Predictive Classification System for Low Back Pain Based on Unsupervised Clustering.

STUDY DESIGN: Retrospective study. OBJECTIVE: Lumbar magnetic resonance imaging (MRI) findings are believed to be associated with low back pain (LBP). This study sought to develop a new predictive classification system for low back pain. METHOD: Normal subjects with repeated lumbar MRI scans were retrospectively enrolled. A new classification system, based on the radiological features on MRI, was developed using an unsupervised clustering method. RESULTS: One hundred and fifty-nine subjects were included. Three distinguishable clusters were identified with unsupervised clustering that were significantly correlated with LBP (P = .017). The incidence of LBP was highest in cluster 3 (57.14%), nearly twice the incidence in cluster 1 (30.11%). There were obvious differences in the sagittal parameters among the 3 clusters. Cluster 3 had the smallest intervertebral height. Based on follow-up findings, 27% of subjects changed clusters. More subjects changed from cluster 1 to clusters 2 or 3 (14.5%) than changed from cluster 2 or cluster 3 to cluster 1 (5%). Participation in sport was more frequent in subjects who changed from cluster 3 to cluster 1. CONCLUSION: Using an unsupervised clustering method, we developed a new classification system comprising 3 clusters, which were significantly correlated with LBP. The prediction of LBP is independent of age and better than that based on individual sagittal parameters derived from MRI. A change in cluster during follow-up may partially predict lumbar degeneration. This study provides a new system for the prediction of LBP that should be useful for its diagnosis and treatment.

Deep learning for digitizing highly noisy paper-based ECG records.

Electrocardiography (ECG) is essential in many heart diseases. However, some ECGs are recorded by paper, which can be highly noisy. Digitizing the paper-based ECG records into a high-quality signal is critical for further analysis. We formulated the digitization problem as a segmentation problem and proposed a deep learning method to digitize highly noisy ECG scans. Our method extracts the ECG signal in an end-to-end manner and can handle different paper record layouts. In the experiment, our model clearly extracted the ECG waveform with a Dice coefficient of 0.85 and accurately measured the common ECG parameters with more than 0.90 Pearson's correlation. We showed that the end-to-end approach with deep learning can be powerful in ECG digitization. To the best of our knowledge, we provide the first approach to digitize the least informative noisy binary ECG scans and potentially be generalized to digitize various ECG records.