In real-world clinical settings, traditional deep learning-based classification methods struggle with diagnosing newly introduced disease types because they require samples from all disease classes for offline training. Class incremental learning offers a promising solution by adapting a deep network trained on specific disease classes to handle new diseases. However, catastrophic forgetting occurs, decreasing the performance of earlier classes when adapting the model to new data. Prior proposed methodologies to overcome this require perpetual storage of previous samples, posing potential practical concerns regarding privacy and storage regulations in healthcare. To this end, we propose a novel data-free class incremental learning framework that utilizes data synthesis on learned classes instead of data storage from previous classes. Our key contributions include acquiring synthetic data known as Continual Class-Specific Impression (CCSI) for previously inaccessible trained classes and presenting a methodology to effectively utilize this data for updating networks when introducing new classes. We obtain CCSI by employing data inversion over gradients of the trained classification model on previous classes starting from the mean image of each class inspired by common landmarks shared among medical images and utilizing continual normalization layers statistics as a regularizer in this pixel-wise optimization process. Subsequently, we update the network by combining the synthesized data with new class data and incorporate several losses, including an intra-domain contrastive loss to generalize the deep network trained on the synthesized data to real data, a margin loss to increase separation among previous classes and new ones, and a cosine-normalized cross-entropy loss to alleviate the adverse effects of imbalanced distributions in training data. Extensive experiments show that the proposed framework achieves state-of-the-art performance on four of the public MedMNIST datasets and in-house echocardiography cine series, with an improvement in classification accuracy of up to 51% compared to baseline data-free methods. Our code is available at https://github.com/ubc-tea/Continual-Impression-CCSI.
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http://dx.doi.org/10.1016/j.media.2024.103239 | DOI Listing |
Thyroid
January 2025
Division of Endocrine Surgery, Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong.
Cytologically indeterminate thyroid nodules (Bethesda class III or IV) carry a 10-40% risk of malignancy. Diagnostic lobectomies are frequently performed but negative surgeries incur unnecessary costs on the healthcare system, potential complications, and negative impacts on quality of life. Molecular tests (MTs) have been developed to reduce unnecessary surgeries.
View Article and Find Full Text PDFLancet Reg Health Am
February 2025
National Institute of Science and Technology for Health Technology Assessment, Porto Alegre, Brazil.
Background: Heart failure, a complex clinical syndrome with high morbidity and mortality, has become a significant burden on public health. Recently, a new class of antidiabetic agents-the sodium-glucose cotransporter 2 (SGLT2) inhibitors-was associated with a significant reduction on mortality and hospitalization in HF with reduced ejection fraction (HFrEF) when added to standard pharmacological treatment. Considering the lack of data on its cost-effectiveness, the present study aims to estimate the incremental cost-effectiveness ratio of add-on dapagliflozin treatment for HFrEF from the Brazilian public healthcare system perspective.
View Article and Find Full Text PDFUnlabelled: As sequencing costs decrease, short-read and long-read technologies are indispensable tools for uncovering the genetic drivers behind bacterial pathogen resistance. This study explores the differences between the use of short-read (Illumina) and long-read (Oxford Nanopore Technologies, ONT) sequencing in detecting antimicrobial resistance (AMR) genes in ESKAPE pathogens ( and ). Utilizing a dataset of 1,385 whole genome sequences and applying commonly used bioinformatic methods in bacterial genomics, we assessed the differences in genomic completeness, pangenome structure, and AMR gene and point mutation identification.
View Article and Find Full Text PDFBackground: The purpose of this study was to investigate whether circulating pyruvate kinase M2 (PK-M2) levels are elevated in the peripheral blood and to assess their association with diagnosis and prognosis in patients with heart failure (HF).
Methods And Results: We conducted a prospective investigation involving 222 patients with HF and 103 control subjects, measuring PK-M2 concentrations using ELISA. The primary outcome, assessed over a median follow-up of 2 years (interquartile range: 776 to 926 days), was the time to the first occurrence of either rehospitalization for worsening HF or cardiovascular death.
Circ Rep
January 2025
Cardiovascular Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital Osaka Japan.
Background: We recently reported that the self-care management system for heart failure (HF) decreased re-hospitalization for HF. In the present study we estimate the cost-effectiveness of this system.
Methods And Results: We retrospectively enrolled 569 consecutive patients who were admitted for HF treatment at Kitano Hospital.
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