AI to enhance interactive simulation-based training in resuscitation medicine

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Abstract

When patients become acutely unwell, the ability of frontline healthcare professionals to act quickly and effectively can mean the difference between life and death. High-fidelity simulation is the gold standard by which medics acquire and maintain key resuscitation skills, but the resource-intensive nature of current, face-to-face training limits access to training and allows “skills fade” to creep in. We propose that human computer interaction-based simulations augmented by artificial intelligence could provide a cost-effective alternative to traditional training and allow clinicians much greater access to training. This paper is mostly an in-depth discussion; however, we also present a 3D simulator for resuscitation skills training which we developed using the Unity games physics engine.

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Human-level control through deep reinforcement learning.

Volodymyr Mnih, Koray Kavukcuoglu, David F. Silver … (2015)

The theory of reinforcement learning provides a normative account, deeply rooted in psychological and neuroscientific perspectives on animal behaviour, of how agents may optimize their control of an environment. To use reinforcement learning successfully in situations approaching real-world complexity, however, agents are confronted with a difficult task: they must derive efficient representations of the environment from high-dimensional sensory inputs, and use these to generalize past experience to new situations. Remarkably, humans and other animals seem to solve this problem through a harmonious combination of reinforcement learning and hierarchical sensory processing systems, the former evidenced by a wealth of neural data revealing notable parallels between the phasic signals emitted by dopaminergic neurons and temporal difference reinforcement learning algorithms. While reinforcement learning agents have achieved some successes in a variety of domains, their applicability has previously been limited to domains in which useful features can be handcrafted, or to domains with fully observed, low-dimensional state spaces. Here we use recent advances in training deep neural networks to develop a novel artificial agent, termed a deep Q-network, that can learn successful policies directly from high-dimensional sensory inputs using end-to-end reinforcement learning. We tested this agent on the challenging domain of classic Atari 2600 games. We demonstrate that the deep Q-network agent, receiving only the pixels and the game score as inputs, was able to surpass the performance of all previous algorithms and achieve a level comparable to that of a professional human games tester across a set of 49 games, using the same algorithm, network architecture and hyperparameters. This work bridges the divide between high-dimensional sensory inputs and actions, resulting in the first artificial agent that is capable of learning to excel at a diverse array of challenging tasks.

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Preventable deaths due to problems in care in English acute hospitals: a retrospective case record review study

Helen Hogan, Frances Healey, Graham Neale … (2012)

Introduction Monitoring hospital mortality rates is widely recommended. However, the number of preventable deaths remains uncertain with estimates in England ranging from 840 to 40 000 per year, these being derived from studies that identified adverse events but not whether events contributed to death or shortened life expectancy of those affected. Methods Retrospective case record reviews of 1000 adults who died in 2009 in 10 acute hospitals in England were undertaken. Trained physician reviewers estimated life expectancy on admission, to identified problems in care contributing to death and judged if deaths were preventable taking into account patients' overall condition at that time. Results Reviewers judged 5.2% (95% CI 3.8% to 6.6%) of deaths as having a 50% or greater chance of being preventable. The principal problems associated with preventable deaths were poor clinical monitoring (31.3%; 95% CI 23.9 to 39.7), diagnostic errors (29.7%; 95% CI 22.5% to 38.1%), and inadequate drug or fluid management (21.1%; 95% CI 14.9 to 29.0). Extrapolating from these figures suggests there would have been 11 859 (95% CI 8712 to 14 983) adult preventable deaths in hospitals in England. Most preventable deaths (60%) occurred in elderly, frail patients with multiple comorbidities judged to have had less than 1 year of life left to live. Conclusions The incidence of preventable hospital deaths is much lower than previous estimates. The burden of harm from preventable problems in care is still substantial. A focus on deaths may not be the most efficient approach to identify opportunities for improvement given the low proportion of deaths due to problems with healthcare.

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Machine learning and radiology.

Shijun Wang, Ronald Summers (2012)

In this paper, we give a short introduction to machine learning and survey its applications in radiology. We focused on six categories of applications in radiology: medical image segmentation, registration, computer aided detection and diagnosis, brain function or activity analysis and neurological disease diagnosis from fMR images, content-based image retrieval systems for CT or MRI images, and text analysis of radiology reports using natural language processing (NLP) and natural language understanding (NLU). This survey shows that machine learning plays a key role in many radiology applications. Machine learning identifies complex patterns automatically and helps radiologists make intelligent decisions on radiology data such as conventional radiographs, CT, MRI, and PET images and radiology reports. In many applications, the performance of machine learning-based automatic detection and diagnosis systems has shown to be comparable to that of a well-trained and experienced radiologist. Technology development in machine learning and radiology will benefit from each other in the long run. Key contributions and common characteristics of machine learning techniques in radiology are discussed. We also discuss the problem of translating machine learning applications to the radiology clinical setting, including advantages and potential barriers. Copyright © 2012. Published by Elsevier B.V.

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Affiliations

[1 ]Cardiovascular Research Unit, Craigavon Area Hospital, 68 Lurgan Rd, Portadown, BT63 5QQ

[2 ]Computer Science Research Institute, Ulster University, Shore Road, Newtonabbey, BT37 0QB

[3 ]Nanotechnology and Integrated BioEngineering Centre, Ulster University, Shore Road, Newtonabbey, BT37 0QB

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Rob Brisk

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Publication date: July 2018

Publication date (Print): July 2018

Pages: 1-4

ID: 10.14236/ewic/HCI2018.64

Copyright statement: © Brisk et al. Published by BCS Learning and Development Ltd. Proceedings of British HCI 2018. Belfast, UK.

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This work is licensed under a Creative Commons Attribution 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

Conference name: Proceedings of the 32nd International BCS Human Computer Interaction Conference

Conference acronym: HCI

Conference number: 32

Conference location: Belfast, UK

Conference date: 4 - 6 July 2018

Conference sponsor: Electronic Workshops in Computing (eWiC)

Conference theme: Human Computer Interaction Conference

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Product Information: 1477-9358 BCS Learning & Development

Self URI (article page): https://www.scienceopen.com/hosted-document?doi=10.14236/ewic/HCI2018.64

Self URI (journal page): https://ewic.bcs.org/

AI to enhance interactive simulation-based training in resuscitation medicine

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Electronic Workshops in Computing (eWiC)

Most cited references 26

Human-level control through deep reinforcement learning.

Preventable deaths due to problems in care in English acute hospitals: a retrospective case record review study

Machine learning and radiology.

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