Computer-based summative assessment of clinical reasoning in clerkships: A mixed-method comparison of key feature problems with case-based multiple choice questions

Background: It is yet unclear if there are differences between using electronic key feature problems (KFPs) or electronic case-based multiple choice questions (cbMCQ) for the assessment of clinical decision making. Summary of Work: Fifth year medical students were exposed to clerkships which ended with a summative exam. Assessment of knowledge per exam was done by 6-9 KFPs, 9-20 cbMCQ and 9-28 MC questions. Each KFP consisted of a case vignette and three key features (KF) using “long menu” as question format. We sought students’ perceptions of the KFPs and cbMCQs in focus groups (n of students=39). Furthermore statistical data of 11 exams (n of students=377) concerning the KFPs and (cb)MCQs were compared. Summary of Results: The analysis of the focus groups resulted in four themes reflecting students’ perceptions of KFPs and their comparison with (cb)MCQ: KFPs were perceived as (i) more realistic, (ii) more difficult, (iii) more motivating for the intense study of clinical reasoning than (cb)MCQ and (iv) showed an overall good acceptance when some preconditions are taken into account. The statistical analysis revealed that there was no difference in difficulty; however KFP showed a higher discrimination and reliability (G-coefficient) even when corrected for testing times. Correlation of the different exam parts was intermediate. Conclusions: Students perceived the KFPs as more motivating for the study of clinical reasoning. Statistically KFPs showed a higher discrimination and higher reliability than cbMCQs. Take-home messages: Including KFPs with long menu questions into summative clerkship exams seems to offer positive educational effects.

Outcome-based adaptive randomization for binary data in clinical trials---Compare and contrast

Monte Carlo simulation has been conducted to investigate parameter estimation and hypothesis testing in some well known adaptive randomization procedures. The four urn models studied are Randomized Play-the-Winner (RPW), Randomized Pôlya Urn (RPU), Birth and Death Urn with Immigration (BDUI), and Drop-the-Loses Urn (DL). Two sequential estimation methods, the sequential maximum likelihood estimation (SMLE) and the doubly adaptive biased coin design (DABC), are simulated at three optimal allocation targets that minimize the expected number of failures under the assumption of constant variance of simple difference (RSIHR), relative risk (ORR), and odds ratio (OOR) respectively. Log likelihood ratio test and three Wald-type tests (simple difference, log of relative risk, log of odds ratio) are compared in different adaptive procedures. ^ Simulation results indicates that although RPW is slightly better in assigning more patients to the superior treatment, the DL method is considerably less variable and the test statistics have better normality. When compared with SMLE, DABC has slightly higher overall response rate with lower variance, but has larger bias and variance in parameter estimation. Additionally, the test statistics in SMLE have better normality and lower type I error rate, and the power of hypothesis testing is more comparable with the equal randomization. Usually, RSIHR has the highest power among the 3 optimal allocation ratios. However, the ORR allocation has better power and lower type I error rate when the log of relative risk is the test statistics. The number of expected failures in ORR is smaller than RSIHR. It is also shown that the simple difference of response rates has the worst normality among all 4 test statistics. The power of hypothesis test is always inflated when simple difference is used. On the other hand, the normality of the log likelihood ratio test statistics is robust against the change of adaptive randomization procedures. ^

An Interval-based Multiobjective Approach to Feature Subset Selection Using Joint Modeling of Objectives and Variables

This paper studies feature subset selection in classification using a multiobjective estimation of distribution algorithm. We consider six functions, namely area under ROC curve, sensitivity, specificity, precision, F1 measure and Brier score, for evaluation of feature subsets and as the objectives of the problem. One of the characteristics of these objective functions is the existence of noise in their values that should be appropriately handled during optimization. Our proposed algorithm consists of two major techniques which are specially designed for the feature subset selection problem. The first one is a solution ranking method based on interval values to handle the noise in the objectives of this problem. The second one is a model estimation method for learning a joint probabilistic model of objectives and variables which is used to generate new solutions and advance through the search space. To simplify model estimation, l1 regularized regression is used to select a subset of problem variables before model learning. The proposed algorithm is compared with a well-known ranking method for interval-valued objectives and a standard multiobjective genetic algorithm. Particularly, the effects of the two new techniques are experimentally investigated. The experimental results show that the proposed algorithm is able to obtain comparable or better performance on the tested datasets.

Semi-supervised subspace clustering and applications to neuroscience

Machine learning techniques are used for extracting valuable knowledge from data. Nowa¬days, these techniques are becoming even more important due to the evolution in data ac¬quisition and storage, which is leading to data with different characteristics that must be exploited. Therefore, advances in data collection must be accompanied with advances in machine learning techniques to solve new challenges that might arise, on both academic and real applications. There are several machine learning techniques depending on both data characteristics and purpose. Unsupervised classification or clustering is one of the most known techniques when data lack of supervision (unlabeled data) and the aim is to discover data groups (clusters) according to their similarity. On the other hand, supervised classification needs data with supervision (labeled data) and its aim is to make predictions about labels of new data. The presence of data labels is a very important characteristic that guides not only the learning task but also other related tasks such as validation. When only some of the available data are labeled whereas the others remain unlabeled (partially labeled data), neither clustering nor supervised classification can be used. This scenario, which is becoming common nowadays because of labeling process ignorance or cost, is tackled with semi-supervised learning techniques. This thesis focuses on the branch of semi-supervised learning closest to clustering, i.e., to discover clusters using available labels as support to guide and improve the clustering process. Another important data characteristic, different from the presence of data labels, is the relevance or not of data features. Data are characterized by features, but it is possible that not all of them are relevant, or equally relevant, for the learning process. A recent clustering tendency, related to data relevance and called subspace clustering, claims that different clusters might be described by different feature subsets. This differs from traditional solutions to data relevance problem, where a single feature subset (usually the complete set of original features) is found and used to perform the clustering process. The proximity of this work to clustering leads to the first goal of this thesis. As commented above, clustering validation is a difficult task due to the absence of data labels. Although there are many indices that can be used to assess the quality of clustering solutions, these validations depend on clustering algorithms and data characteristics. Hence, in the first goal three known clustering algorithms are used to cluster data with outliers and noise, to critically study how some of the most known validation indices behave. The main goal of this work is however to combine semi-supervised clustering with subspace clustering to obtain clustering solutions that can be correctly validated by using either known indices or expert opinions. Two different algorithms are proposed from different points of view to discover clusters characterized by different subspaces. For the first algorithm, available data labels are used for searching for subspaces firstly, before searching for clusters. This algorithm assigns each instance to only one cluster (hard clustering) and is based on mapping known labels to subspaces using supervised classification techniques. Subspaces are then used to find clusters using traditional clustering techniques. The second algorithm uses available data labels to search for subspaces and clusters at the same time in an iterative process. This algorithm assigns each instance to each cluster based on a membership probability (soft clustering) and is based on integrating known labels and the search for subspaces into a model-based clustering approach. The different proposals are tested using different real and synthetic databases, and comparisons to other methods are also included when appropriate. Finally, as an example of real and current application, different machine learning tech¬niques, including one of the proposals of this work (the most sophisticated one) are applied to a task of one of the most challenging biological problems nowadays, the human brain model¬ing. Specifically, expert neuroscientists do not agree with a neuron classification for the brain cortex, which makes impossible not only any modeling attempt but also the day-to-day work without a common way to name neurons. Therefore, machine learning techniques may help to get an accepted solution to this problem, which can be an important milestone for future research in neuroscience. Resumen Las técnicas de aprendizaje automático se usan para extraer información valiosa de datos. Hoy en día, la importancia de estas técnicas está siendo incluso mayor, debido a que la evolución en la adquisición y almacenamiento de datos está llevando a datos con diferentes características que deben ser explotadas. Por lo tanto, los avances en la recolección de datos deben ir ligados a avances en las técnicas de aprendizaje automático para resolver nuevos retos que pueden aparecer, tanto en aplicaciones académicas como reales. Existen varias técnicas de aprendizaje automático dependiendo de las características de los datos y del propósito. La clasificación no supervisada o clustering es una de las técnicas más conocidas cuando los datos carecen de supervisión (datos sin etiqueta), siendo el objetivo descubrir nuevos grupos (agrupaciones) dependiendo de la similitud de los datos. Por otra parte, la clasificación supervisada necesita datos con supervisión (datos etiquetados) y su objetivo es realizar predicciones sobre las etiquetas de nuevos datos. La presencia de las etiquetas es una característica muy importante que guía no solo el aprendizaje sino también otras tareas relacionadas como la validación. Cuando solo algunos de los datos disponibles están etiquetados, mientras que el resto permanece sin etiqueta (datos parcialmente etiquetados), ni el clustering ni la clasificación supervisada se pueden utilizar. Este escenario, que está llegando a ser común hoy en día debido a la ignorancia o el coste del proceso de etiquetado, es abordado utilizando técnicas de aprendizaje semi-supervisadas. Esta tesis trata la rama del aprendizaje semi-supervisado más cercana al clustering, es decir, descubrir agrupaciones utilizando las etiquetas disponibles como apoyo para guiar y mejorar el proceso de clustering. Otra característica importante de los datos, distinta de la presencia de etiquetas, es la relevancia o no de los atributos de los datos. Los datos se caracterizan por atributos, pero es posible que no todos ellos sean relevantes, o igualmente relevantes, para el proceso de aprendizaje. Una tendencia reciente en clustering, relacionada con la relevancia de los datos y llamada clustering en subespacios, afirma que agrupaciones diferentes pueden estar descritas por subconjuntos de atributos diferentes. Esto difiere de las soluciones tradicionales para el problema de la relevancia de los datos, en las que se busca un único subconjunto de atributos (normalmente el conjunto original de atributos) y se utiliza para realizar el proceso de clustering. La cercanía de este trabajo con el clustering lleva al primer objetivo de la tesis. Como se ha comentado previamente, la validación en clustering es una tarea difícil debido a la ausencia de etiquetas. Aunque existen muchos índices que pueden usarse para evaluar la calidad de las soluciones de clustering, estas validaciones dependen de los algoritmos de clustering utilizados y de las características de los datos. Por lo tanto, en el primer objetivo tres conocidos algoritmos se usan para agrupar datos con valores atípicos y ruido para estudiar de forma crítica cómo se comportan algunos de los índices de validación más conocidos. El objetivo principal de este trabajo sin embargo es combinar clustering semi-supervisado con clustering en subespacios para obtener soluciones de clustering que puedan ser validadas de forma correcta utilizando índices conocidos u opiniones expertas. Se proponen dos algoritmos desde dos puntos de vista diferentes para descubrir agrupaciones caracterizadas por diferentes subespacios. Para el primer algoritmo, las etiquetas disponibles se usan para bus¬car en primer lugar los subespacios antes de buscar las agrupaciones. Este algoritmo asigna cada instancia a un único cluster (hard clustering) y se basa en mapear las etiquetas cono-cidas a subespacios utilizando técnicas de clasificación supervisada. El segundo algoritmo utiliza las etiquetas disponibles para buscar de forma simultánea los subespacios y las agru¬paciones en un proceso iterativo. Este algoritmo asigna cada instancia a cada cluster con una probabilidad de pertenencia (soft clustering) y se basa en integrar las etiquetas conocidas y la búsqueda en subespacios dentro de clustering basado en modelos. Las propuestas son probadas utilizando diferentes bases de datos reales y sintéticas, incluyendo comparaciones con otros métodos cuando resulten apropiadas. Finalmente, a modo de ejemplo de una aplicación real y actual, se aplican diferentes técnicas de aprendizaje automático, incluyendo una de las propuestas de este trabajo (la más sofisticada) a una tarea de uno de los problemas biológicos más desafiantes hoy en día, el modelado del cerebro humano. Específicamente, expertos neurocientíficos no se ponen de acuerdo en una clasificación de neuronas para la corteza cerebral, lo que imposibilita no sólo cualquier intento de modelado sino también el trabajo del día a día al no tener una forma estándar de llamar a las neuronas. Por lo tanto, las técnicas de aprendizaje automático pueden ayudar a conseguir una solución aceptada para este problema, lo cual puede ser un importante hito para investigaciones futuras en neurociencia.

knOWLearn: a reuse-based approach for building ontologies in a semi-automatic way

In this poster paper we present an overview of knOWLearn, a novel approach for building domain ontologies in a semi-automatic fashion.

Brain structures identification based on feature descriptor

Traumatic Brain Injury -TBI- -1- is defined as an acute event that causes certain damage to areas of the brain. TBI may result in a significant impairment of an individuals physical, cognitive and psychosocial functioning. The main consequence of TBI is a dramatic change in the individuals daily life involving a profound disruption of the family, a loss of future income capacity and an increase of lifetime cost. One of the main challenges of TBI Neuroimaging is to develop robust automated image analysis methods to detect signatures of TBI, such as: hyper-intensity areas, changes in image contrast and in brain shape. The final goal of this research is to develop a method to identify the altered brain structures by automatically detecting landmarks on the image where signal changes and to provide comprehensive information to the clinician about them. These landmarks identify injured structures by co-registering the patient?s image with an atlas where landmarks have been previously detected. The research work has been initiated by identifying brain structures on healthy subjects to validate the proposed method. Later, this method will be used to identify modified structures on TBI imaging studies.

Multi-Camera very wide baseline feature matching based on view-adaptive junction detection

This paper presents a strategy for solving the feature matching problem in calibrated very wide-baseline camera settings. In this kind of settings, perspective distortion, depth discontinuities and occlusion represent enormous challenges. The proposed strategy addresses them by using geometrical information, specifically by exploiting epipolar-constraints. As a result it provides a sparse number of reliable feature points for which 3D position is accurately recovered. Special features known as junctions are used for robust matching. In particular, a strategy for refinement of junction end-point matching is proposed which enhances usual junction-based approaches. This allows to compute cross-correlation between perfectly aligned plane patches in both images, thus yielding better matching results. Evaluation of experimental results proves the effectiveness of the proposed algorithm in very wide-baseline environments.

Model Based On-Line Energy Prediction System for Semi-Autonomous Mobile Robots

Maximizing energy autonomy is a consistent challenge when deploying mobile robots in ionizing radiation or other hazardous environments. Having a reliable robot system is essential for successful execution of missions and to avoid manual recovery of the robots in environments that are harmful to human beings. For deployment of robots missions at short notice, the ability to know beforehand the energy required for performing the task is essential. This paper presents a on-line method for predicting energy requirements based on the pre-determined power models for a mobile robot. A small mobile robot, Khepera III is used for the experimental study and the results are promising with high prediction accuracy. The applications of the energy prediction models in energy optimization and simulations are also discussed along with examples of significant energy savings.

Expressive power of binary relevance and chain classifiers based on Bayesian Networks for multi-label classification

Bayesian network classifiers are widely used in machine learning because they intuitively represent causal relations. Multi-label classification problems require each instance to be assigned a subset of a defined set of h labels. This problem is equivalent to finding a multi-valued decision function that predicts a vector of h binary classes. In this paper we obtain the decision boundaries of two widely used Bayesian network approaches for building multi-label classifiers: Multi-label Bayesian network classifiers built using the binary relevance method and Bayesian network chain classifiers. We extend our previous single-label results to multi-label chain classifiers, and we prove that, as expected, chain classifiers provide a more expressive model than the binary relevance method.

Finite element code-based modeling of a multi-feature isolation system and passive alleviation of possible inner pounding

The existing seismic isolation systems are based on well-known and accepted physical principles, but they are still having some functional drawbacks. As an attempt of improvement, the Roll-N-Cage (RNC) isolator has been recently proposed. It is designed to achieve a balance in controlling isolator displacement demands and structural accelerations. It provides in a single unit all the necessary functions of vertical rigid support, horizontal flexibility with enhanced stability, resistance to low service loads and minor vibration, and hysteretic energy dissipation characteristics. It is characterized by two unique features that are a self-braking (buffer) and a self-recentering mechanism. This paper presents an advanced representation of the main and unique features of the RNC isolator using an available finite element code called SAP2000. The validity of the obtained SAP2000 model is then checked using experimental, numerical and analytical results. Then, the paper investigates the merits and demerits of activating the built-in buffer mechanism on both structural pounding mitigation and isolation efficiency. The paper addresses the problem of passive alleviation of possible inner pounding within the RNC isolator, which may arise due to the activation of its self-braking mechanism under sever excitations such as near-fault earthquakes. The results show that the obtained finite element code-based model can closely match and accurately predict the overall behavior of the RNC isolator with effectively small errors. Moreover, the inherent buffer mechanism of the RNC isolator could mitigate or even eliminate direct structure-tostructure pounding under severe excitation considering limited septation gaps between adjacent structures. In addition, the increase of inherent hysteretic damping of the RNC isolator can efficiently limit its peak displacement together with the severity of the possibly developed inner pounding and, therefore, alleviate or even eliminate the possibly arising negative effects of the buffer mechanism on the overall RNC-isolated structural responses.

A study of feature combination for vehicle detection based on image processing

Video analytics play a critical role in most recent traffic monitoring and driver assistance systems. In this context, the correct detection and classification of surrounding vehicles through image analysis has been the focus of extensive research in the last years. Most of the pieces of work reported for image-based vehicle verification make use of supervised classification approaches and resort to techniques, such as histograms of oriented gradients (HOG), principal component analysis (PCA), and Gabor filters, among others. Unfortunately, existing approaches are lacking in two respects: first, comparison between methods using a common body of work has not been addressed; second, no study of the combination potentiality of popular features for vehicle classification has been reported. In this study the performance of the different techniques is first reviewed and compared using a common public database. Then, the combination capabilities of these techniques are explored and a methodology is presented for the fusion of classifiers built upon them, taking into account also the vehicle pose. The study unveils the limitations of single-feature based classification and makes clear that fusion of classifiers is highly beneficial for vehicle verification.

Simultaneous assessment of loss of heterozygosity at multiple microsatellite loci using semi-automated fluorescence-based detection: subregional mapping of chromosome 4 in cervical carcinoma.

Detection of loss of heterozygosity (LOH) by comparison of normal and tumor genotypes using PCR-based microsatellite loci provides considerable advantages over traditional Southern blotting-based approaches. However, current methodologies are limited by several factors, including the numbers of loci that can be evaluated for LOH in a single experiment, the discrimination of true alleles versus "stutter bands," and the use of radionucleotides in detecting PCR products. Here we describe methods for high throughput simultaneous assessment of LOH at multiple loci in human tumors; these methods rely on the detection of amplified microsatellite loci by fluorescence-based DNA sequencing technology. Data generated by this approach are processed by several computer software programs that enable the automated linear quantitation and calculation of allelic ratios, allowing rapid ascertainment of LOH. As a test of this approach, genotypes at a series of loci on chromosome 4 were determined for 58 carcinomas of the uterine cervix. The results underscore the efficacy, sensitivity, and remarkable reproducibility of this approach to LOH detection and provide subchromosomal localization of two regions of chromosome 4 commonly altered in cervical tumors.

3D plane-based egomotion for SLAM on semi-structured environment

Several works deal with 3D data in SLAM problem. Data come from a 3D laser sweeping unit or a stereo camera, both providing a huge amount of data. In this paper, we detail an efficient method to extract planar patches from 3D raw data. Then, we use these patches in an ICP-like method in order to address the SLAM problem. Using ICP with planes is not a trivial task. It needs some adaptation from the original ICP. Some promising results are shown for outdoor environment.

Exploring automatic feature selection for transition-based dependency parsing

En este artículo se investigan técnicas automáticas para encontrar un modelo óptimo de características en el caso de un analizador de dependencias basado en transiciones. Mostramos un estudio comparativo entre algoritmos de búsqueda, sistemas de validación y reglas de decisión demostrando al mismo tiempo que usando nuestros métodos es posible conseguir modelos complejos que proporcionan mejores resultados que los modelos que siguen configuraciones por defecto.

Real-time 3D semi-local surface patch extraction using GPGPU

Feature vectors can be anything from simple surface normals to more complex feature descriptors. Feature extraction is important to solve various computer vision problems: e.g. registration, object recognition and scene understanding. Most of these techniques cannot be computed online due to their complexity and the context where they are applied. Therefore, computing these features in real-time for many points in the scene is impossible. In this work, a hardware-based implementation of 3D feature extraction and 3D object recognition is proposed to accelerate these methods and therefore the entire pipeline of RGBD based computer vision systems where such features are typically used. The use of a GPU as a general purpose processor can achieve considerable speed-ups compared with a CPU implementation. In this work, advantageous results are obtained using the GPU to accelerate the computation of a 3D descriptor based on the calculation of 3D semi-local surface patches of partial views. This allows descriptor computation at several points of a scene in real-time. Benefits of the accelerated descriptor have been demonstrated in object recognition tasks. Source code will be made publicly available as contribution to the Open Source Point Cloud Library.