IEEE J Biomed Health Inform. 2021 Jun;25(6):2162-2171. doi: 10.1109/JBHI.2020.3027910. Epub 2021 Jun 3.
Traditionally, abnormal heart sound classification is framed as a three-stage process. The first stage involves segmenting the phonocardiogram to detect fundamental heart sounds; after which features are extracted and classification is performed. Some researchers in the field argue the segmentation step is an unwanted computational burden, whereas others embrace it as a prior step to feature extraction. When comparing accuracies achieved by studies that have segmented heart sounds before analysis with those who have overlooked that step, the question of whether to segment heart sounds before feature extraction is still open. In this study, we explicitly examine the importance of heart sound segmentation as a prior step for heart sound classification, and then seek to apply the obtained insights to propose a robust classifier for abnormal heart sound detection. Furthermore, recognizing the pressing need for explainable Artificial Intelligence (AI) models in the medical domain, we also unveil hidden representations learned by the classifier using model interpretation techniques. Experimental results demonstrate that the segmentation which can be learned by the model plays an essential role in abnormal heart sound classification. Our new classifier is also shown to be robust, stable and most importantly, explainable, with an accuracy of almost 100% on the widely used PhysioNet dataset.
传统上,异常心音分类被框定为一个三阶段的过程。第一阶段涉及分段心音图以检测基本心音;然后提取特征并进行分类。该领域的一些研究人员认为,分割步骤是不必要的计算负担,而另一些研究人员则将其视为特征提取的前置步骤。在比较已经在分析之前对心音进行分段的研究和忽略该步骤的研究所达到的准确性时,是否在心音特征提取之前对心音进行分段的问题仍然存在争议。在这项研究中,我们明确地检查了心音分段作为心音分类的前置步骤的重要性,然后寻求应用获得的见解来提出一种用于异常心音检测的鲁棒分类器。此外,认识到医学领域中对可解释人工智能 (AI) 模型的迫切需求,我们还使用模型解释技术揭示分类器学习的隐藏表示。实验结果表明,模型可以学习的分割在异常心音分类中起着至关重要的作用。我们的新分类器也表现出稳健性、稳定性,最重要的是可解释性,在广泛使用的 PhysioNet 数据集上的准确率几乎达到 100%。