We are witnessing a widespread adoption of artificial intelligence in healthcare. However, most of the advancements in deep learning (DL) in this area consider only unimodal data, neglecting other modalities. Their multimodal interpretation necessary for supporting diagnosis, prognosis and treatment decisions. In this work we present a deep architecture, explainable by design, which jointly learns modality reconstructions and sample classifications using tabular and imaging data. The explanation of the decision taken is computed by applying a latent shift that, simulates a counterfactual prediction revealing the features of each modality that contribute the most to the decision and a quantitative score indicating the modality importance. We validate our approach in the context of COVID-19 pandemic using the AIforCOVID dataset, which contains multimodal data for the early identification of patients at risk of severe outcome. The results show that the proposed method provides meaningful explanations without degrading the classification performance.
Recent epidemiological data report that worldwide more than 53 million people have been infected by SARS-CoV-2, resulting in 1.3 million deaths. The disease has been spreading very rapidly and few months after the identification of the first infected, shortage of hospital resources quickly became a problem. In this work we investigate whether chest X-ray (CXR) can be used as a possible tool for the early identification of patients at risk of severe outcome, like intensive care or death. CXR is a radiological technique that compared to computed tomography (CT) it is simpler, faster, more widespread and it induces lower radiation dose. We present a dataset including data collected from 820 patients by six Italian hospitals in spring 2020 during the first COVID-19 emergency. The dataset includes CXR images, several clinical attributes and clinical outcomes. We investigate the potential of artificial intelligence to predict the prognosis of such patients, distinguishing between severe and mild cases, thus offering a baseline reference for other researchers and practitioners. To this goal, we present three approaches that use features extracted from CXR images, either handcrafted or automatically by convolutional neuronal networks, which are then integrated with the clinical data. Exhaustive evaluation shows promising performance both in 10-fold and leave-one-centre-out cross-validation, implying that clinical data and images have the potential to provide useful information for the management of patients and hospital resources.