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Multimodal Deep Learning for Integrating Chest Radiographs and Clinical Parameters: A Case for Transformers
Firas Khader1, Gustav Müller-Franzes1, Tianci Wang1
1From the Department of Diagnostic and Interventional Radiology (F.K., G.M.F., T.W., S.T.A., C.K., S.N., D.T.) and Department of Medicine III (J.N.K.), University Hospital Aachen, Pauwelsstraße 30, 52074 Aachen, Germany; Physics of Molecular Imaging Systems, Institute of Experimental Molecular Imaging (T.H.), and Institute of Imaging and Computer Vision (J.S.), RWTH Aachen University, Aachen, Germany; Ocumeda, Munich, Germany (C.H.); Department of Diagnostic and Interventional Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany (K.B.); Else Kroener Fresenius Center for Digital Health, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany (J.N.K.); Division of Pathology and Data Analytics, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK (J.N.K.); and Department of Medical Oncology, National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany (J.N.K.).
A new neural network integrating imaging and nonimaging patient data significantly improved disease diagnosis in intensive care units (ICUs). This multimodal approach outperformed single-data models for identifying various pathologic conditions.
Area of Science:
- Artificial Intelligence in Medicine
- Multimodal Deep Learning
- Clinical Decision Support Systems
Background:
- Current machine learning diagnostic tools often rely on single data types, limiting comprehensive patient assessment.
- Integrating diverse patient data, including imaging and nonimaging information, is crucial for accurate clinical diagnosis.
Purpose of the Study:
- To develop and evaluate a novel transformer-based neural network architecture for multimodal data integration.
- To compare the diagnostic performance of this multimodal model against single-modality models for up to 25 conditions.
Main Methods:
- Retrospective analysis of chest radiographs and clinical data from MIMIC and internal ICU databases (2008-2020).
- Training a transformer-based neural network on nonimaging data, imaging data, or both.
- Performance assessment using area under the receiver operating characteristic curve (AUC).
Main Results:
- The multimodal model demonstrated superior diagnostic performance across all evaluated pathologic conditions.
- For the MIMIC dataset, mean AUC was 0.77 (multimodal) vs. 0.70 (imaging only) and 0.72 (nonimaging only).
- Similar improvements were observed in the internal dataset, confirming the multimodal model's efficacy.
Conclusions:
- A neural network integrating both imaging and nonimaging data significantly enhances disease diagnosis accuracy in ICU patients.
- Multimodal data fusion offers a more robust approach for diagnosing multiple conditions compared to single-modality models.
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