We introduce Kvasir-VQA, an extended dataset derived from the HyperKvasir and Kvasir-Instrument datasets, augmented with question- and-answer annotations to facilitate advanced machine learning tasks in Gastrointestinal (GI) diagnostics. This dataset comprises 6,500 annotated images spanning various GI tract conditions and surgical instruments, and it supports multiple question types including yes/no, choice, location, and numerical count. The dataset is intended for applications such as image captioning, Visual Question Answering (VQA), text-based generation of synthetic medical images, object detection, and classification. Our experiments demonstrate the dataset's effectiveness in training models for three selected tasks, showcasing significant applications in medical image analysis and diagnostics. We also present evaluation metrics for each task, highlighting the usability and versatility of our dataset. The dataset and supporting artifacts are available at https://datasets.simula.no/kvasir-vqa.

Meibomian gland dysfunction is the most common cause of dry eye disease and leads to significantly reduced quality of life and social burdens. Because meibomian gland dysfunction results in impaired function of the tear film lipid layer, studying the expression of tear proteins might increase the understanding of the etiology of the condition. Machine learning is able to detect patterns in complex data. This study applied machine learning to classify levels of meibomian gland dysfunction from tear proteins. The aim was to investigate proteomic changes between groups with different severity levels of meibomian gland dysfunction, as opposed to only separating patients with and without this condition. An established feature importance method was used to identify the most important proteins for the resulting models. Moreover, a new method that can take the uncertainty of the models into account when creating explanations was proposed. By examining the identified proteins, potential biomarkers for meibomian gland dysfunction were discovered. The overall findings are largely confirmatory, indicating that the presented machine learning approaches are promising for detecting clinically relevant proteins. While this study provides valuable insights into proteomic changes associated with varying severity levels of meibomian gland dysfunction, it should be noted that it was conducted without a healthy control group. Future research could benefit from including such a comparison to further validate and extend the findings presented here.

Deep neural networks are complex machine learning models that have shown promising results in analyzing high-dimensional data such as those collected from medical examinations. Such models have the potential to provide fast and accurate medical diagnoses. However, the high complexity makes deep neural networks and their predictions difficult to understand. Providing model explanations can be a way of increasing the understanding of “black box” models and building trust. In this work, we applied transfer learning to develop a deep neural network to predict sex from electrocardiograms. Using the visual explanation method Grad-CAM, heat maps were generated from the model in order to understand how it makes predictions. To evaluate the usefulness of the heat maps and determine if the heat maps identified electrocardiogram features that could be recognized to discriminate sex, medical doctors provided feedback. Based on the feedback, we concluded that, in our setting, this mode of explainable artificial intelligence does not provide meaningful information to medical doctors and is not useful in the clinic. Our results indicate that improved explanation techniques that are tailored to medical data should be developed before deep neural networks can be applied in the clinic for diagnostic purposes.

Objective: Evaluate popular explanation methods using heatmap visualizations to explain the predictions of deep neural networks for electrocardiogram (ECG) analysis and provide recommendations for selection of explanations methods. Materials and Methods: A residual deep neural network was trained on ECGs to predict intervals and amplitudes. Nine commonly used explanation methods (Saliency, Deconvolution, Guided backpropagation, Gradient SHAP, SmoothGrad, Input × gradient, DeepLIFT, Integrated gradients, GradCAM) were qualitatively evaluated by medical experts and objectively evaluated using a perturbation-based method. Results: No single explanation method consistently outperformed the other methods, but some methods were clearly inferior. We found considerable disagreement between the human expert evaluation and the objective evaluation by perturbation. Discussion: The best explanation method depended on the ECG measure. To ensure that future explanations of deep neural networks for medical data analyses are useful to medical experts, data scientists developing new explanation methods should collaborate tightly with domain experts. Because there is no explanation method that performs best in all use cases, several methods should be applied. Conclusion: Several explanation methods should be used to determine the most suitable approach.

Deep learning has achieved immense success in computer vision and has the potential to help physicians analyze visual content for disease and other abnormalities. However, the current state of deep learning is very much a black box, making medical professionals skeptical about integrating these methods into clinical practice. Several methods have been proposed to shed some light on these black boxes, but there is no consensus on the opinion of medical doctors that will consume these explanations. This paper presents a study asking medical professionals about their opinion of current state-of-the-art explainable artificial intelligence methods when applied to a gastrointestinal disease detection use case. We compare two different categories of explanation methods, intrinsic and extrinsic, and gauge their opinion of the current value of these explanations. The results indicate that intrinsic explanations are preferred and that physicians see value in the explanations. Based on the feedback collected in our study, future explanations of medical deep neural networks can be tailored to the needs and expectations of doctors. Hopefully, this will contribute to solving the issue of black box medical systems and lead to successful implementation of this powerful technology in the clinic.