deep-learning systems for the assessment of pneumonia could facilitate early intervention and provide support for clinical decision-making.