Publications by authors named "Benjamin D Solomon"

Purpose: Stargardt disease, also called ABCA4-related retinopathy (ABCA4R), is the most common form of juvenile-onset macular dystrophy and yet lacks an FDA approved treatment. Substantial progress has been made through landmark studies like that of the Progression of Atrophy Secondary to Stargardt Disease (ProgStar), but tasks like image segmentation and phenotyping still pose major challenges in terms of monitoring disease progression and categorizing patient subgroups. Furthermore, these methods are subjective and laborious.

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Background: Rare bone diseases (RBDs) are an important group of conditions characterized by abnormalities in bone and cartilage. Their large number, individual rarity, and heterogeneity make accurate and timely diagnosis challenging. Establishing correlations between genotype and phenotype (mainly via imaging) is critical for diagnosing RBDs.

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Artificial intelligence (AI) tools are increasingly employed in clinical genetics to assist in diagnosing genetic conditions by assessing photographs of patients. For medical uses of AI, explainable AI (XAI) methods offer a promising approach by providing interpretable outputs, such as saliency maps and region relevance visualizations. XAI has been discussed as important for regulatory purposes and to enable clinicians to better understand how AI tools work in practice.

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Unlike some health conditions that have been extensively delineated throughout the lifespan, many genetic conditions are largely described in pediatric populations, with a focus on early manifestations like congenital anomalies and developmental delay. An apparent gap exists in understanding clinical features and optimal management as patients age. Generative artificial intelligence is transforming biomedical disciplines including through the introduction of large language models (LLMs).

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Artificial intelligence (AI) is rapidly transforming numerous aspects of daily life, including clinical practice and biomedical research. In light of this rapid transformation, and in the context of medical genetics, we assembled a group of leaders in the field to respond to the question about how AI is affecting, and especially how AI will affect, medical genetics. The authors who contributed to this collection of essays intentionally represent different areas of expertise, career stages, and geographies, and include diverse types of clinicians, computer scientists, and researchers.

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Deep learning (DL) is increasingly used to analyze medical imaging, but is less refined for rare conditions, which require novel pre-processing and analytical approaches. To assess DL in the context of rare diseases, this study focused on alkaptonuria (AKU), a rare disorder that affects the spine and involves other sequelae; treatments include the medication nitisinone. Since assessing x-rays to determine disease severity can be a slow, manual process requiring considerable expertise, this study aimed to determine whether these DL methods could accurately identify overall spine severity at specific regions of the spine and whether patients were receiving nitisinone.

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Purpose: Artificial intelligence (AI) applications for clinical genetics hold the potential to improve patient care through supporting diagnostics and management as well as automating administrative tasks, thus enhancing and potentially enabling clinician/patient interactions. While the introduction of AI into clinical genetics is increasing, there remain unclear questions about risks and benefits, and the readiness of the workforce.

Methods: To assess the current clinical genetics workforce's use, knowledge, and attitudes toward available medical AI applications, we conducted a survey involving 215 US-based genetics clinicians and trainees.

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Most genetic conditions are described in pediatric populations, leaving a gap in understanding their clinical progression and management in adulthood. Motivated by other applications of large language models (LLMs), we evaluated whether Llama-2-70b-chat (70b) and GPT-3.5 (GPT) could generate plausible medical vignettes, patient-geneticist dialogues and management plans for a hypothetical child and adult patients across 282 genetic conditions (selected by prevalence and categorized based on age-related characteristics).

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Advances in genomics have redefined our understanding of thymic epithelial heterogeneity and architecture, yet signals driving thymic epithelial differentiation remain incompletely understood. Here, we elucidated pathways instructing human thymic epithelial cell development in the context of other anterior foregut-derived organs. Activation of interferon response gene regulatory networks distinguished epithelial cells of the thymus from those of other anterior foregut-derived organs.

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Deep learning (DL) is increasingly used to analyze medical imaging, but is less refined for rare conditions, which require novel pre-processing and analytical approaches. To assess DL in the context of rare diseases, we focused on alkaptonuria (AKU), a rare disorder that affects the spine and involves other sequelae; treatments include the medication nitisinone. Since assessing X-rays to determine disease severity can be a slow, manual process requiring considerable expertise, we aimed to determine whether our DL methods could accurately identify overall spine severity, severity at specific regions of the spine, and whether DL could detect whether patients were receiving nitisinone.

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The facial gestalt (overall facial morphology) is a characteristic clinical feature in many genetic disorders that is often essential for suspecting and establishing a specific diagnosis. Therefore, publishing images of individuals affected by pathogenic variants in disease-associated genes has been an important part of scientific communication. Furthermore, medical imaging data is also crucial for teaching and training deep-learning models such as GestaltMatcher.

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Artificial intelligence (AI) has been growing more powerful and accessible, and will increasingly impact many areas, including virtually all aspects of medicine and biomedical research. This review focuses on previous, current, and especially emerging applications of AI in clinical genetics. Topics covered include a brief explanation of different general categories of AI, including machine learning, deep learning, and generative AI.

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Article Synopsis
  • - The diagnosis of mast cell activation syndrome (MCAS) has risen, but while there are established consortium criteria, there are also alternative criteria that may not be as specific.
  • - Researchers used advanced language models to analyze diagnostic probabilities and found that alternative criteria led to broader and less precise diagnoses compared to the consortium criteria.
  • - The study concluded that alternative MCAS criteria result in a diverse range of diagnoses, making them less reliable and potentially leading to misclassifications when compared to established conditions like systemic lupus erythematosus.
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Large language models (LLMs) are generating interest in medical settings. For example, LLMs can respond coherently to medical queries by providing plausible differential diagnoses based on clinical notes. However, there are many questions to explore, such as evaluating differences between open- and closed-source LLMs as well as LLM performance on queries from both medical and non-medical users.

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  • DNA replication is crucial for cell division and maintaining genetic stability, with the RFC complex playing a key role by loading important proteins onto DNA.
  • While RFC1's involvement in certain disorders is recognized, the impact of RFC2-5 subunits, particularly RFC4, on human genetic diseases remains under-researched.
  • Our study identifies harmful variants in RFC4 linked to a new disorder marked by muscle weakness and hearing issues, showing how these variants disrupt RFC complex formation and ultimately affect DNA replication and cell cycle processes.
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Artificial intelligence (AI) is increasingly used in genomics research and practice, and generative AI has garnered significant recent attention. In clinical applications of generative AI, aspects of the underlying datasets can impact results, and confounders should be studied and mitigated. One example involves the facial expressions of people with genetic conditions.

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  • Dysmorphologists face challenges due to the diverse phenotypic variability of human faces, particularly when using Next-Generation Phenotyping (NGP) tools, which are often trained on limited data.
  • To address this, the GestaltMatcher Database (GMDB) was created, compiling over 10,980 facial images from various global populations, significantly improving the representation of underrepresented ancestries, especially African and Asian patients.
  • The study found that incorporating data from non-European patients enhanced NGP accuracy by over 11% without compromising performance for European patients, highlighting the importance of diverse datasets in identifying genetic disorders.
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Importance: The lack of standardized genetics training in pediatrics residencies, along with a shortage of medical geneticists, necessitates innovative educational approaches.

Objective: To compare pediatric resident recognition of Kabuki syndrome (KS) and Noonan syndrome (NS) after 1 of 4 educational interventions, including generative artificial intelligence (AI) methods.

Design, Setting, And Participants: This comparative effectiveness study used generative AI to create images of children with KS and NS.

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  • AI for facial diagnostics is being used in genetics clinics to identify potential genetic conditions, primarily through Deep Learning (DL) technologies, which show high accuracy for many disorders.
  • A study comparing eye-tracking of geneticists and non-clinicians revealed significant differences in how humans and DL models focus on images of individuals with genetic conditions, with notable discrepancies in visual attention patterns.
  • The findings suggest that better understanding of these differences can enhance the development and implementation of AI tools in clinical settings, fostering improved integration between clinicians and AI technologies.
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Artificial intelligence (AI) is used in an increasing number of areas, with recent interest in generative AI, such as using ChatGPT to generate programming code or DALL-E to make illustrations. We describe the use of generative AI in medical education. Specifically, we sought to determine whether generative AI could help train pediatric residents to better recognize genetic conditions.

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Article Synopsis
  • - Deep learning and AI are being applied in medical genetics, particularly for diagnosing potential genetic conditions using image evaluations.
  • - A study was conducted to compare how geneticist clinicians and non-clinicians visually assess these images, using eye-tracking analyses and DL-based saliency maps for comparison.
  • - Results indicated significant differences in visual attention between humans and the DL model, with clinicians and non-clinicians showing distinct patterns in their image inspection.
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Virtually all areas of biomedicine will be increasingly affected by applications of artificial intelligence (AI). We discuss how AI may affect fields of medical genetics, including both clinicians and laboratorians. In addition to reviewing the anticipated impact, we provide recommendations for ways in which these groups may want to evolve in light of the influence of AI.

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Article Synopsis
  • The significant phenotypic variability of human faces complicates the work of dysmorphologists by challenging Next-Generation Phenotyping (NGP) tools, especially when analyzing patients from diverse genetic backgrounds.
  • The research established the GestaltMatcher Database (GMDB), which includes over 10,000 facial images from patients with rare genetic disorders worldwide, striving to improve representation of underrepresented populations, particularly Asian and African patients.
  • The analysis showed that incorporating data from non-European patients enhanced the accuracy of NGP in diagnosing facial disorders without negatively affecting performance on European patients, emphasizing the need for more diverse datasets in medical genetics.
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