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Papers by DR. MOHAMMED SAADAT KHALEEL

IEEE Journal of Biomedical and Health Informatics, 2022

During the past decades, many automated image analysis methods have been developed for colonoscop... more During the past decades, many automated image analysis methods have been developed for colonoscopy. Real-time implementation of the most promising methods during colonoscopy has been tested in clinical trials, including several recent multi-center studies. All trials have shown results that may contribute to prevention of colorectal cancer. We summarize the past and present development of colonoscopy video analysis methods, focusing on two categories of artificial intelligence (AI) technologies used in clinical trials. These are (1) analysis and feedback for improving colonoscopy quality and (2) detection of abnormalities. Our survey includes methods that use traditional machine learning algorithms on carefully designed hand-crafted features as well as recent deep-learning methods. Lastly, we present the gap between current state-of-the-art technology and desirable clinical features and conclude with future directions of endoscopic AI technology development that will bridge the current gap.

Recent advances in deep neural networks have achieved outstanding success in natural language pro... more Recent advances in deep neural networks have achieved outstanding success in natural language processing. Due to the success and the black-box nature of the deep models, interpretation methods that provide insight into the decision-making process of the models have received an influx of research attention. However, there is no quantitative evaluation comparing interpretation methods for text classification other than observing classification accuracy or prediction confidence when important word grams are removed. This is due to the lack of interpretation ground truth. Manual labeling of a large interpretation ground truth is time-consuming. We propose IDC, a new benchmark for quantitative evaluation of I nterpretation methods for D eep text C lassification models. IDC consists of three methods that take existing text classification ground truth and generate three corresponding pseudo-interpretation ground truth datasets. We propose to use interpretation recall, interpretation precis...

The variance in number and types of tasks required to be implemented within Distributed Virtual E... more The variance in number and types of tasks required to be implemented within Distributed Virtual Environments (DVE) highlights the needs for communication protocols can achieve consistency. In addition, these applications have to handle an increasing number of participants and deal with the difficult problem of scalability. Moreover, the real-time requirements of these applications make the scalability problem more difficult to solve. In this paper, we have implemented Updatable Queue Abstraction protocol (UQA) on TCP (TCP-UQA) and compared it with original TCP, UDP, and Updatable Queue Abstraction based on UDP (UDP-UQA) protocols. Results showed that TCP-UQA was the best in queue management.

Spine, 2014

Study Design/Setting-SPORT subgroup analysis Objective-To evaluate the effect of extreme obesity ... more Study Design/Setting-SPORT subgroup analysis Objective-To evaluate the effect of extreme obesity on management of lumbar spinal stenosis (SpS), degenerative spondylolisthesis (DS), and intervertebral disc herniation (IDH) Summary of Background Data-Prior SPORT analyses compared nonobese and obese. This study compares nonobese to class I obesity and class II/III extreme obesity. Methods-For SpS, 250/634 nonobese, 104/167 obese, and 59/94 extremely obese patients underwent surgery. For DS, 233/376 nonobese, 90/129 obese, and 66/96 extremely obese patients had surgery. For IDH, 542/854 nonobese, 151/207 obese, 94/129 extremely obese patients had surgery. Outcomes included SF-36, Oswestry Disability Index, Stenosis/Sciatica Bothersomeness Index, Low Back Pain Bothersomeness Index, operative events, complications, and reoperations. Results-Extremely obese patients had increased comorbidities. Baseline SF-36 physical function scores were lower for obese; lowest for extremely obese. For SpS, surgical treatment effect and operative events among groups were not significantly different. For DS, 4-year SF-36 physical function scores had greatest treatment effect in extremely obese. This observation was found in most primary outcome measures, and is attributable to the significantly poorer nonoperative outcomes. Operative times and wound infection rates were greatest for the extremely obese. Additional surgery at 3 and 4 years was higher in both obese cohorts.

Current Orthopaedic Practice, 2010

ABSTRACT Current research on total joint arthroplasty has identified psychological distress as a ... more ABSTRACT Current research on total joint arthroplasty has identified psychological distress as a predictor of poor treatment out-comes. Most recent studies on total knee or hip arthroplasty that include psychological variables have found that preoperative indicators of ...

Current Orthopaedic Practice, 2010

Total joint arthroplasty is one of the most successful and cost-effective treatments for end-stag... more Total joint arthroplasty is one of the most successful and cost-effective treatments for end-stage arthritis. Understanding the disparity of outcomes associated with total knee and hip arthroplasty is crucial in the treatment of arthritis. Disparity in health care occurs in a variety of ...

The Spine Journal, 2008

BACKGROUND: A growing population of patients with osteoporosis and fragility fractures has develo... more BACKGROUND: A growing population of patients with osteoporosis and fragility fractures has developed. Fragility fractures, including vertebral compression fractures, have been associated with increased mortality. Early operative interventions for patients sustaining hip fractures have been found to reduce mortality. PURPOSE: To determine if kyphoplasty improves survival after vertebral compression fractures. STUDY DESIGN: A retrospective chart review of all kyphoplasty procedures performed by the same orthopedic surgeon between June 2000 and June 2004 and a review of patients receiving nonoperative care consisting of oral analgesia and an orthosis during the same time period were conducted. PATIENT SAMPLE: Patients seen by a single surgeon for an osteoporotic vertebral body fracture. OUTCOME MEASURES: The primary outcome measured was patient death within the study time period. METHODS: Data from both groups were tabulated and analyzed for statistical differences by Student t test and chi-squared analysis. Kaplan-Meier curves comparing age, medical comorbidity, and surgical intervention were constructed. Log-rank test was used to analyze the survival curves. RESULTS: Of the 94 patients who elected for kyphoplasty, 38 patients were deceased at the close of the current study which ended in September 2006, whereas 26 of the 90 patients who elected for conservative therapy had died. Student t test revealed a significant age difference between patients treated with kyphoplasty and those who were treated nonoperatively (p5.0002). Chi-squared analysis revealed a significant difference between the two populations with respect to Charlson score (p5.050) but no statistical difference between the two populations with respect to ASA (p5.81) or gender (p5.1207). Kaplan-Meier curves were constructed to independently assess the influence of age, medical comorbidity, and kyphoplasty on survival. A significant relationship was detected by log-rank test for age (p5.0172), ASA (p5.0497), and Charlson score (p5.0015) but not treatment with kyphoplasty (p5.1037). An age-adjusted mortality rate was calculated and was found to be 35.3 per 1,000 patient-years for the conservative treatment population and 40.1 for the surgical population. A multivariate analysis comparing age, comorbidity, and surgical treatment with survival did not detect a statistical relationship. CONCLUSION: Kyphoplasty did not seem to effect the survival of patients with a vertebral compression fracture.

Journal of Bone and Joint Surgery, 2012

Background: Factors other than surgical technique and implants impact patient outcomes following ... more Background: Factors other than surgical technique and implants impact patient outcomes following a total knee arthroplasty. The purpose of this study was to analyze the effects of psychopathology on the rate of improvement following total knee arthroplasty in an indigent population. Methods: One hundred and fifty-four consecutive indigent patients undergoing a primary total knee arthroplasty for arthritis were enrolled and available for follow-up. Patients were classified as having psychopathology on the basis of the presence of somatization, depression, and/or a panic or anxiety disorder as assessed with the Patient Health Questionnaire. Outcome measures were completed preoperatively and one year postoperatively. Univariate analyses, controlled for sex and age, were used to compare the rates of improvement in patients who exhibited psychopathology with the rates in those without psychopathology. Results: Fifty-four patients (35%) were diagnosed with at least one Axis-I psychological disorder. The psychopathology group showed significantly lower Short Form-36 mental component summary scores both at baseline and one year postoperatively (p < 0.001 for both). The psychopathology group also reported significantly higher levels of perceived disability at baseline on the Pain Disability Questionnaire (p < 0.001) and worse scores on the Western Ontario and McMaster Universities Osteoarthritis Index (p = 0.004); however, the improvement on both of these scales did not differ significantly between the two groups (p > 0.05). The Knee Society Score differed significantly between the two groups at both baseline and the one-year follow-up evaluation (p = 0.003 and p = 0.001, respectively), but there was no significant difference in the total rate of improvement between the two comparison groups (p > 0.05). Conclusions: Not only is there a high prevalence of psychopathology in the indigent population, but psychopathology may result in lower patient-perceived outcome scores at one year after a total knee arthroplasty. Even though outcome scores may be worse for patients with psychopathology, our study showed that these patients still benefit, with the same degree of improvement in function.

The Journal of Arthroplasty, 2011

Anesthesiology Clinics, 2007

Vertebral compression fractures occur more frequently than hip and ankle fractures combined. Thes... more Vertebral compression fractures occur more frequently than hip and ankle fractures combined. These fragility fractures frequently result in both acute and chronic pain, but more importantly are a source of increased morbidity and possibly mortality. Percutaneous veretebral augmentation offers a minimally invasive approach for the treatment of vertebral compression fractures. The history, technique, and results of vertebroplasty and kyphoplasty are reviewed. Both methods allow for the introduction of bone cement into the fracture site with clinical results indicating substantial pain relief in approximately 90% of patients.

IEEE Journal of Biomedical and Health Informatics, 2022

During the past decades, many automated image analysis methods have been developed for colonoscop... more During the past decades, many automated image analysis methods have been developed for colonoscopy. Real-time implementation of the most promising methods during colonoscopy has been tested in clinical trials, including several recent multi-center studies. All trials have shown results that may contribute to prevention of colorectal cancer. We summarize the past and present development of colonoscopy video analysis methods, focusing on two categories of artificial intelligence (AI) technologies used in clinical trials. These are (1) analysis and feedback for improving colonoscopy quality and (2) detection of abnormalities. Our survey includes methods that use traditional machine learning algorithms on carefully designed hand-crafted features as well as recent deep-learning methods. Lastly, we present the gap between current state-of-the-art technology and desirable clinical features and conclude with future directions of endoscopic AI technology development that will bridge the current gap.

Recent advances in deep neural networks have achieved outstanding success in natural language pro... more Recent advances in deep neural networks have achieved outstanding success in natural language processing. Due to the success and the black-box nature of the deep models, interpretation methods that provide insight into the decision-making process of the models have received an influx of research attention. However, there is no quantitative evaluation comparing interpretation methods for text classification other than observing classification accuracy or prediction confidence when important word grams are removed. This is due to the lack of interpretation ground truth. Manual labeling of a large interpretation ground truth is time-consuming. We propose IDC, a new benchmark for quantitative evaluation of I nterpretation methods for D eep text C lassification models. IDC consists of three methods that take existing text classification ground truth and generate three corresponding pseudo-interpretation ground truth datasets. We propose to use interpretation recall, interpretation precis...

The variance in number and types of tasks required to be implemented within Distributed Virtual E... more The variance in number and types of tasks required to be implemented within Distributed Virtual Environments (DVE) highlights the needs for communication protocols can achieve consistency. In addition, these applications have to handle an increasing number of participants and deal with the difficult problem of scalability. Moreover, the real-time requirements of these applications make the scalability problem more difficult to solve. In this paper, we have implemented Updatable Queue Abstraction protocol (UQA) on TCP (TCP-UQA) and compared it with original TCP, UDP, and Updatable Queue Abstraction based on UDP (UDP-UQA) protocols. Results showed that TCP-UQA was the best in queue management.

Spine, 2014

Study Design/Setting-SPORT subgroup analysis Objective-To evaluate the effect of extreme obesity ... more Study Design/Setting-SPORT subgroup analysis Objective-To evaluate the effect of extreme obesity on management of lumbar spinal stenosis (SpS), degenerative spondylolisthesis (DS), and intervertebral disc herniation (IDH) Summary of Background Data-Prior SPORT analyses compared nonobese and obese. This study compares nonobese to class I obesity and class II/III extreme obesity. Methods-For SpS, 250/634 nonobese, 104/167 obese, and 59/94 extremely obese patients underwent surgery. For DS, 233/376 nonobese, 90/129 obese, and 66/96 extremely obese patients had surgery. For IDH, 542/854 nonobese, 151/207 obese, 94/129 extremely obese patients had surgery. Outcomes included SF-36, Oswestry Disability Index, Stenosis/Sciatica Bothersomeness Index, Low Back Pain Bothersomeness Index, operative events, complications, and reoperations. Results-Extremely obese patients had increased comorbidities. Baseline SF-36 physical function scores were lower for obese; lowest for extremely obese. For SpS, surgical treatment effect and operative events among groups were not significantly different. For DS, 4-year SF-36 physical function scores had greatest treatment effect in extremely obese. This observation was found in most primary outcome measures, and is attributable to the significantly poorer nonoperative outcomes. Operative times and wound infection rates were greatest for the extremely obese. Additional surgery at 3 and 4 years was higher in both obese cohorts.

Current Orthopaedic Practice, 2010

ABSTRACT Current research on total joint arthroplasty has identified psychological distress as a ... more ABSTRACT Current research on total joint arthroplasty has identified psychological distress as a predictor of poor treatment out-comes. Most recent studies on total knee or hip arthroplasty that include psychological variables have found that preoperative indicators of ...

Current Orthopaedic Practice, 2010

Total joint arthroplasty is one of the most successful and cost-effective treatments for end-stag... more Total joint arthroplasty is one of the most successful and cost-effective treatments for end-stage arthritis. Understanding the disparity of outcomes associated with total knee and hip arthroplasty is crucial in the treatment of arthritis. Disparity in health care occurs in a variety of ...

The Spine Journal, 2008

BACKGROUND: A growing population of patients with osteoporosis and fragility fractures has develo... more BACKGROUND: A growing population of patients with osteoporosis and fragility fractures has developed. Fragility fractures, including vertebral compression fractures, have been associated with increased mortality. Early operative interventions for patients sustaining hip fractures have been found to reduce mortality. PURPOSE: To determine if kyphoplasty improves survival after vertebral compression fractures. STUDY DESIGN: A retrospective chart review of all kyphoplasty procedures performed by the same orthopedic surgeon between June 2000 and June 2004 and a review of patients receiving nonoperative care consisting of oral analgesia and an orthosis during the same time period were conducted. PATIENT SAMPLE: Patients seen by a single surgeon for an osteoporotic vertebral body fracture. OUTCOME MEASURES: The primary outcome measured was patient death within the study time period. METHODS: Data from both groups were tabulated and analyzed for statistical differences by Student t test and chi-squared analysis. Kaplan-Meier curves comparing age, medical comorbidity, and surgical intervention were constructed. Log-rank test was used to analyze the survival curves. RESULTS: Of the 94 patients who elected for kyphoplasty, 38 patients were deceased at the close of the current study which ended in September 2006, whereas 26 of the 90 patients who elected for conservative therapy had died. Student t test revealed a significant age difference between patients treated with kyphoplasty and those who were treated nonoperatively (p5.0002). Chi-squared analysis revealed a significant difference between the two populations with respect to Charlson score (p5.050) but no statistical difference between the two populations with respect to ASA (p5.81) or gender (p5.1207). Kaplan-Meier curves were constructed to independently assess the influence of age, medical comorbidity, and kyphoplasty on survival. A significant relationship was detected by log-rank test for age (p5.0172), ASA (p5.0497), and Charlson score (p5.0015) but not treatment with kyphoplasty (p5.1037). An age-adjusted mortality rate was calculated and was found to be 35.3 per 1,000 patient-years for the conservative treatment population and 40.1 for the surgical population. A multivariate analysis comparing age, comorbidity, and surgical treatment with survival did not detect a statistical relationship. CONCLUSION: Kyphoplasty did not seem to effect the survival of patients with a vertebral compression fracture.

Journal of Bone and Joint Surgery, 2012

Background: Factors other than surgical technique and implants impact patient outcomes following ... more Background: Factors other than surgical technique and implants impact patient outcomes following a total knee arthroplasty. The purpose of this study was to analyze the effects of psychopathology on the rate of improvement following total knee arthroplasty in an indigent population. Methods: One hundred and fifty-four consecutive indigent patients undergoing a primary total knee arthroplasty for arthritis were enrolled and available for follow-up. Patients were classified as having psychopathology on the basis of the presence of somatization, depression, and/or a panic or anxiety disorder as assessed with the Patient Health Questionnaire. Outcome measures were completed preoperatively and one year postoperatively. Univariate analyses, controlled for sex and age, were used to compare the rates of improvement in patients who exhibited psychopathology with the rates in those without psychopathology. Results: Fifty-four patients (35%) were diagnosed with at least one Axis-I psychological disorder. The psychopathology group showed significantly lower Short Form-36 mental component summary scores both at baseline and one year postoperatively (p < 0.001 for both). The psychopathology group also reported significantly higher levels of perceived disability at baseline on the Pain Disability Questionnaire (p < 0.001) and worse scores on the Western Ontario and McMaster Universities Osteoarthritis Index (p = 0.004); however, the improvement on both of these scales did not differ significantly between the two groups (p > 0.05). The Knee Society Score differed significantly between the two groups at both baseline and the one-year follow-up evaluation (p = 0.003 and p = 0.001, respectively), but there was no significant difference in the total rate of improvement between the two comparison groups (p > 0.05). Conclusions: Not only is there a high prevalence of psychopathology in the indigent population, but psychopathology may result in lower patient-perceived outcome scores at one year after a total knee arthroplasty. Even though outcome scores may be worse for patients with psychopathology, our study showed that these patients still benefit, with the same degree of improvement in function.

The Journal of Arthroplasty, 2011

Anesthesiology Clinics, 2007

Vertebral compression fractures occur more frequently than hip and ankle fractures combined. Thes... more Vertebral compression fractures occur more frequently than hip and ankle fractures combined. These fragility fractures frequently result in both acute and chronic pain, but more importantly are a source of increased morbidity and possibly mortality. Percutaneous veretebral augmentation offers a minimally invasive approach for the treatment of vertebral compression fractures. The history, technique, and results of vertebroplasty and kyphoplasty are reviewed. Both methods allow for the introduction of bone cement into the fracture site with clinical results indicating substantial pain relief in approximately 90% of patients.