OBJECTIVES: Traditional methods for medical device post-market surveillance often fail to accurately account for operator learning effects, leading to biased assessments of device safety. These methods struggle with non-linearity, complex learning curves, and time-varying covariates, such as physician experience. To address these limitations, we sought to develop a machine learning (ML) framework to detect and adjust for operator learning effects. MATERIALS AND METHODS: A gradient-boosted decision tree ML method was used to analyze synthetic datasets that replicate the complexity of clinical scenarios involving high-risk medical devices. We designed this process to detect learning effects using a risk-adjusted cumulative sum method, quantify the excess adverse event rate attributable to operator inexperience, and adjust for these alongside patient factors in evaluating device safety signals. To maintain integrity, we employed blinding between data generation and analysis teams. Synthetic data used underlying distributions and patient feature correlations based on clinical data from the Department of Veterans Affairs between 2005 and 2012. We generated 2494 synthetic datasets with widely varying characteristics including number of patient features, operators and institutions, and the operator learning form. Each dataset contained a hypothetical study device, Device B, and a reference device, Device A. We evaluated accuracy in identifying learning effects and identifying and estimating the strength of the device safety signal. Our approach also evaluated different clinically relevant thresholds for safety signal detection. RESULTS: Our framework accurately identified the presence or absence of learning effects in 93.6% of datasets and correctly determined device safety signals in 93.4% of cases. The estimated device odds ratios' 95% confidence intervals were accurately aligned with the specified ratios in 94.7% of datasets. In contrast, a comparative model excluding operator learning effects significantly underperformed in detecting device signals and in accuracy. Notably, our framework achieved 100% specificity for clinically relevant safety signal thresholds, although sensitivity varied with the threshold applied. DISCUSSION: A machine learning framework, tailored for the complexities of post-market device evaluation, may provide superior performance compared to standard parametric techniques when operator learning is present. CONCLUSION: Demonstrating the capacity of ML to overcome complex evaluative challenges, our framework addresses the limitations of traditional statistical methods in current post-market surveillance processes. By offering a reliable means to detect and adjust for learning effects, it may significantly improve medical device safety evaluation.

We develop information geometric techniques to understand the representations learned by deep networks when they are trained on different tasks using supervised, meta-, semi-supervised and contrastive learning. We shed light on the following phenomena that relate to the structure of the space of tasks: (1) the manifold of probabilistic models trained on different tasks using different representation learning methods is effectively low-dimensional; (2) supervised learning on one task results in a surprising amount of progress even on seemingly dissimilar tasks; progress on other tasks is larger if the training task has diverse classes; (3) the structure of the space of tasks indicated by our analysis is consistent with parts of the Wordnet phylogenetic tree; (4) episodic meta-learning algorithms and supervised learning traverse different trajectories during training but they fit similar models eventually; (5) contrastive and semi-supervised learning methods traverse trajectories similar to those of supervised learning. We use classification tasks constructed from the CIFAR-10 and Imagenet datasets to study these phenomena. Code is available at https://github.com/grasp-lyrl/picture_of_space_of_tasks.

We show that the input correlation matrix of typical classification datasets has an eigenspectrum where, after a sharp initial drop, a large number of small eigenvalues are distributed uniformly over an exponentially large range. This structure is mirrored in a network trained on this data: we show that the Hessian and the Fisher Information Matrix (FIM) have eigenvalues that are spread uniformly over exponentially large ranges. We call such eigenspectra “sloppy” because sets of weights corresponding to small eigenvalues can be changed by large magnitudes without affecting the loss. Networks trained on atypical datasets with non-sloppy inputs do not share these traits and deep networks trained on such datasets generalize poorly. Inspired by this, we study the hypothesis that sloppiness of inputs aids generalization in deep networks. We show that if the Hessian is sloppy, we can compute non-vacuous PAC-Bayes generalization bounds analytically. By exploiting our empirical observation that training predominantly takes place in the non-sloppy subspace of the FIM, we develop data-distribution dependent PAC-Bayes priors that lead to accurate generalization bounds using numerical optimization.

Large convolutional neural networks (CNN) can be difficult to train in the differentially private (DP) regime, since the optimization algorithms require a computationally expensive operation, known as the per-sample gradient clipping. We propose an efficient and scalable implementation of this clipping on convolutional layers, termed as the mixed ghost clipping, that significantly eases the private training in terms of both time and space complexities, without affecting the accuracy. The improvement in efficiency is rigorously studied through the first complexity analysis for the mixed ghost clipping and existing DP training algorithms.Extensive experiments on vision classification tasks, with large ResNet, VGG, and Vision Transformers (ViT), demonstrate that DP training with mixed ghost clipping adds $1\sim 10\%$ memory overhead and $<2\times$ slowdown to the standard non-private training. Specifically, when training VGG19 on CIFAR10, the mixed ghost clipping is $3\times$ faster than state-of-the-art Opacus library with $18\times$ larger maximum batch size. To emphasize the significance of efficient DP training on convolutional layers, we achieve 96.7\% accuracy on CIFAR10 and 83.0\% on CIFAR100 at $\epsilon=1$ using BEiT, while the previous best results are 94.8\% and 67.4\%, respectively. We open-source a privacy engine (\url{https://github.com/woodyx218/private_vision}) that implements DP training of CNN (including convolutional ViT) with a few lines of code.

We study the problem of multiset prediction. The goal of multiset prediction is to train a predictor that maps an input to a multiset consisting of multiple items. Unlike existing problems in supervised learning, such as classification, ranking and sequence generation, there is no known order among items in a target multiset, and each item in the multiset may appear more than once, making this problem extremely challenging. In this paper, we propose a novel multiset loss function by viewing this problem from the perspective of sequential decision making. The proposed multiset loss function is empirically evaluated on two families of datasets, one synthetic and the other real, with varying levels of difficulty, against various baseline loss functions including reinforcement learning, sequence, and aggregated distribution matching loss functions. The experiments reveal the effectiveness of the proposed loss function over the others.

Humans process visual scenes selectively and sequentially using attention. Central to models of human visual attention is the saliency map. We propose a hierarchical visual architecture that operates on a saliency map and uses a novel attention mechanism to sequentially focus on salient regions and take additional glimpses within those regions. The architecture is motivated by human visual attention, and is used for multi-label image classification on a novel multiset task, demonstrating that it achieves high precision and recall while localizing objects with its attention. Unlike conventional multi-label image classification models, the model supports multiset prediction due to a reinforcement-learning based training process that allows for arbitrary label permutation and multiple instances per label.