EEG-based outcome prediction after cardiac arrest with convolutional neural networks: Performance and visualization of discriminative features.
Details
Serval ID
serval:BIB_F826417D3644
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
EEG-based outcome prediction after cardiac arrest with convolutional neural networks: Performance and visualization of discriminative features.
Journal
Human brain mapping
ISSN
1097-0193 (Electronic)
ISSN-L
1065-9471
Publication state
Published
Issued date
01/11/2019
Peer-reviewed
Oui
Volume
40
Number
16
Pages
4606-4617
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
Prognostication for comatose patients after cardiac arrest is a difficult but essential task. Currently, visual interpretation of electroencephalogram (EEG) is one of the main modality used in outcome prediction. There is a growing interest in computer-assisted EEG interpretation, either to overcome the possible subjectivity of visual interpretation, or to identify complex features of the EEG signal. We used a one-dimensional convolutional neural network (CNN) to predict functional outcome based on 19-channel-EEG recorded from 267 adult comatose patients during targeted temperature management after CA. The area under the receiver operating characteristic curve (AUC) on the test set was 0.885. Interestingly, model architecture and fine-tuning only played a marginal role in classification performance. We then used gradient-weighted class activation mapping (Grad-CAM) as visualization technique to identify which EEG features were used by the network to classify an EEG epoch as favorable or unfavorable outcome, and also to understand failures of the network. Grad-CAM showed that the network relied on similar features than classical visual analysis for predicting unfavorable outcome (suppressed background, epileptiform transients). This study confirms that CNNs are promising models for EEG-based prognostication in comatose patients, and that Grad-CAM can provide explanation for the models' decision-making, which is of utmost importance for future use of deep learning models in a clinical setting.
Keywords
Aged, Aged, 80 and over, Brain Mapping, Coma/diagnosis, Coma/diagnostic imaging, Deep Learning, Electroencephalography, Epilepsy/diagnostic imaging, Epilepsy/physiopathology, Female, Heart Arrest/diagnosis, Heart Arrest/diagnostic imaging, Humans, Machine Learning, Magnetic Resonance Imaging, Male, Middle Aged, Neural Networks, Computer, Prognosis, Sleep, Treatment Outcome, coma, convolutional neural networks, deep-learning, electroencephalogram, grad-CAM, hypoxic ischemic encephalopathy, interpretability, prognostication
Pubmed
Web of science
Open Access
Yes
Create date
04/08/2019 15:09
Last modification date
27/04/2020 5:20