DeepStroke: An Efficient Stroke Screening Framework for Emergency Rooms with Multimodal Adversarial Deep Learning.

In an emergency room (ER) setting, the diagnosis of stroke is a common challenge. Due to excessive execution time and cost, an MRI scan is usually not available in the ER. Clinical tests are commonly referred to in stroke screening, but neurologists may not be immediately available. We propose a novel multimodal deep learning framework, DeepStroke, to achieve computer-aided stroke presence assessment by recognizing the patterns of facial motion incoordination and speech inability for patients with suspicion of stroke in an acute setting. Our proposed DeepStroke takes video data for local facial paralysis detection and audio data for global speech disorder analysis. It further leverages a multi-modal lateral fusion to combine the low- and high-level features and provides mutual regularization for joint training. A novel adversarial training loss is also introduced to obtain identity-independent and stroke-discriminative features. Experiments on our video-audio dataset with actual ER patients show that the proposed approach outperforms state-of-the-art models and achieves better performance than ER doctors, attaining a 6.60% higher sensitivity and maintaining 4.62% higher accuracy when specificity is aligned. Meanwhile, each assessment can be completed in less than 6 minutes, demonstrating the framework's great potential for clinical implementation.