AI-clinician collaboration via disagreement prediction: A decision pipeline and retrospective analysis of real-world radiologist-AI interactions.

Clinical decision support tools can improve diagnostic performance or reduce variability, but they are also subject to post-deployment underperformance. Although using AI in an assistive setting offsets many concerns with autonomous AI in medicine, systems that present all predictions equivalently fail to protect against key AI safety concerns. We design a decision pipeline that supports the diagnostic model with an ecosystem of models, integrating disagreement prediction, clinical significance categorization, and prediction quality modeling to guide prediction presentation. We characterize disagreement using data from a deployed chest X-ray interpretation aid and compare clinician burden in this proposed pipeline to the diagnostic model in isolation. The average disagreement rate is 6.5%, and the expected burden reduction is 4.8%, even if 5% of disagreements on urgent findings receive a second read. We conclude that, in our production setting, we can adequately balance risk mitigation with clinician burden if disagreement false positives are reduced.

Wavelet radiomics features from multiphase CT images for screening hepatocellular carcinoma: analysis and comparison.

Early detection of liver malignancy based on medical image analysis plays a crucial role in patient prognosis and personalized treatment. This task, however, is challenging due to several factors, including medical data scarcity and limited training samples. This paper presents a study of three important aspects of radiomics feature from multiphase computed tomography (CT) for classifying hepatocellular carcinoma (HCC) and other focal liver lesions: wavelet-transformed feature extraction, relevant feature selection, and radiomics features-based classification under the inadequate training samples. Our analysis shows that combining radiomics features extracted from the wavelet and original CT domains enhance the classification performance significantly, compared with using those extracted from the wavelet or original domain only. To facilitate the multi-domain and multiphase radiomics feature combination, we introduce a logistic sparsity-based model for feature selection with Bayesian optimization and find that the proposed model yields more discriminative and relevant features than several existing methods, including filter-based, wrapper-based, or other model-based techniques. In addition, we present analysis and performance comparison with several recent deep convolutional neural network (CNN)-based feature models proposed for hepatic lesion diagnosis. The results show that under the inadequate data scenario, the proposed wavelet radiomics feature model produces comparable, if not higher, performance metrics than the CNN-based feature models in terms of area under the curve.