An innovative artificial intelligence-based method to compress complex models into explainable, model-agnostic and reduced decision support systems with application to healthcare (NEAR).

BACKGROUND AND OBJECTIVE: In everyday clinical practice, medical decision is currently based on clinical guidelines which are often static and rigid, and do not account for population variability, while individualized, patient-oriented decision and/or treatment are the paradigm change necessary to enter into the era of precision medicine. Most of the limitations of a guideline-based system could be overcome through the adoption of Clinical Decision Support Systems (CDSSs) based on Artificial Intelligence (AI) algorithms. However, the black-box nature of AI algorithms has hampered a large adoption of AI-based CDSSs in clinical practice. In this study, an innovative AI-based method to compress AI-based prediction models into explainable, model-agnostic, and reduced decision support systems (NEAR) with application to healthcare is presented and validated. METHODS: NEAR is based on the Shapley Additive Explanations framework and can be applied to complex input models to obtain the contributions of each input feature to the output. Technically, the simplified NEAR models approximate contributions from input features using a custom library and merge them to determine the final output. Finally, NEAR estimates the confidence error associated with the single input feature contributing to the final score, making the result more interpretable. Here, NEAR is evaluated on a clinical real-world use case, the mortality prediction in patients who experienced Acute Coronary Syndrome (ACS), applying three different Machine Learning/Deep Learning models as implementation examples. RESULTS: NEAR, when applied to the ACS use case, exhibits performances like the ones of the AI-based model from which it is derived, as in the case of the Adaptive Boosting classifier, whose Area Under the Curve is not statistically different from the NEAR one, even the model's simplification. Moreover, NEAR comes with intrinsic explainability and modularity, as it can be tested on the developed web application platform (https://neardashboard.pythonanywhere.com/). CONCLUSIONS: An explainable and reliable CDSS tailored to single-patient analysis has been developed. The proposed AI-based system has the potential to be used alongside the clinical guidelines currently employed in the medical setting making them more personalized and dynamic and assisting doctors in taking their everyday clinical decisions.

Streaming MASSIF: Cascading Reasoning for Efficient Processing of IoT Data Streams.

In the Internet of Things (IoT), multiple sensors and devices are generating heterogeneous streams of data. To perform meaningful analysis over multiple of these streams, stream processing needs to support expressive reasoning capabilities to infer implicit facts and temporal reasoning to capture temporal dependencies. However, current approaches cannot perform the required reasoning expressivity while detecting time dependencies over high frequency data streams. There is still a mismatch between the complexity of processing and the rate data is produced in volatile domains. Therefore, we introduce Streaming MASSIF, a Cascading Reasoning approach performing expressive reasoning and complex event processing over high velocity streams. Cascading Reasoning is a vision that solves the problem of expressive reasoning over high frequency streams by introducing a hierarchical approach consisting of multiple layers. Each layer minimizes the processed data and increases the complexity of the data processing. Cascading Reasoning is a vision that has not been fully realized. Streaming MASSIF is a layered approach allowing IoT service to subscribe to high-level and temporal dependent concepts in volatile data streams. We show that Streaming MASSIF is able to handle high velocity streams up to hundreds of events per second, in combination with expressive reasoning and complex event processing. Streaming MASSIF realizes the Cascading Reasoning vision and is able to combine high expressive reasoning with high throughput of processing. Furthermore, we formalize semantically how the different layers in our Cascading Reasoning Approach collaborate.

Enabling the European Patient Summary through triplespaces.

One of the main items on the eHealth agenda of the European Community is the design and promotion of electronic patient summaries as an instrument to guarantee the continuity of healthcare across national boundaries and to facilitate the pervasive delivery of healthcare, thus ensuring the right to patient mobility and increasing the productivity and quality of health service delivery. From a technical point of view, this objective requires middleware technology which is able to cope with the stringent interoperability, multi-lingualism, distribution, and privacy requirements arising in eHealth settings. This paper presents triplespace computing, a coordination middleware for the Semantic Web,and demonstrates its relevance to the realization of the European Patient Summary, an infrastructure for sharing and coordinating access to patient summaries at the European level.