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Advancing Machine Learning for Precision Medicine and AI-Driven Clinical Decision Support for Bladder Cancer Treatment Response Assessment and Survival Prediction
Advancing Machine Learning for Precision Medicine and AI-Driven Clinical Decision Support ...
Advancing Machine Learning for Precision Medicine and AI-Driven Clinical Decision Support for Bladder Cancer Treatment Response Assessment and Survival Prediction

상세정보

자료유형  
 학위논문 서양
최종처리일시  
20260202105233
ISBN  
9798291567494
DDC  
004
저자명  
Sun, Di.
서명/저자  
Advancing Machine Learning for Precision Medicine and AI-Driven Clinical Decision Support for Bladder Cancer Treatment Response Assessment and Survival Prediction
발행사항  
[Sl] : University of Michigan, 2025
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2025
형태사항  
168 p
주기사항  
Source: Dissertations Abstracts International, Volume: 87-02, Section: B.
주기사항  
Advisor: Hadjiyski, Lubomir M.;Matuszak, Martha M.
학위논문주기  
Thesis (Ph.D.)--University of Michigan, 2025.
초록/해제  
요약Bladder cancer is a common and clinically challenging malignancy with a substantial impact on global health, making it crucial to develop advanced methodologies for diagnosis, prognosis, and treatment planning. This dissertation explores the application of advanced machine learning (ML) and artificial intelligence (AI) techniques to improve clinical decision-making, enhance assessment of treatment response, and predict patient outcomes for bladder cancer. The research developed and evaluated several AI-driven models, focusing on integrating multi-modal data sources, including imaging, clinical, and genomic information, to build predictive tools that can guide personalized treatment strategies.A key contribution of this work was the development of a deep-learning convolutional neural network model combined with radiomics features from CT urography, demonstrating the potential of AI in assessing bladder cancer treatment response to neoadjuvant chemotherapy. This model achieved an area under the receiver operating characteristic curve (AUC) of 0.77-0.80, highlighting its feasibility and potential for clinical implementation.Additionally, the dissertation introduced a multi-modal model (termed CRD) for five-year survival prediction of bladder cancer patients post-cystectomy. This model, which integrated clinical, radiomics, and deep-learning features, achieved an AUC of 0.87, demonstrating the importance of combining diverse data sources for more accurate survival predictions. An enhanced CRD model was proposed by incorporating large language models (LLMs) into the modeling to improve efficiency by automating clinical information extraction from unstructured electronic medical records. The results showed the LLM-assisted model achieved survival prediction AUCs comparable to those based on manually curated data, emphasizing the potential of LLMs to automate clinical data extraction. LLM reliability and its impact on downstream prediction model were further investigated. The results showed GPT-4 and Llama held outstanding consistency in information retrieval for predictive modeling.Furthermore, an observer study was conducted and its result demonstrated that AI-based decision support systems (CDSS-T) significantly improved diagnostic accuracy of 17 clinicians when assessing bladder cancer treatment response. The use of AI tools to assist in clinical decision-making resulted in a notable increase in diagnostic performance, with AUC improving from 0.73 to 0.77 (p = 0.002). These findings highlight the practical benefits of integrating AI into clinical practice, suggesting that AI can complement and enhance clinician expertise, particularly in complex diagnostic scenarios.The dissertation also explored methods for confidence estimation of AI outputs and examined the influence of case complexity and physician characteristics on AI-assisted assessments. This is crucial for providing the user with an estimate of the trustworthiness of AI output, allowing the user to properly weight the AI recommendation with their own assessment, thus maximizing the benefits of AI-assisted decision-making.In conclusion, this work advances the integration of AI and ML in bladder cancer prognosis and treatment response assessment. By developing robust predictive models, evaluating AI in a pre-clinical multi-institutional observer study, and investigating the reliability and trustworthiness of ML models, this research underscores the transformative potential of AI in improving patient care. Future research will focus on integrating multi-institutional data to enhance model generalizability, developing longitudinal models to track disease progression, and conducting prospective study of the impact of AI tools in clinical settings. Ethical considerations and human-AI collaboration will be essential to ensure AI supports, rather than replaces, clinician judgment. This dissertation contributes to integrating AI into clinical workflows for more personalized, accurate, and timely interventions to improve outcomes for bladder cancer patients worldwide.
일반주제명  
Computer science
일반주제명  
Medical imaging
일반주제명  
Oncology
일반주제명  
Biomedical engineering
키워드  
Bladder cancer
키워드  
Radiology
키워드  
Computer vision
키워드  
Artificial intelligence
키워드  
Large language models
기타저자  
University of Michigan Nuclear Engineering & Radiological Sciences
기본자료저록  
Dissertations Abstracts International. 87-02B.
전자적 위치 및 접속  
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MARC

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■24510▼aAdvancing  Machine  Learning  for  Precision  Medicine  and  AI-Driven  Clinical  Decision  Support  for  Bladder  Cancer  Treatment  Response  Assessment  and  Survival  Prediction
■260    ▼a[Sl]▼bUniversity  of  Michigan▼c2025
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2025
■300    ▼a168  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  87-02,  Section:  B.
■500    ▼aAdvisor:  Hadjiyski,  Lubomir  M.;Matuszak,  Martha  M.
■5021  ▼aThesis  (Ph.D.)--University  of  Michigan,  2025.
■520    ▼aBladder  cancer  is  a  common  and  clinically  challenging  malignancy  with  a  substantial  impact  on  global  health,  making  it  crucial  to  develop  advanced  methodologies  for  diagnosis,  prognosis,  and  treatment  planning.  This  dissertation  explores  the  application  of  advanced  machine  learning  (ML)  and  artificial  intelligence  (AI)  techniques  to  improve  clinical  decision-making,  enhance  assessment  of  treatment  response,  and  predict  patient  outcomes  for  bladder  cancer.  The  research  developed  and  evaluated  several  AI-driven  models,  focusing  on  integrating  multi-modal  data  sources,  including  imaging,  clinical,  and  genomic  information,  to  build  predictive  tools  that  can  guide  personalized  treatment  strategies.A  key  contribution  of  this  work  was  the  development  of  a  deep-learning  convolutional  neural  network  model  combined  with  radiomics  features  from  CT  urography,  demonstrating  the  potential  of  AI  in  assessing  bladder  cancer  treatment  response  to  neoadjuvant  chemotherapy.  This  model  achieved  an  area  under  the  receiver  operating  characteristic  curve  (AUC)  of  0.77-0.80,  highlighting  its  feasibility  and  potential  for  clinical  implementation.Additionally,  the  dissertation  introduced  a  multi-modal  model  (termed  CRD)  for  five-year  survival  prediction  of  bladder  cancer  patients  post-cystectomy.  This  model,  which  integrated  clinical,  radiomics,  and  deep-learning  features,  achieved  an  AUC  of  0.87,  demonstrating  the  importance  of  combining  diverse  data  sources  for  more  accurate  survival  predictions.  An  enhanced  CRD  model  was  proposed  by  incorporating  large  language  models  (LLMs)  into  the  modeling  to  improve  efficiency  by  automating  clinical  information  extraction  from  unstructured  electronic  medical  records.  The  results  showed  the  LLM-assisted  model  achieved  survival  prediction  AUCs  comparable  to  those  based  on  manually  curated  data,  emphasizing  the  potential  of  LLMs  to  automate  clinical  data  extraction.  LLM  reliability  and  its  impact  on  downstream  prediction  model  were  further  investigated.  The  results  showed  GPT-4  and  Llama  held  outstanding  consistency  in  information  retrieval  for  predictive  modeling.Furthermore,  an  observer  study  was  conducted  and  its  result  demonstrated  that  AI-based  decision  support  systems  (CDSS-T)  significantly  improved  diagnostic  accuracy  of  17  clinicians  when  assessing  bladder  cancer  treatment  response.  The  use  of  AI  tools  to  assist  in  clinical  decision-making  resulted  in  a  notable  increase  in  diagnostic  performance,  with  AUC  improving  from  0.73  to  0.77  (p  =  0.002).  These  findings  highlight  the  practical  benefits  of  integrating  AI  into  clinical  practice,  suggesting  that  AI  can  complement  and  enhance  clinician  expertise,  particularly  in  complex  diagnostic  scenarios.The  dissertation  also  explored  methods  for  confidence  estimation  of  AI  outputs  and  examined  the  influence  of  case  complexity  and  physician  characteristics  on  AI-assisted  assessments.  This  is  crucial  for  providing  the  user  with  an  estimate  of  the  trustworthiness  of  AI  output,  allowing  the  user  to  properly  weight  the  AI  recommendation  with  their  own  assessment,  thus  maximizing  the  benefits  of  AI-assisted  decision-making.In  conclusion,  this  work  advances  the  integration  of  AI  and  ML  in  bladder  cancer  prognosis  and  treatment  response  assessment.  By  developing  robust  predictive  models,  evaluating  AI  in  a  pre-clinical  multi-institutional  observer  study,  and  investigating  the  reliability  and  trustworthiness  of  ML  models,  this  research  underscores  the  transformative  potential  of  AI  in  improving  patient  care.  Future  research  will  focus  on  integrating  multi-institutional  data  to  enhance  model  generalizability,  developing  longitudinal  models  to  track  disease  progression,  and  conducting  prospective  study  of  the  impact  of  AI  tools  in  clinical  settings.  Ethical  considerations  and  human-AI  collaboration  will  be  essential  to  ensure  AI  supports,  rather  than  replaces,  clinician  judgment.  This  dissertation  contributes  to  integrating  AI  into  clinical  workflows  for  more  personalized,  accurate,  and  timely  interventions  to  improve  outcomes  for  bladder  cancer  patients  worldwide.
■590    ▼aSchool  code:  0127.
■650  4▼aComputer  science
■650  4▼aMedical  imaging
■650  4▼aOncology
■650  4▼aBiomedical  engineering
■653    ▼aBladder  cancer
■653    ▼aRadiology
■653    ▼aComputer  vision
■653    ▼aArtificial  intelligence
■653    ▼aLarge  language  models
■690    ▼a0574
■690    ▼a0984
■690    ▼a0992
■690    ▼a0541
■71020▼aUniversity  of  Michigan▼bNuclear  Engineering  &  Radiological  Sciences.
■7730  ▼tDissertations  Abstracts  International▼g87-02B.
■790    ▼a0127
■791    ▼aPh.D.
■792    ▼a2025
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17359899▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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