Question answering systems for health professionals at the point of care -- a systematic review

Objective: Question answering (QA) systems have the potential to improve the quality of clinical care by providing health professionals with the latest and most relevant evidence. However, QA systems have not been widely adopted. This systematic review aims to characterize current medical QA systems, assess their suitability for healthcare, and identify areas of improvement. Materials and methods: We searched PubMed, IEEE Xplore, ACM Digital Library, ACL Anthology and forward and backward citations on 7th February 2023. We included peer-reviewed journal and conference papers describing the design and evaluation of biomedical QA systems. Two reviewers screened titles, abstracts, and full-text articles. We conducted a narrative synthesis and risk of bias assessment for each study. We assessed the utility of biomedical QA systems. Results: We included 79 studies and identified themes, including question realism, answer reliability, answer utility, clinical specialism, systems, usability, and evaluation methods. Clinicians' questions used to train and evaluate QA systems were restricted to certain sources, types and complexity levels. No system communicated confidence levels in the answers or sources. Many studies suffered from high risks of bias and applicability concerns. Only 8 studies completely satisfied any criterion for clinical utility, and only 7 reported user evaluations. Most systems were built with limited input from clinicians. Discussion: While machine learning methods have led to increased accuracy, most studies imperfectly reflected real-world healthcare information needs. Key research priorities include developing more realistic healthcare QA datasets and considering the reliability of answer sources, rather than merely focusing on accuracy.

Uncertainty-Aware Deep Attention Recurrent Neural Network for Heterogeneous Time Series Imputation

Missingness is ubiquitous in multivariate time series and poses an obstacle to reliable downstream analysis. Although recurrent network imputation achieved the SOTA, existing models do not scale to deep architectures that can potentially alleviate issues arising in complex data. Moreover, imputation carries the risk of biased estimations of the ground truth. Yet, confidence in the imputed values is always unmeasured or computed post hoc from model output. We propose DEep Attention Recurrent Imputation (DEARI), which jointly estimates missing values and their associated uncertainty in heterogeneous multivariate time series. By jointly representing feature-wise correlations and temporal dynamics, we adopt a self attention mechanism, along with an effective residual component, to achieve a deep recurrent neural network with good imputation performance and stable convergence. We also leverage self-supervised metric learning to boost performance by optimizing sample similarity. Finally, we transform DEARI into a Bayesian neural network through a novel Bayesian marginalization strategy to produce stochastic DEARI, which outperforms its deterministic equivalent. Experiments show that DEARI surpasses the SOTA in diverse imputation tasks using real-world datasets, namely air quality control, healthcare and traffic.

Knowledge Enhanced Conditional Imputation for Healthcare Time-series

This study presents a novel approach to addressing the challenge of missing data in multivariate time series, with a particular focus on the complexities of healthcare data. Our Conditional Self-Attention Imputation (CSAI) model, grounded in a transformer-based framework, introduces a conditional hidden state initialization tailored to the intricacies of medical time series data. This methodology diverges from traditional imputation techniques by specifically targeting the imbalance in missing data distribution, a crucial aspect often overlooked in healthcare datasets. By integrating advanced knowledge embedding and a non-uniform masking strategy, CSAI adeptly adjusts to the distinct patterns of missing data in Electronic Health Records (EHRs).

Identifying depression-related topics in smartphone-collected free-response speech recordings using an automatic speech recognition system and a deep learning topic model

Language use has been shown to correlate with depression, but large-scale validation is needed. Traditional methods like clinic studies are expensive. So, natural language processing has been employed on social media to predict depression, but limitations remain-lack of validated labels, biased user samples, and no context. Our study identified 29 topics in 3919 smartphone-collected speech recordings from 265 participants using the Whisper tool and BERTopic model. Six topics with a median PHQ-8 greater than or equal to 10 were regarded as risk topics for depression: No Expectations, Sleep, Mental Therapy, Haircut, Studying, and Coursework. To elucidate the topic emergence and associations with depression, we compared behavioral (from wearables) and linguistic characteristics across identified topics. The correlation between topic shifts and changes in depression severity over time was also investigated, indicating the importance of longitudinally monitoring language use. We also tested the BERTopic model on a similar smaller dataset (356 speech recordings from 57 participants), obtaining some consistent results. In summary, our findings demonstrate specific speech topics may indicate depression severity. The presented data-driven workflow provides a practical approach to collecting and analyzing large-scale speech data from real-world settings for digital health research.