Machine Learning for Automation of Radiology Protocols for Quality and Efficiency Improvement.

Purpose: The aim of this study was to enhance multispecialty CT and MRI protocol assignment quality and efficiency through development, testing, and proposed workflow design of a natural language processing (NLP)-based machine learning classifier.Methods: NLP-based machine learning classification mo...

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Publicado en:Journal of the American College of Radiology Vol. 17; no. 9; pp. 1149 - 1159
Autores principales: Kalra, Angad, Chakraborty, Amit, Fine, Benjamin, Reicher, Joshua
Formato: research tables/charts Journal Article
Publicado: Elsevier B.V. Sep2020
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: Journal of the American College of Radiology
      issn: 15461440
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      dt: Sep2020
      vid: 17
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      pub: Elsevier B.V.
      place: New York, New York
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        145496860
        145496860
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        145496860
        10.1016/j.jacr.2020.03.012
        NLM32278847
        145496860
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        atl: Machine Learning for Automation of Radiology Protocols for Quality and Efficiency Improvement.
      aug:
        au:
          Kalra, Angad
          Chakraborty, Amit
          Fine, Benjamin
          Reicher, Joshua
        affil: Department of Computer Science, University of Toronto, Toronto, Ontario, Canada
      sug:
        subj:
          Automation
          Specialties, Medical
          Natural Language Processing
          Human
      ab: Purpose: The aim of this study was to enhance multispecialty CT and MRI protocol assignment quality and efficiency through development, testing, and proposed workflow design of a natural language processing (NLP)-based machine learning classifier.Methods: NLP-based machine learning classification models were developed using order entry input data and radiologist-assigned protocols from more than 18,000 unique CT and MRI examinations obtained during routine clinical use. k-Nearest neighbor, random forest, and deep neural network classification models were evaluated at baseline and after applying class frequency and confidence thresholding techniques. To simulate performance in real-world deployment, the model was evaluated in two operating modes in combination: automation (automated assignment of the top result) and clinical decision support (CDS; top-three protocol suggestion for clinical review). Finally, model-radiologist discordance was subjectively reviewed to guide explainability and safe use.Results: Baseline protocol assignment performance achieved weighted precision of 0.757 to 0.824. Simulating real-world deployment using combined thresholding techniques, the optimized deep neural network model assigned 69% of protocols in automation mode with 95% accuracy. In the remaining 31% of cases, the model achieved 92% accuracy in CDS mode. Analysis of discordance with subspecialty radiologist labels revealed both more and less appropriate model predictions.Conclusions: A multiclass NLP-based classification algorithm was designed to drive local operational improvement in CT and MR radiology protocol assignment at subspecialist quality. The results demonstrate a simulated workflow deployment enabling automated assignment of protocols in nearly 7 of 10 cases with very few errors combined with top-three CDS for remaining cases supporting a high-quality, efficient radiology workflow.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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