In-Sensor Artificial Intelligence and Fusion With Electronic Medical Records for At-Home Monitoring.

This work presents an artificial intelligence (AI) framework for real-time, personalized sepsis prediction four hours before onset through fusion of electrocardiogram (ECG) and patient electronic medical record. An on-chip classifier combines analog reservoir-computer and artificial neural network to perform prediction without front-end data converter or feature extraction which reduces energy by 13× compared to digital baseline at normalized power efficiency of 528 TOPS/W, and reduces energy by 159× compared to RF transmission of all digitized ECG samples. The proposed AI framework predicts sepsis onset with 89.9% and 92.9% accuracy on patient data from Emory University Hospital and MIMIC-III respectively. The proposed framework is non-invasive and does not require lab tests which makes it suitable for at-home monitoring.

Multi-modal fusion model for predicting adverse cardiovascular outcome post percutaneous coronary intervention.

Background.Clinical medicine relies heavily on the synthesis of information and data from multiple sources. However, often simple feature concatenation is used as a strategy for developing a multimodal machine learning model in the cardiovascular domain, and thus the models are often limited by pre-selected features and moderate accuracy.Method.We proposed a two-branched joint fusion model for fusing the 12-lead electrocardiogram (ECG) signal data with clinical variables from the electronic medical record (EMR) in an end-to-end deep learning architecture. The model follows the joint fusion scheme and learns complementary information from ECG and EMR. Retrospective data from the Mayo Clinic Health Systems across four sites for patients that underwent percutaneous coronary intervention (PCI) were obtained. Model performance was assessed by area under the receiver-operating characteristics (AUROC) and Delong's test.Results.The final cohort included 17,356 unique patients with a mean age of 67.2 ± 12.6 year (mean ± std) and 9,163 (52.7%) were male. The joint fusion model outperformed the ECG time-domain model with statistical margin. The model with clinical data obtained the highest AUROC for all-cause mortality (0.91 at 6 months) but the joint fusion model outperformed for cardiovascular outcomes - heart failure hospitalization and ischemic stroke with a significant margin (Delong's p < 0.05).Conclusion.To the best of our knowledge, this is the first study that developed a deep learning model with joint fusion architecture for the prediction of post-PCI prognosis and outperformed machine learning models developed using traditional single-source features (clinical variables or ECG features). Adding ECG data with clinical variables did not improve prediction of all-cause mortality as may be expected, but the improved performance of related cardiac outcomes shows that the fusion of ECG generates additional value.

In-sensor neural network for high energy efficiency analog-to-information conversion.

This work presents an on-chip analog-to-information conversion technique that utilizes analog hyper-dimensional computing based on reservoir-computing paradigm to process electrocardiograph (ECG) signals locally in-sensor and reduce radio frequency transmission by more than three orders-of-magnitude. Instead of transmitting the naturally sparse ECG signal or extracted features, the on-chip analog-to-information converter analyzes the ECG signal through a nonlinear reservoir kernel followed by an artificial neural network, and transmits the prediction results. The proposed technique is demonstrated for detection of sepsis onset and achieves state-of-the-art accuracy and energy efficiency while reducing sensor power by [Formula: see text] with test-chips prototyped in 65 nm CMOS.

Fusion of fully integrated analog machine learning classifier with electronic medical records for real-time prediction of sepsis onset.

The objective of this work is to develop a fusion artificial intelligence (AI) model that combines patient electronic medical record (EMR) and physiological sensor data to accurately predict early risk of sepsis. The fusion AI model has two components-an on-chip AI model that continuously analyzes patient electrocardiogram (ECG) data and a cloud AI model that combines EMR and prediction scores from on-chip AI model to predict fusion sepsis onset score. The on-chip AI model is designed using analog circuits for sepsis prediction with high energy efficiency for integration with resource constrained wearable device. Combination of EMR and sensor physiological data improves prediction performance compared to EMR or physiological data alone, and the late fusion model has an accuracy of 93% in predicting sepsis 4 h before onset. The key differentiation of this work over existing sepsis prediction literature is the use of single modality patient vital (ECG) and simple demographic information, instead of comprehensive laboratory test results and multiple vital signs. Such simple configuration and high accuracy makes our solution favorable for real-time, at-home use for self-monitoring.