A Standardized Clinical Data Harmonization Pipeline for Scalable AI Application Deployment (FHIR-DHP): Validation and Usability Study.

BACKGROUND: Increasing digitalization in the medical domain gives rise to large amounts of health care data, which has the potential to expand clinical knowledge and transform patient care if leveraged through artificial intelligence (AI). Yet, big data and AI oftentimes cannot unlock their full potential at scale, owing to nonstandardized data formats, lack of technical and semantic data interoperability, and limited cooperation between stakeholders in the health care system. Despite the existence of standardized data formats for the medical domain, such as Fast Healthcare Interoperability Resources (FHIR), their prevalence and usability for AI remain limited. OBJECTIVE: In this paper, we developed a data harmonization pipeline (DHP) for clinical data sets relying on the common FHIR data standard. METHODS: We validated the performance and usability of our FHIR-DHP with data from the Medical Information Mart for Intensive Care IV database. RESULTS: We present the FHIR-DHP workflow in respect of the transformation of "raw" hospital records into a harmonized, AI-friendly data representation. The pipeline consists of the following 5 key preprocessing steps: querying of data from hospital database, FHIR mapping, syntactic validation, transfer of harmonized data into the patient-model database, and export of data in an AI-friendly format for further medical applications. A detailed example of FHIR-DHP execution was presented for clinical diagnoses records. CONCLUSIONS: Our approach enables the scalable and needs-driven data modeling of large and heterogenous clinical data sets. The FHIR-DHP is a pivotal step toward increasing cooperation, interoperability, and quality of patient care in the clinical routine and for medical research.

Finding stationary subspaces in multivariate time series.

Identifying temporally invariant components in complex multivariate time series is key to understanding the underlying dynamical system and predict its future behavior. In this Letter, we propose a novel technique, stationary subspace analysis (SSA), that decomposes a multivariate time series into its stationary and nonstationary part. The method is based on two assumptions: (a) the observed signals are linear superpositions of stationary and nonstationary sources; and (b) the nonstationarity is measurable in the first two moments. We characterize theoretical and practical properties of SSA and study it in simulations and cortical signals measured by electroencephalography. Here, SSA succeeds in finding stationary components that lead to a significantly improved prediction accuracy and meaningful topographic maps which contribute to a better understanding of the underlying nonstationary brain processes.

A mathematical model for the two-learners problem.

OBJECTIVE: We present the first generic theoretical formulation of the co-adaptive learning problem and give a simple example of two interacting linear learning systems, a human and a machine. APPROACH: After the description of the training protocol of the two learning systems, we define a simple linear model where the two learning agents are coupled by a joint loss function. The simplicity of the model allows us to find learning rules for both human and machine that permit computing theoretical simulations. MAIN RESULTS: As seen in simulations, an astonishingly rich structure is found for this eco-system of learners. While the co-adaptive learners are shown to easily stall or get out of sync for some parameter settings, we can find a broad sweet spot of parameters where the learning system can converge quickly. It is defined by mid-range learning rates on the side of the learning machine, quite independent of the human in the loop. Despite its simplistic assumptions the theoretical study could be confirmed by a real-world experimental study where human and machine co-adapt to perform cursor control under distortion. Also in this practical setting the mid-range learning rates yield the best performance and behavioral ratings. SIGNIFICANCE: The results presented in this mathematical study allow the computation of simple theoretical simulations and performance of real experimental paradigms. Additionally, they are nicely in line with previous results in the BCI literature.

Explorative data analysis for changes in neural activity.

Neural recordings are non-stationary time series, i.e. their properties typically change over time. Identifying specific changes, e.g., those induced by a learning task, can shed light on the underlying neural processes. However, such changes of interest are often masked by strong unrelated changes, which can be of physiological origin or due to measurement artifacts. We propose a novel algorithm for disentangling such different causes of non-stationarity and in this manner enable better neurophysiological interpretation for a wider set of experimental paradigms. A key ingredient is the repeated application of Stationary Subspace Analysis (SSA) using different temporal scales. The usefulness of our explorative approach is demonstrated in simulations, theory and EEG experiments with 80 brain-computer interfacing subjects.

Feature extraction for change-point detection using stationary subspace analysis.

Detecting changes in high-dimensional time series is difficult because it involves the comparison of probability densities that need to be estimated from finite samples. In this paper, we present the first feature extraction method tailored to change-point detection, which is based on an extended version of stationary subspace analysis. We reduce the dimensionality of the data to the most nonstationary directions, which are most informative for detecting state changes in the time series. In extensive simulations on synthetic data, we show that the accuracy of three change-point detection algorithms is significantly increased by a prior feature extraction step. These findings are confirmed in an application to industrial fault monitoring.

Separation of stationary and non-stationary sources with a generalized eigenvalue problem.

Non-stationary effects are ubiquitous in real world data. In many settings, the observed signals are a mixture of underlying stationary and non-stationary sources that cannot be measured directly. For example, in EEG analysis, electrodes on the scalp record the activity from several sources located inside the brain, which one could only measure invasively. Discerning stationary and non-stationary contributions is an important step towards uncovering the mechanisms of the data generating system. To that end, in Stationary Subspace Analysis (SSA), the observed signal is modeled as a linear superposition of stationary and non-stationary sources, where the aim is to separate the two groups in the mixture. In this paper, we propose the first SSA algorithm that has a closed form solution. The novel method, Analytic SSA (ASSA), is more than 100 times faster than the state-of-the-art, numerically stable, and guaranteed to be optimal when the covariance between stationary and non-stationary sources is time-constant. In numerical simulations on wide range of settings, we show that our method yields superior results, even for signals with time-varying group-wise covariance. In an application to geophysical data analysis, ASSA extracts meaningful components that shed new light on the Pi 2 pulsations of the geomagnetic field.

Direct density-ratio estimation with dimensionality reduction via least-squares hetero-distributional subspace search.

Methods for directly estimating the ratio of two probability density functions have been actively explored recently since they can be used for various data processing tasks such as non-stationarity adaptation, outlier detection, and feature selection. In this paper, we develop a new method which incorporates dimensionality reduction into a direct density-ratio estimation procedure. Our key idea is to find a low-dimensional subspace in which densities are significantly different and perform density-ratio estimation only in this subspace. The proposed method, D(3)-LHSS (Direct Density-ratio estimation with Dimensionality reduction via Least-squares Hetero-distributional Subspace Search), is shown to overcome the limitation of baseline methods.

Finding stationary brain sources in EEG data.

Neurophysiological measurements obtained from e.g. EEG or fMRI are inherently non-stationary because the properties of the underlying brain processes vary over time. For example, in Brain-Computer-Interfacing (BCI), deteriorating performance (bitrate) is a common phenomenon since the parameters determined during the calibration phase can be suboptimal under the application regime, where the brain state is different, e.g. due to increased tiredness or changes in the experimental paradigm. We show that Stationary Subspace Analysis (SSA), a time series analysis method, can be used to identify the underlying stationary and non-stationary brain sources from high-dimensional EEG measurements. Restricting the BCI to the stationary sources found by SSA can significantly increase the performance. Moreover, SSA yields topographic maps corresponding to stationary- and non-stationary brain sources which reveal their spatial characteristics.