Neural networks are frequently used in medical diagnosis. However, due to their black-box nature, model explainers are used to help clinicians understand better and trust model outputs. This paper introduces an explainer method for classifying Retinopathy of Prematurity (ROP) from fundus images. Previous methods fail to generate explanations that preserve input image structures such as smoothness and sparsity. We introduce Sparse and Smooth Explainer (SSplain), a method that generates pixel-wise explanations while preserving image structures by enforcing smoothness and sparsity. This results in realistic explanations to enhance the understanding of the given black-box model. To achieve this goal, we define an optimization problem with combinatorial constraints and solve it using the Alternating Direction Method of Multipliers (ADMM). Experimental results show that SSplain outperforms commonly used explainers in terms of both post-hoc accuracy and smoothness analyses. Additionally, SSplain identifies features that are consistent with domain-understandable features that clinicians consider as discriminative factors for ROP. We also show SSplain’s generalization by applying it to additional publicly available datasets. Code is available at https://github.com/neu-spiral/SSplain.

We introduce a new concept of panoramic retinal (panretinal) optical coherence tomography (OCT) imaging system with a 140° field of view (FOV). To achieve this unprecedented FOV, a contact imaging approach was used which enabled faster, more efficient, and quantitative retinal imaging with measurement of axial eye length. The utilization of the handheld panretinal OCT imaging system could allow earlier recognition of peripheral retinal disease and prevent permanent vision loss. In addition, adequate visualization of the peripheral retina has a great potential for better understanding disease mechanisms regarding the periphery. To the best of our knowledge, the panretinal OCT imaging system presented in this manuscript has the widest FOV among all the retina OCT imaging systems and offers significant values in both clinical ophthalmology and basic vision science.

Accurate disease diagnosis requires objective assessment of clinical image quality. Automated image quality assessment (IQA) could enhance screening and diagnosis workflows. However, development of generalizable quality assessment tools requires large labeled clinical image datasets from different sites. Obtaining these datasets is often infeasible; and quality indicators may vary with acquisition settings due to domain shift. We introduce a minimally-supervised image quality assessment (MIQA) approach that can learn effectively with small datasets and limited labels in class-imbalanced domain shift scenarios. We formulate the IQA task as an anomaly detection problem, and use a small number of target domain images to identify a compact subset of source domain data for better representation of acceptable quality features. For this compact source domain dataset, we extract features with a pre-trained CNN, perform adaptive feature selection, and develop a one-class classifier to detect poor quality images. We evaluate our approach on two ophthalmology datasets, and show substantial AUC gains and improved cross-site generalizability over competitive baselines. Our approach has implications for improved image quality audit in many clinical settings.

We study the problem of ranking regression, in which a dataset of rankings is used to learn Plackett–Luce scores as functions of sample features. We propose a novel spectral algorithm to accelerate learning in ranking regression. Our main technical contribution is to show that the Plackett–Luce negative log-likelihood augmented with a proximal penalty has stationary points that satisfy the balance equations of a Markov Chain. This allows us to tackle the ranking regression problem via an efficient spectral algorithm by using the Alternating Directions Method of Multipliers (ADMM). ADMM separates the learning of scores and model parameters, and in turn, enables us to devise fast spectral algorithms for ranking regression via both shallow and deep neural network (DNN) models. For shallow models, our algorithms are up to 579 times faster than the Newton’s method. For DNN models, we extend the standard ADMM via a Kullback–Leibler proximal penalty and show that this is still amenable to fast inference via a spectral approach. Compared to a state-of-the-art siamese network, our resulting algorithms are up to 175 times faster and attain better predictions by up to 26% Top-1 Accuracy and 6% Kendall-Tau correlation over five real-life ranking datasets.

Learning from ranking observations arises in many domains, and siamese deep neural networks have shown excellent inference performance in this setting. However, SGD does not scale well, as an epoch grows exponentially with the ranking observation size. We show that a spectral algorithm can be combined with deep learning methods to significantly accelerate training. We combine a spectral estimate of Plackett-Luce ranking scores with a deep model via the Alternating Directions Method of Multipliers with a Kullback-Leibler proximal penalty. Compared to a state-of-the-art siamese network, our algorithms are up to 175 times faster and attain better predictions by up to 26% Top-1 Accuracy and 6% Kendall-Tau correlation over five real-life ranking datasets.

We consider a ranking regression problem in which we use a dataset of ranked choices to learn Plackett-Luce scores as functions of sample features. We solve the maximum likelihood estimation problem by using the Alternating Directions Method of Multipliers (ADMM), effectively separating the learning of scores and model parameters. This separation allows us to express scores as the stationary distribution of a continuous-time Markov Chain. Using this equivalence, we propose two spectral algorithms for ranking regression that learn model parameters up to 579 times faster than the Newton’s method.

In many supervised learning settings, elicited labels comprise pairwise comparisons or rankings of samples. We propose a Bayesian inference model for ranking datasets, allowing us to take a probabilistic approach to ranking inference. Our probabilistic assumptions are motivated by, and consistent with, the so-called Plackett-Luce model. We propose a variational inference method to extract a closed-form Gaussian posterior distribution. We show experimentally that the resulting posterior yields more reliable ranking predictions compared to predictions via point estimates.

Retinopathy of Prematurity (ROP) is a leading cause for childhood blindness worldwide. An automated ROP detection system could significantly improve the chance of a child receiving proper diagnosis and treatment. We propose a means of producing a continuous severity score in an automated fashion, regressed from both (a) diagnostic class labels as well as (b) comparison outcomes. Our generative model combines the two sources, and successfully addresses inherent variability in diagnostic outcomes. In particular, our method exhibits an excellent predictive performance of both diagnostic and comparison outcomes over a broad array of metrics, including AUC, precision, and recall.

Pairwise comparison labels are more informative and less variable than class labels, but generating them poses a challenge: their number grows quadratically in the dataset size. We study a natural experimental design objective, namely, D-optimality, that can be used to identify which K pairwise comparisons to generate. This objective is known to perform well in practice, and is submodular, making the selection approximable via the greedy algorithm. A naïve greedy implementation has O(N2 d2 K) complexity, where N is the dataset size, d is the feature space dimension, and K is the number of generated comparisons. We show that, by exploiting the inherent geometry of the dataset–namely, that it consists of pairwise comparisons–the greedy algorithm's complexity can be reduced to O(N2 (K + d) + N(dK + d2) + d2 K). We apply the same acceleration also to the so-called lazy greedy algorithm. When combined, the above improvements lead to an execution time of less than 1 hour for a dataset with 108 comparisons; the naïve greedy algorithm on the same dataset would require more than 10 days to terminate.

Labels generated by human experts via comparisons exhibit smaller variance compared to traditional sample labels. Collecting comparison labels is challenging over large datasets, as the number of comparisons grows quadratically with the dataset size. We study the following experimental design problem: given a budget of expert comparisons, and a set of existing sample labels, we determine the comparison labels to collect that lead to the highest classification improvement. We study several experimental design objectives motivated by the Bradley-Terry model. The resulting optimization problems amount to maximizing submodular functions. We experimentally evaluate the performance of these methods over synthetic and real-life datasets.