Increasing evidence suggests that non-operative management (NOM) with antibiotics could serve as a safe alternative to surgery for the treatment of uncomplicated acute appendicitis (AA). However, accurately differentiating between uncomplicated and complicated AA remains challenging. Our aim was to develop and validate machine-learning-based diagnostic models to differentiate uncomplicated from complicated AA. This was a multicenter cohort trial conducted from January 2021 and December 2022 across five tertiary hospitals. Three distinct diagnostic models were created, namely, the clinical-parameter-based model, the CT-radiomics-based model, and the clinical-radiomics-fused model. These models were developed using a comprehensive set of eight machine-learning algorithms, which included logistic regression (LR), support vector machine (SVM), random forest (RF), decision tree (DT), gradient boosting (GB), K-nearest neighbors (KNN), Gaussian Naïve Bayes (GNB), and multi-layer perceptron (MLP). The performance and accuracy of these diverse models were compared. All models exhibited excellent diagnostic performance in the training cohort, achieving a maximal AUC of 1.00. For the clinical-parameter model, the GB classifier yielded the optimal AUC of 0.77 (95% confidence interval [CI]: 0.64-0.90) in the testing cohort, while the LR classifier yielded the optimal AUC of 0.76 (95% CI: 0.66-0.86) in the validation cohort. For the CT-radiomics-based model, GB classifier achieved the best AUC of 0.74 (95% CI: 0.60-0.88) in the testing cohort, and SVM yielded an optimal AUC of 0.63 (95% CI: 0.51-0.75) in the validation cohort. For the clinical-radiomics-fused model, RF classifier yielded an optimal AUC of 0.84 (95% CI: 0.74-0.95) in the testing cohort and 0.76 (95% CI: 0.67-0.86) in the validation cohort. An open-access, user-friendly online tool was developed for clinical application. This multicenter study suggests that the clinical-radiomics-fused model, constructed using RF algorithm, effectively differentiated between complicated and uncomplicated AA.

Thyroid nodule, as a common clinical endocrine disease, has become increasingly prevalent worldwide. Ultrasound, as the premier method of thyroid imaging, plays an important role in accurately diagnosing and managing thyroid nodules. However, there is a high degree of inter- and intra-observer variability in image interpretation due to the different knowledge and experience of sonographers who have huge ultrasound examination tasks everyday. Artificial intelligence based on computer-aided diagnosis technology maybe improve the accuracy and time efficiency of thyroid nodules diagnosis. This study introduced an artificial intelligence software called SW-TH01/II to evaluate ultrasound image characteristics of thyroid nodules including echogenicity, shape, border, margin, and calcification. We included 225 ultrasound images from two hospitals in Shanghai, respectively. The sonographers and software performed characteristics analysis on the same group of images. We analyzed the consistency of the two results and used the sonographers' results as the gold standard to evaluate the accuracy of SW-TH01/II. A total of 449 images were included in the statistical analysis. For the seven indicators, the proportions of agreement between SW-TH01/II and sonographers' analysis results were all greater than 0.8. For the echogenicity (with very hypoechoic), aspect ratio and margin, the kappa coefficient between the two methods were above 0.75 (P < 0.001). The kappa coefficients of echogenicity (echotexture and echogenicity level), border and calcification between the two methods were above 0.6 (P < 0.001). The median time it takes for software and sonographers to interpret an image were 3 (2, 3) seconds and 26.5 (21.17, 34.33) seconds, respectively, and the difference were statistically significant (z = -18.36, P < 0.001). SW-TH01/II has a high degree of accuracy and great time efficiency benefits in judging the characteristics of thyroid nodule. It can provide more objective results and improve the efficiency of ultrasound examination. SW-TH01/II can be used to assist the sonographers in characterizing the thyroid nodule ultrasound images.

Magnetic Resonance Imaging (MRI) is a crucial diagnostic tool in medicine, widely used to detect and assess various health conditions. Different MRI sequences, such as T1-weighted, T2-weighted, and FLAIR, serve distinct roles by highlighting different tissue characteristics and contrasts. However, distinguishing them based solely on the description file is currently impossible due to confusing or incorrect annotations. Additionally, there is a notable lack of effective tools to differentiate these sequences. In response, we developed a deep learning-based toolkit tailored for small, unrefined MRI datasets. This toolkit enables precise sequence classification and delivers performance comparable to systems trained on large, meticulously curated datasets. Utilizing lightweight model architectures and incorporating a voting ensemble method, the toolkit enhances accuracy and stability. It achieves a 99% accuracy rate using only 10% of the data typically required in other research. The code is available at https://github.com/JinqianPan/MRISeqClassifier.

Breast cancer is the most common malignant tumor among women worldwide, and early diagnosis is crucial for reducing mortality rates. Traditional diagnostic methods have significant limitations in terms of accuracy and consistency. Imaging is a common technique for diagnosing and predicting breast cancer, but human error remains a concern. Increasingly, artificial intelligence (AI) is being employed to assist physicians in reducing diagnostic errors. We developed an intelligent diagnostic model combining deep learning and radiomics to enhance breast tumor diagnosis. The model integrates MobileNet with ResNeXt-inspired depthwise separable and grouped convolutions, improving feature processing and efficiency while reducing parameters. Using AI-Dhabyani and TCIA breast ultrasound datasets, we validated the model internally and externally, comparing it to VGG16, ResNet, AlexNet, and MobileNet. Results: The internal validation set achieved an accuracy of 83.84% with an AUC of 0.92, outperforming other models. The external validation set showed an accuracy of 69.44% with an AUC of 0.75, demonstrating high robustness and generalizability. Conclusions: We developed an intelligent diagnostic model using deep learning and radiomics to improve breast tumor diagnosis. The model combines MobileNet with ResNeXt-inspired depthwise separable and grouped convolutions, enhancing feature processing and efficiency while reducing parameters. It was validated internally and externally using the AI-Dhabyani and TCIA breast ultrasound datasets and compared with VGG16, ResNet, AlexNet, and MobileNet.

The use of artificial intelligence (AI) in medicine has shown promise to improve the quality of healthcare decisions. However, AI can be biased in a manner that produces unfair predictions for certain demographic subgroups. In MIMIC-CXR, a publicly available dataset of over 300,000 chest X-ray images, diagnostic AI has been shown to have a higher false negative rate for racial minorities. We evaluated the capacity of synthetic data augmentation, oversampling, and demographic-based corrections to enhance the fairness of AI predictions. We show that adjusting unfair predictions for demographic attributes, such as race, is ineffective at improving fairness or predictive performance. However, using oversampling and synthetic data augmentation to modify disease prevalence reduced such disparities by 74.7% and 10.6%, respectively. Moreover, such fairness gains were accomplished without reduction in performance (95% CI AUC: [0.816, 0.820] versus [0.810, 0.819] versus [0.817, 0.821] for baseline, oversampling, and augmentation, respectively).

Machine learning (ML) algorithms play a crucial role in the early and accurate diagnosis of Alzheimer's Disease (AD), which is essential for effective treatment planning. However, existing methods are not well-suited for identifying Mild Cognitive Impairment (MCI), a critical transitional stage between normal aging and AD. This inadequacy is primarily due to label imbalance and bias from different sensitve attributes in MCI classification. To overcome these challenges, we have designed an end-to-end fairness-aware approach for label-imbalanced classification, tailored specifically for neuroimaging data. This method, built on the recently developed FACIMS framework, integrates into STREAMLINE, an automated ML environment. We evaluated our approach against nine other ML algorithms and found that it achieves comparable balanced accuracy to other methods while prioritizing fairness in classifications with five different sensitive attributes. This analysis contributes to the development of equitable and reliable ML diagnostics for MCI detection.