搜索结果：Handbook of clinical neurology

Medical imaging technologies have undergone extensive development, enabling non-invasive visualization of clinical information. The traditional review of medical images by clinicians remains subjective, time-consuming, and prone to human error. With the recent availability of medical imaging data, quantification have become important goals in the field. Radiomics, a methodology aimed at extracting quantitative information from imaging data, has emerged as a promising approach to uncover hidden biological information and support decision-making in clinical practice. This paper presents a review of the radiomic pipeline from the clinical neuroimaging perspective, providing a detailed overview of each step with practical advice. It discusses the application of handcrafted and deep radiomics in neuroimaging, stratified by neurological diagnosis. Although radiomics shows great potential for increasing diagnostic precision and improving treatment quality in neurology, several limitations hinder its clinical implementation. Addressing these challenges requires collaborative efforts, advancements in image harmonization methods, and the establishment of reproducible and standardized pipelin

Current clinical artificial intelligence (AI) systems are evaluated almost exclusively on clean, standardised, English-language inputs, conditions that do not reflect the realities of healthcare delivery in low-resource settings. This study presents the first systematic dual audit of two orthogonal safety vulnerabilities in clinical AI: adversarial image fragility and cross-lingual diagnostic drift. Using DenseNet121, the architecture underlying CheXNet, fine-tuned on the COVID-QU-Ex chest X-ray dataset (85,318 images; COVID-19, Non-COVID Pneumonia, Normal), we demonstrate that diagnostic accuracy collapses from 89.3% to 62.0% under a Fast Gradient Method (FGM) perturbation of epsilon=0.021, a magnitude imperceptible to the human eye. Standard defensive strategies including Gaussian smoothing and ensemble voting failed to restore clinical safety. In a parallel language fragility experiment, we tested Llama3.1:8b and NatLAS (N-ATLAS) on 20 COVID-19 clinical cases presented in Standard English, Nigerian Pidgin (Naija), and Yoruba-inflected English. Both models exhibited significant accuracy degradation: Llama3.1:8b dropped from 80.0% to 65.0% on Pidgin; NatLAS, an African-context mod

We introduce SoftTiger, a clinical large language model (CLaM) designed as a foundation model for healthcare workflows. The narrative and unstructured nature of clinical notes is a major obstacle for healthcare intelligentization. We address a critical problem of structuring clinical notes into clinical data, according to international interoperability standards. We collect and annotate data for three subtasks, namely, international patient summary, clinical impression and medical encounter. We then supervised fine-tuned a state-of-the-art LLM using public and credentialed clinical data. The training is orchestrated in a way that the target model can first support basic clinical tasks such as abbreviation expansion and temporal information extraction, and then learn to perform more complex downstream clinical tasks. Moreover, we address several modeling challenges in the healthcare context, e.g., extra long context window. Our blind pairwise evaluation shows that SoftTiger outperforms other popular open-source models and GPT-3.5, comparable to Gemini-pro, with a mild gap from GPT-4. We believe that LLMs may become a step-stone towards healthcare digitalization and democratization.

Barcode scans, clear phone calls, reliable data storage, satellite communication, and large-scale quantum computation are all made possible by error correction. We present a handbook version of The Error Correction Zoo, a curated reference of methods for protecting classical or quantum information from errors during storage and transmission. The handbook includes descriptions of these error-correcting codes and a classification according to the symbols they use. It also catalogues relations among codes and related objects such as sphere packings, lattices, designs, groups, and classical and quantum phases of matter. The collection is intended both as a rigorous reference and as a practical aid for tracing the web of code relationships and uncovering new connections.

This volume contains revised versions of the papers selected for the fourth volume of the Online Handbook of Argumentation for AI (OHAAI). Previously, formal theories of argument and argument interaction have been proposed and studied, and this has led to the more recent study of computational models of argument. Argumentation, as a field within artificial intelligence (AI), is highly relevant for researchers interested in symbolic representations of knowledge and defeasible reasoning. The purpose of this handbook is to provide an open access and curated anthology for the argumentation research community. OHAAI is designed to serve as a research hub to keep track of the latest and upcoming PhD-driven research on the theory and application of argumentation in all areas related to AI.

The competency of any intelligent agent is bounded by its formal account of the world in which it operates. Clinical AI lacks such an account. Existing frameworks address evaluation, regulation, or system design in isolation, without a shared model of the clinical world to connect them. We introduce the Clinical World Model, a framework that formalizes care as a tripartite interaction among Patient, Provider, and Ecosystem. To formalize how any agent, whether human or artificial, transforms information into clinical action, we develop parallel decision-making architectures for providers, patients, and AI agents, grounded in validated principles of clinical cognition. The Clinical AI Skill-Mix operationalizes competency through eight dimensions. Five define the clinical competency space (condition, phase, care setting, provider role, and task) and three specify how AI engages human reasoning (assigned authority, agent facing, and anchoring layer). The combinatorial product of these dimensions yields a space of billions of distinct competency coordinates. A central structural implication is that validation within one coordinate provides minimal evidence for performance in another, re

Clinical decision-making relies on the integrated analysis of medical images and the associated clinical reports. While Vision-Language Models (VLMs) can offer a unified framework for such tasks, they can exhibit strong biases toward one modality, frequently overlooking critical visual cues in favor of textual information. In this work, we introduce Selective Modality Shifting (SMS), a perturbation-based approach to quantify a model's reliance on each modality in binary classification tasks. By systematically swapping images or text between samples with opposing labels, we expose modality-specific biases. We assess six open-source VLMs-four generalist models and two fine-tuned for medical data-on two medical imaging datasets with distinct modalities: MIMIC-CXR (chest X-ray) and FairVLMed (scanning laser ophthalmoscopy). By assessing model performance and the calibration of every model in both unperturbed and perturbed settings, we reveal a marked dependency on text input, which persists despite the presence of complementary visual information. We also perform a qualitative attention-based analysis which further confirms that image content is often overshadowed by text details. Our

Bioinformatics platforms have significantly changed clinical diagnostics by facilitating the analysis of genomic data, thereby advancing personalized medicine and improving patient care. This study examines the integration, usage patterns, challenges, and impact of the Galaxy platform within clinical diagnostics laboratories. We employed a convergent parallel mixed-methods design, collecting quantitative survey data and qualitative insights from structured interviews with fifteen participants across various clinical roles. The findings indicate a wide adoption of Galaxy, with participants expressing high satisfaction due to its user-friendly interface and notable improvements in workflow efficiency and diagnostic accuracy. Challenges such as data security and training needs were also identified, highlighting the platform's role in simplifying complex data analysis tasks. This study contributes to understanding the transformative potential of Galaxy in clinical practice and offers recommendations for optimizing its integration and functionality. These insights are crucial for advancing clinical diagnostics and enhancing patient outcomes.

Robotic technology has the potential to revolutionize the field of neurology by providing new methods for diagnosis, treatment, and rehabilitation of neurological disorders. In recent years, there has been an increasing interest in the development of robotics applications for neurology, driven by advances in sensing, actuation, and control systems. This review paper provides a comprehensive overview of the recent advancements in robotics technology for neurology, with a focus on three main areas: diagnosis, treatment, and rehabilitation. In the area of diagnosis, robotics has been used for developing new imaging techniques and tools for more accurate and non-invasive mapping of brain structures and functions. For treatment, robotics has been used for developing minimally invasive surgical procedures, including stereotactic and endoscopic approaches, as well as for the delivery of therapeutic agents to specific targets in the brain. In rehabilitation, robotics has been used for developing assistive devices and platforms for motor and cognitive training of patients with neurological disorders. The paper also discusses the challenges and limitations of current robotics technology for

Despite the plethora of AI-based algorithms developed for anomaly detection in radiology, subsequent integration into clinical setting is rarely evaluated. In this work, we assess the applicability and utility of an AI-based model for brain aneurysm detection comparing the performance of two readers with different levels of experience (2 and 13 years). We aim to answer the following questions: 1) Do the readers improve their performance when assisted by the AI algorithm? 2) How much does the AI algorithm impact routine clinical workflow? We reuse and enlarge our open-access, Time-Of-Flight Magnetic Resonance Angiography dataset (N=460). We use 360 subjects for training/validating our algorithm and 100 as unseen test set for the reading session. Even though our model reaches state-of-the-art results on the test set (sensitivity=74%, false positive rate=1.6), we show that neither the junior nor the senior reader significantly increase their sensitivity (p=0.59, p=1, respectively). In addition, we find that reading time for both readers is significantly higher in the "AI-assisted" setting than in the "Unassisted" (+15 seconds, on average; p=3x10^(-4) junior, p=3x10^(-5) senior). The c

Widespread adoption of AI for medical decision making is still hindered due to ethical and safety-related concerns. For AI-based decision support systems in healthcare settings it is paramount to be reliable and trustworthy. Common deep learning approaches, however, have the tendency towards overconfidence under data shift. Such inappropriate extrapolation beyond evidence-based scenarios may have dire consequences. This highlights the importance of reliable estimation of local uncertainty and its communication to the end user. While stochastic neural networks have been heralded as a potential solution to these issues, this study investigates their actual reliability in clinical applications. We centered our analysis on the exemplary use case of mortality prediction for ICU hospitalizations using EHR from MIMIC3 study. For predictions on the EHR time series, Encoder-Only Transformer models were employed. Stochasticity of model functions was achieved by incorporating common methods such as Bayesian neural network layers and model ensembles. Our models achieve state of the art performance in terms of discrimination performance (AUC ROC: 0.868+-0.011, AUC PR: 0.554+-0.034) and calibrat

Objective: Integrating EHR data with other resources is essential in rare disease research due to low disease prevalence. Such integration is dependent on the alignment of ontologies used for data annotation. The International Classification of Diseases (ICD) is used to annotate clinical diagnoses; the Human Phenotype Ontology (HPO) to annotate phenotypes. Although these ontologies overlap in biomedical entities described, the extent to which they are interoperable is unknown. We investigate how well aligned these ontologies are and whether such alignments facilitate EHR data integration. Materials and Methods: We conducted an empirical analysis of the coverage of mappings between ICD and HPO. We interpret this mapping coverage as a proxy for how easily clinical data can be integrated with research ontologies such as HPO. We quantify how exhaustively ICD codes are mapped to HPO by analyzing mappings in the UMLS Metathesaurus. We analyze the proportion of ICD codes mapped to HPO within a real-world EHR dataset. Results and Discussion: Our analysis revealed that only 2.2% of ICD codes have direct mappings to HPO in UMLS. Within our EHR dataset, less than 50% of ICD codes have mapping

This paper is dedicated to the design and evaluation of the first AMR parser tailored for clinical notes. Our objective was to facilitate the precise transformation of the clinical notes into structured AMR expressions, thereby enhancing the interpretability and usability of clinical text data at scale. Leveraging the colon cancer dataset from the Temporal Histories of Your Medical Events (THYME) corpus, we adapted a state-of-the-art AMR parser utilizing continuous training. Our approach incorporates data augmentation techniques to enhance the accuracy of AMR structure predictions. Notably, through this learning strategy, our parser achieved an impressive F1 score of 88% on the THYME corpus's colon cancer dataset. Moreover, our research delved into the efficacy of data required for domain adaptation within the realm of clinical notes, presenting domain adaptation data requirements for AMR parsing. This exploration not only underscores the parser's robust performance but also highlights its potential in facilitating a deeper understanding of clinical narratives through structured semantic representations.

Introduction: Semantic search, which retrieves documents based on conceptual similarity rather than keyword matching, offers substantial advantages for retrieval of clinical information. However, deploying semantic search across entire health systems, comprising hundreds of millions of clinical notes, presents formidable engineering, cost, and governance challenges that have prevented adoption. Methods: We deployed a semantic search system at a large children's hospital indexing 166 million clinical notes (484 million vectors) from 1.68 million patients. The system uses instruction-tuned qwen3-embedding-0.6B embeddings, stores vectors in a managed database with storage-optimized indexing, maintains full-text metadata in a low-latency key-value store, and operates within a HIPAA-compliant governance framework. We evaluated the system through three experiments: optimization of embedding model and chunking strategy using a physician-authored benchmark dataset, characterization of full-scale performance (cost, latency, retrieval quality), and clinical utility assessment via comparison of chart abstraction efficiency across three tasks. Results: The system delivers sub-second query late

Accurate segmentation of pulmonary vessels plays a very critical role in diagnosing and assessing various lung diseases. Currently, many automated algorithms are primarily targeted at CTPA (Computed Tomography Pulmonary Angiography) types of data. However, the segmentation precision of these methods is insufficient, and support for NCCT (Non-Contrast Computed Tomography) types of data is also a requirement in some clinical scenarios. In this study, we propose a 3D image segmentation algorithm for automated pulmonary vessel segmentation from both contrast-enhanced and non-contrast CT images. In the network, we designed a Vessel Lumen Structure Optimization Module (VLSOM), which extracts the centerline (Cl) of vessels and adjusts the weights based on the positional information and adds a Cl-Dice Loss to supervise the stability of the vessels structure. We used 427 sets of high-precision annotated CT data from multiple vendors and countries to train the model and achieved Cl-DICE, Cl-Recall, and Recall values of 0.892, 0.861, 0.924 for CTPA data and 0.925, 0.903, 0.949 for NCCT data. This shows that our model has achieved good performance in both accuracy and completeness of pulmonary

Detecting duplicate patient participation in clinical trials is a major challenge because repeated patients can undermine the credibility and accuracy of the trial's findings and result in significant health and financial risks. Developing accurate automated speaker verification (ASV) models is crucial to verify the identity of enrolled individuals and remove duplicates, but the size and quality of data influence ASV performance. However, there has been limited investigation into the factors that can affect ASV capabilities in clinical environments. In this paper, we bridge the gap by conducting analysis of how participant demographic characteristics, audio quality criteria, and severity level of Alzheimer's disease (AD) impact the performance of ASV utilizing a dataset of speech recordings from 659 participants with varying levels of AD, obtained through multiple speech tasks. Our results indicate that ASV performance: 1) is slightly better on male speakers than on female speakers; 2) degrades for individuals who are above 70 years old; 3) is comparatively better for non-native English speakers than for native English speakers; 4) is negatively affected by clinician interference,