Key result
Novel global and local explainability methods revealed that EEG is globally the most important modality for most sleep stages, while local explanations captured subject-level differences obscured by global methods.
Why the study?
Explainability is vital for clinical classifiers, but deep learning on raw multimodal electrophysiology time-series data makes explainability difficult and few studies apply such methods.
Novel explainability methods for multimodal electrophysiology classifiers reveal subject-level differences and demographic effects, enhancing the interpretability of deep learning models for potential clinical implementation.
May enhance interpretability of multimodal sleep classifiers; leaves open prospective validation before clinical use.
Introduction: Multimodal classification is increasingly common in electrophysiology studies. Many studies use deep learning classifiers with raw time-series data, which makes explainability difficult, and has resulted in relatively few studies applying explainability methods. This is concerning because explainability is vital to the development and implementation of clinical classifiers. As such, new multimodal explainability methods are needed. Methods: In this study, we train a convolutional neural network for automated sleep stage classification with electroencephalogram (EEG), electrooculogram, and electromyogram data. We then present a global explainability approach that is uniquely adapted for electrophysiology analysis and compare it to an existing approach. We present the first two local multimodal explainability approaches. We look for subject-level differences in the local explanations that are obscured by global methods and look for relationships between the explanations and clinical and demographic variables in a novel analysis. Results: We find a high level of agreement between methods. We find that EEG is globally the most important modality for most sleep stages and that subject-level differences in importance arise in local explanations that are not captured in global explanations. We further show that sex, followed by medication and age, had significant effects upon the patterns learned by the classifier. Discussion: Our novel methods enhance explainability for the growing field of multimodal electrophysiology classification, provide avenues for the advancement of personalized medicine, yield unique insights into the effects of demographic and clinical variables upon classifiers, and help pave the way for the implementation of multimodal electrophysiology clinical classifiers.
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Ellis et al. (2023) studied Primary sleep onset insomnia (Sleep stage classification) (n=22). Novel multimodal explainability methods (global and local ablation, LRP) vs. Standard zero-out ablation was evaluated on Modality importance and classification performance. Novel global and local explainability methods revealed that EEG is globally the most important modality for most sleep stages, while local explanations captured subject-level differences obscured by global methods.
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