Automated Assessment System for Neonatal Endotracheal Intubation Using Dilated Convolutional Neural Network.

Neonatal endotracheal intubation (ETI) is an important, complex resuscitation skill, which requires a significant amount of practice to master. Current ETI practice is conducted on the physical manikin and relies on the expert instructors' assessment. Since the training opportunities are limited by the availability of expert instructors, an automatic assessment model is highly desirable. However, automating ETI assessment is challenging due to the complexity of identifying crucial features, providing accurate evaluations and offering valuable feedback to trainees. In this paper, we propose a dilated Convolutional Neural Network (CNN) based ETI assessment model, which can automatically provide an overall score and performance feedback to pediatric trainees. The proposed assessment model takes the captured kinematic multivariate time-series (MTS) data from the manikin-based augmented ETI system that we developed, automatically extracts the crucial features of captured data, and eventually provides an overall score as output. Furthermore, the visualization based on the class activation mapping (CAM) can automatically identify the motions that have significant impact on the overall score, thus providing useful feedback to trainees. Our model can achieve 92.2% average classification accuracy using the Leave-One-Out-Cross-Validation (LOOCV).