Reducing inference cost of Alzheimer’s disease identification using an uncertainty-aware ensemble of uni-modal and multi-modal learners
Bibliographic record
Abstract
While multi-modal deep learning approaches trained using magnetic resonance imaging (MRI) and fluorodeoxyglucose positron emission tomography (FDG PET) data have shown promise in the accurate identification of Alzheimer's disease, their clinical applicability is hindered by the assumption that both modalities are always available during model inference. In practice, clinicians adjust diagnostic tests based on available information and specific clinical contexts. We propose a novel MRI- and FDG PET-based multi-modal deep learning approach that mimics clinical decision-making by incorporating uncertainty estimates of an MRI-based model (generated using Monte Carlo dropout and evidential deep learning) to determine the necessity of an FDG PET scan, and only inputting the FDG PET to a multi-modal model when required. This approach significantly reduces the reliance on FDG PET scans, which are costly and expose patients to radiation. Our approach reduces the need for FDG PET by up to 92% without compromising model performance, thus optimizing resource use and patient safety. Furthermore, using a global model explanation technique, we provide insights into how anatomical changes in brain regions-such as the entorhinal cortex, amygdala, and ventricles-can positively or negatively influence the need for FDG PET scans in alignment with clinical understanding of Alzheimer's disease.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".