团队合作：放射科医生和深度学习

There was a recent paper in Nature that detailed the prospects of radiologist cooperation with deep learning algorithms to analyze chest X-rays. The results and their implications are particularly interesting, and this is the topic I will expound upon in this article, providing additional interpretation and speculation.

最近在《 自然》杂志上发表了一篇论文 ，详细介绍了放射学家与深度学习算法合作分析胸部X射线的前景。 结果及其含义特别有趣，这是我将在本文中阐述的主题，提供了更多的解释和推测。

实验与结果 (The Experiment and Results)

In the experiment, a deep learning model, individual radiologists, and a group of radiologists connected with “swarm technology” were tasked to diagnose pneumonia from chest X-rays. Swarm technology sounds fancy, but it is essentially just a real-time collaborative software. It is designed to help a group of radiologists cooperate more effectively than by performing group votes for diagnoses, which is a method prone to unfavorable social influence.

在实验中，一个深度学习模型，个别放射线医师和一组与“群热技术”相关的放射线医师的任务是从胸部X射线诊断肺炎。 Swarm技术听起来很花哨，但实际上它只是一个实时协作软件。 它旨在通过与团体投票进行诊断相比，帮助一组放射科医生更有效地合作，这是一种易于受到不利的社会影响的方法。

The results were that the deep learning model (called CheXMax) performed the best on some metrics, while the swarm radiologists outperformed the model on other metrics. So, which one is better? The two perform best on different aspects of the task.

结果是，深度学习模型(称为CheXMax)在某些指标上表现最佳，而在其他指标上，群体放射科医生的表现优于该模型。 那么，哪个更好？ 两者在任务的不同方面表现最佳。

Indeed, the model had better sensitivity (more precise at detecting pneumonia if it does exist), and the swarm radiologists exhibited higher specificity (more precise when pneumonia does not exist). It follows from the model’s sensitivity that CheXMax tends to predict more low-confidence positives when the label is in fact negative. On the other hand, the swarm radiologists will be better at distinguishing those low-confidence positives since they more often err on high-confidence negatives.

实际上，该模型具有更好的灵敏度 (如果确实存在，则可以更精确地检测肺炎)，而群体放射科医生表现出更高的特异性 (当不存在肺炎时，则更为精确)。 从模型的敏感性可以得出，当标签实​​际上为阴性时，CheXMax倾向于预测更多的低置信度阳性。 另一方面，成群的放射线医师会更好地区分那些低置信度的阳性，因为它们更经常犯高置信度的阴性。

So the researchers performed another test. The model was used to initially diagnose all patients, then the swarm radiologists re-diagnosed the low-confidence positives. Remarkably, the swarm correctly changed the prediction label 10/11 times.

因此，研究人员进行了另一项测试。 该模型最初用于诊断所有患者，然后群体放射科医生重新诊断了低置信度阳性。 值得注意的是，该群体正确地将预测标签更改了10/11次。

含义 (The Implications)

And hence we have arrived at the optimal pneumonia-diagnosing apparatus: a deep learning model augmented by a group of radiologists for its low-confidence positive predictions.

因此，我们已经找到了最佳的肺炎诊断设备：一种由一群放射科医生为其低置信度阳性预测而增强的深度学习模型。

To be frank, the complementarity of the deep learning model and human diagnoses is probably a happy accident for the jobs of a great deal of radiologists as they are now. Not only does a single radiologist retain their use in a human-augmented deep learning system, but a group is also necessary to produce optimal predictions.

坦率地说，深度学习模型和人类诊断的互补性对于当今许多放射科医生的工作而言，可能是一件不幸的事。 不仅放射线医师会保留其在人类增强的深度学习系统中的用途，而且一组放射线医师对于产生最佳预测也必不可少。

Although the deep learning model will cut the total number of cases that radiologists must review by presenting only low-confidence positives, each case would require more radiologists if swarm technology it to be utilized. The authors suggest that for understaffed hospitals and clinics, a single radiologist augmenting the deep learning model is still better than none, but demand for more radiologists would nevertheless remain.

尽管深度学习模型将通过仅呈现低置信度的肯定值来减少放射科医生必须审查的病例总数，但如果要利用蜂群技术，每个病例都需要更多的放射科医生。 作者建议，对于人手不足的医院和诊所，增加深度学习模型的放射线医师总比没有放射线医师要好，但是仍然需要更多放射线医师。

That is the current state of affairs, but I have reason to believe that it may change. The authors mention that the data from the low-confidence positive corrections will be fed back into the model. Thus, with a continually expanding high-quality dataset, it is reasonable to suspect that the deep learning model will surpass the performance of the swarm radiologists in terms of both sensitivity and specificity in due time, without need for any architectural innovations or novel techniques.

那是目前的状况，但我有理由相信它可能会改变。 作者提到，低置信度正校正的数据将反馈到模型中。 因此，随着高质量数据集的不断扩展，有理由怀疑深度学习模型将在适当的时间方面在敏感性和特异性方面超过群体放射线医师的性能，而无需任何架构创新或新颖技术。

In this light, the human augmentation of deep learning models do not necessarily highlight weaknesses inherent within the models, but rather serve as a tool in compensating for our current shortage of medical data. As we continue to collect more data as we exercise the model in real-life trials, this condition of data shortage is apt to change, and so will the optimality of teamwork for diagnoses.

有鉴于此，人类对深度学习模型的扩充并不一定突出模型内部的弱点，而是可以作为弥补我们当前医学数据不足的一种工具。 随着我们在现实生活中试用该模型而继续收集更多数据时，这种数据短缺的状况容易发生变化，因此团队合作对诊断的最佳性也会随之改变。

Primary Source: Patel, B.N. et al. Human–machine partnership with artificial intelligence for chest radiograph diagnosis.

主要来源： Patel，BN 等。 人机合作与人工智能共同进行胸部X光片诊断。

翻译自: https://medium.com/swlh/teamwork-radiologists-and-deep-learning-c7c020563d4d