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Evaluating regression and probabilistic methods for ECG-based electrolyte prediction
Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Systems and Control. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Artificial Intelligence.ORCID iD: 0000-0003-4397-9952
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0001-5456-5515
Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Systems and Control. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Automatic control. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Artificial Intelligence.ORCID iD: 0000-0003-3632-8529
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2024 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 14, no 1, article id 15273Article in journal (Refereed) Published
Abstract [en]

Imbalances in electrolyte concentrations can have severe consequences, but accurate and accessible measurements could improve patient outcomes. The current measurement method based on blood tests is accurate but invasive and time-consuming and is often unavailable for example in remote locations or an ambulance setting. In this paper, we explore the use of deep neural networks (DNNs) for regression tasks to accurately predict continuous electrolyte concentrations from electrocardiograms (ECGs), a quick and widely adopted tool. We analyze our DNN models on a novel dataset of over 290,000 ECGs across four major electrolytes and compare their performance with traditional machine learning models. For improved understanding, we also study the full spectrum from continuous predictions to a binary classification of extreme concentration levels. Finally, we investigate probabilistic regression approaches and explore uncertainty estimates for enhanced clinical usefulness. Our results show that DNNs outperform traditional models but model performance varies significantly across different electrolytes. While discretization leads to good classification performance, it does not address the original problem of continuous concentration level prediction. Probabilistic regression has practical potential, but our uncertainty estimates are not perfectly calibrated. Our study is therefore a first step towards developing an accurate and reliable ECG-based method for electrolyte concentration level prediction—a method with high potential impact within multiple clinical scenarios.

Place, publisher, year, edition, pages
Springer Nature, 2024. Vol. 14, no 1, article id 15273
Keywords [en]
ECGs, Electrolytes, Probabilistic deep learning, Regression, Uncertainty estimation
National Category
Signal Processing
Identifiers
URN: urn:nbn:se:uu:diva-513725DOI: 10.1038/s41598-024-65223-wISI: 001262863000061PubMedID: 38961109OAI: oai:DiVA.org:uu-513725DiVA, id: diva2:1803909
Part of project
SNIC 2.0: Swedish National Infrastructure for Computing, Swedish Research Council
Funder
Uppsala UniversityKjell and Marta Beijer FoundationWallenberg AI, Autonomous Systems and Software Program (WASP)Knut and Alice Wallenberg FoundationEU, Horizon Europe, 101054643Swedish National Infrastructure for Computing (SNIC), sens2020005Swedish National Infrastructure for Computing (SNIC), sens2020598UPPMAXSwedish Research Council, 2018-05973
Note

Title in the list of papers of Fredrik K. Gustafsson's thesis: ECG-Based Electrolyte Prediction: Evaluating Regression and Probabilistic Methods

Available from: 2023-10-10 Created: 2023-10-10 Last updated: 2024-10-23Bibliographically approved
In thesis
1. Towards Accurate and Reliable Deep Regression Models
Open this publication in new window or tab >>Towards Accurate and Reliable Deep Regression Models
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Regression is a fundamental machine learning task with many important applications within computer vision and other domains. In general, it entails predicting continuous targets from given inputs. Deep learning has become the dominant paradigm within machine learning in recent years, and a wide variety of different techniques have been employed to solve regression problems using deep models. There is however no broad consensus on how deep regression models should be constructed for best possible accuracy, or how the uncertainty in their predictions should be represented and estimated. 

These open questions are studied in this thesis, aiming to help take steps towards an ultimate goal of developing deep regression models which are both accurate and reliable enough for real-world deployment within medical applications and other safety-critical domains.

The first main contribution of the thesis is the formulation and development of energy-based probabilistic regression. This is a general and conceptually simple regression framework with a clear probabilistic interpretation, using energy-based models to represent the true conditional target distribution. The framework is applied to a number of regression problems and demonstrates particularly strong performance for 2D bounding box regression, improving the state-of-the-art when applied to the task of visual tracking.

The second main contribution is a critical evaluation of various uncertainty estimation methods. A general introduction to the problem of estimating the predictive uncertainty of deep models is first provided, together with an extensive comparison of the two popular methods ensembling and MC-dropout. A number of regression uncertainty estimation methods are then further evaluated, specifically examining their reliability under real-world distribution shifts. This evaluation uncovers important limitations of current methods and serves as a challenge to the research community. It demonstrates that more work is required in order to develop truly reliable uncertainty estimation methods for regression.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2023. p. 61
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Science and Technology, ISSN 1651-6214 ; 2320
Keywords
Machine Learning, Deep Learning, Regression, Probabilistic Models, Energy-Based Models, Uncertainty Estimation
National Category
Signal Processing
Research subject
Machine learning
Identifiers
urn:nbn:se:uu:diva-513727 (URN)978-91-513-1925-4 (ISBN)
Public defence
2023-11-30, 101121 Sonja Lyttkens, Ångströmlaboratoriet, Lägerhyddsvägen 1, Uppsala, 09:15 (English)
Opponent
Supervisors
Available from: 2023-11-07 Created: 2023-10-10 Last updated: 2023-11-07

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Gedon, DanielGustafsson, Fredrik K.Ribeiro, Antônio H.Lampa, ErikGustafsson, StefanSundström, JohanSchön, Thomas B.

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