Automated Classification for Electrophysiological Data: Machine Learning Approaches for Disease Detection and Emotion Recognition

Smart healthcare is a health service system that utilizes technologies, e.g., artificial intelligence and big data, to alleviate the pressures on healthcare systems. Much recent research has focused on the automatic disease diagnosis and recognition and, typically, our research pays attention on automatic classifications for electrophysiological signals, which are measurements of the electrical activity. Specifically, for electrocardiogram (ECG) and electroencephalogram (EEG) data, we develop a series of algorithms for automatic cardiovascular disease (CVD) classification, emotion recognition and seizure detection. With the ECG signals obtained from wearable devices, the candidate developed novel signal processing and machine learning method for continuous monitoring of heart conditions. Compared to the traditional methods based on the devices at clinical settings, the developed method in this thesis is much more convenient to use. To identify arrhythmia patterns from the noisy ECG signals obtained through the wearable devices, CNN and LSTM are used, and a wavelet-based CNN is proposed to enhance the performance. An emotion recognition method with a single channel ECG is developed, where a novel exploitative and explorative GWO-SVM algorithm is proposed to achieve high performance emotion classification. The attractive part is that the proposed algorithm has the capability to learn the SVM hyperparameters automatically, and it can prevent the algorithm from falling into local solutions, thereby achieving better performance than existing algorithms. A novel EEG-signal based seizure detector is developed, where the EEG signals are transformed to the spectral-temporal domain, so that the dimension of the input features to the CNN can be significantly reduced, while the detector can still achieve superior detection performance

Development of a Real-Time Single-Lead Single-Beat Frequency-Independent Myocardial Infarction Detector

The central aim of this research is the development and deployment of a novel multilayer machine learning design with unique application for the diagnosis of myocardial infarctions (MIs) from individual heartbeats of single-lead electrocardiograms (EKGs) irrespective of their sampling frequencies over a given range. To the best of our knowledge, this design is the first to attempt inter-patient myocardial infarction detection from individual heartbeats of single-lead (lead II) electrocardiograms that achieves high accuracy and near real-time diagnosis. The processing time of 300 milliseconds to a diagnosis is just at the time range in between extremely fast heartbeats of around 300 milliseconds, or 200 beats per minute. The design achieves stable performance metrics over the frequency range of 202Hz to 2.8kHz with an accuracy of 77.12%, positive predictive value (PPV) of 75.85%, and a negative predictive value (NPV) of 83.02% over the entire PTB database; 85.07%, 81.54%, 87.31% over the PTB-XL (the largest EKG database available for research) validation set, and 84.17%, 78.37%, 87.55% over the PTB-XL test set. Major design contributions and findings of this work reveal (1) a method for the realtime detection of ventricular depolarization events in the PQRST complex from 12-lead electrocardiograms using Independent Component Analysis (ICA), with a slightly different use of ICA proposed for electrocardiogram analysis and R-peak detection/localization; (2) a multilayer Long-Short Term Memory (LSTM) neural network design that identifies infarcted patients from a single heartbeat of a single-lead (lead II) electrocardiogram; (3) and integrated LSTM neural network with an algorithm that detects the R-peaks in real time for instantaneous detection of myocardial infarctions and for effective monitoring of patients under cardiac stress and/or at risk of myocardial infarction; (4) a fully integrated 12-lead real-time classifier with even higher detection metrics and a deeper neural architecture, which could serve as a near real-time monitoring tool that could gauge disease progression and evaluate benefits gained from early intervention and treatment planning; (5) a real-time frequency-independent design based on a single-lead single-beat MI detector, which is of pivotal importance to deployment as there is no standard sampling frequency for EKGs, making them span a wider frequency spectrum. vi

Applying Artificial Intelligence to wearable sensor data to diagnose and predict cardiovascular disease: a review

Cardiovascular disease (CVD) is the world’s leading cause of mortality. There is significant interest in using Artificial Intelligence (AI) to analyse data from novel sensors such as wearables to provide an earlier and more accurate prediction and diagnosis of heart disease. Digital health technologies that fuse AI and sensing devices may help disease prevention and reduce the substantial morbidity and mortality caused by CVD worldwide. In this review, we identify and describe recent developments in the application of digital health for CVD, focusing on AI approaches for CVD detection, diagnosis, and prediction through AI models driven by data collected from wearables. We summarise the literature on the use of wearables and AI in cardiovascular disease diagnosis, followed by a detailed description of the dominant AI approaches applied for modelling and prediction using data acquired from sensors such as wearables. We discuss the AI algorithms and models and clinical applications and find that AI and machine-learning-based approaches are superior to traditional or conventional statistical methods for predicting cardiovascular events. However, further studies evaluating the applicability of such algorithms in the real world are needed. In addition, improvements in wearable device data accuracy and better management of their application are required. Lastly, we discuss the challenges that the introduction of such technologies into routine healthcare may fac

Design of a Simulator for Neonatal Multichannel EEG: Application to Time-Frequency Approaches for Automatic Artifact Removal and Seizure Detection

The electroencephalogram (EEG) is used to noninvasively monitor brain activities; it is the most utilized tool to detect abnormalities such as seizures. In recent studies, detection of neonatal EEG seizures has been automated to assist neurophysiologists in diagnosing EEG as manual detection is time consuming and subjective; however it still lacks the necessary robustness that is required for clinical implementation. Moreover, as EEG is intended to record the cerebral activities, extra-cerebral activities external to the brain are also recorded; these are called “artifacts” and can seriously degrade the accuracy of seizure detection. Seizures are one of the most common neurologic problems managed by hospitals occurring in 0.1%-0.5% livebirths. Neonates with seizures are at higher risk for mortality and are reported to be 55-70 times more likely to have severe cerebral-palsy. Therefore, early and accurate detection of neonatal seizures is important to prevent long-term neurological damage. Several attempts in modelling the neonatal EEG and artifacts have been done, but most did not consider the multichannel case. Furthermore, these models were used to test artifact or seizure detection separately, but not together. This study aims to design synthetic models that generate clean or corrupted multichannel EEG to test the accuracy of available artifact and seizure detection algorithms in a controlled environment. In this thesis, synthetic neonatal EEG model is constructed by using; single-channel EEG simulators, head model, 21-electrodes, and propagation equations, to produce clean multichannel EEG. Furthermore, neonatal EEG artifact model is designed using synthetic signals to corrupt EEG waveforms. After that, an automated EEG artifact detection and removal system is designed in both time and time-frequency domains. Artifact detection is optimised and removal performance is evaluated. Finally, an automated seizure detection technique is developed, utilising fused and extended multichannel features along a cross-validated SVM classifier. Results show that the synthetic EEG model mimics real neonatal EEG with 0.62 average correlation, and corrupted-EEG can degrade seizure detection average accuracy from 100% to 70.9%. They also show that using artifact detection and removal enhances the average accuracy to 89.6%, and utilising the extended features enhances it to 97.4% and strengthened its robustness.لمراقبة ورصد أنشطة واشارات المخ، دون الحاجة لأي عملیات (EEG) یستخدم الرسم أو التخطیط الكھربائي للدماغ للدماغجراحیة، وھي تعد الأداة الأكثر استخداما في الكشف عن أي شذوذأو نوبات غیر طبیعیة مثل نوبات الصرع. وقد أظھرت دراسات حدیثة، أن الكشف الآلي لنوبات حدیثي الولادة، ساعد علماء الفسیولوجیا العصبیة في تشخیص الاشارات الدماغیة بشكل أكبر من الكشف الیدوي، حیث أن الكشف الیدوي یحتاج إلى وقت وجھد أكبر وھوذو فعالیة أقل بكثیر، إلا أنھ لا یزال یفتقر إلى المتانة الضروریة والمطلوبة للتطبیق السریري.علاوة على ذلك؛ فكما یقوم الرسم الكھربائي بتسجیل الأنشطة والإشارات الدماغیة الداخلیة، فھو یسجل أیضا أي نشاط أو اشارات خارجیة، مما یؤدي إلى -(artifacts) :حدوث خلل في مدى دقة وفعالیة الكشف عن النوبات الدماغیة الداخلیة، ویطلق على تلك الاشارات مسمى (نتاج صنعي) . 0.5٪ولادة حدیثة في -٪تعد نوبات الصرع من أكثر المشكلات العصبیة انتشارا،ً وھي تصیب ما یقارب 0.1المستشفیات. حیث أن حدیثي الولادة المصابین بنوبات الصرع ھم أكثر عرضة للوفاة، وكما تشیر التقاریر الى أنھم 70مرة أكثر. لذا یعد الكشف المبكر والدقیق للنوبات الدماغیة -معرضین للإصابة بالشلل الدماغي الشدید بما یقارب 55لحدیثي الولادة مھم جدا لمنع الضرر العصبي على المدى الطویل. لقد تم القیام بالعدید من المحاولات التي كانتتھدف الى تصمیم نموذج التخطیط الكھربائي والنتاج الصنعي لدماغ حدیثي الولادة, إلا أن معظمھا لم یعر أي اھتمام الى قضیة تعدد القنوات. إضافة الى ذلك, استخدمت ھذه النماذج , كل على حدة, أو نوبات الصرع. تھدف ھذه الدراسة الى تصمیم نماذج مصطنعة من شأنھا (artifact) لإختبار كاشفات النتاج الصنعيأن تولد اشارات دماغیة متعددة القنوات سلیمة أو معطلة وذلك لفحص مدى دقة فعالیة خوارزمیات الكشف عن نوبات ضمن بیئة یمكن السیطرة علیھا. (artifact) الصرع و النتاج الصنعي في ھذه الأطروحة, یتكون نموذج الرسم الكھربائي المصطنع لحدیثي الولادة من : قناة محاكاة واحده للرسم الكھربائي, نموذج رأس, 21قطب كھربائي و معادلات إنتشار. حیث تھدف جمیعھا لإنتاج إشاراة سلیمة متعدده القنوات للتخطیط عن طریق استخدام اشارات مصطنعة (artifact) الكھربائي للدماغ.علاوة على ذلك, لقد تم تصمیم نموذجالنتاج الصنعيفي نطاقالوقت و (artifact) لإتلاف الرسم الكھربائي للدماغ. بعد ذلك تم انشاء برنامج لكشف و إزالةالنتاج الصناعينطاقالوقت و التردد المشترك. تم تحسین برنامج الكشف النتاج الصناعيالى ابعد ما یمكن بینما تمت عملیة تقییم أداء الإزالة. وفي الختام تم التمكن من تطویر تقنیة الكشف الآلي عن نوبات الصرع, وذلك بتوظیف صفات مدمجة و صفات الذي تم التأكد من صحتھ. (SVM) جدیدة للقنوات المتعددة لإستخدامھا للمصنفلقد أظھرت النتائج أن نموذج الرسم الكھربائي المصطنع لحدیثي الولادة یحاكي الرسمالكھربائي الحقیقي لحدیثي الولادة بمتوسط ترابط 0.62, و أنالرسم الكھربائي المتضرر للدماغ قد یؤدي الى حدوث ھبوطفي مدى دقة متوسط الكشف عن نوبات الصرع من 100%الى 70.9%. وقد أشارت أیضا الى أن استخدام الكشف والإزالة عن النتاج الصنعي (artifact) یؤدي الى تحسن مستوى الدقة الى نسبة 89.6 %, وأن توظیف الصفات الجدیدة للقنوات المتعددة یزید من تحسنھا لتصل الى نسبة 94.4 % مما یعمل على دعم متانتھا

R-peak detection in holter ECG signals using non-negative matrix factorization

International audienceHolter monitoring is mainly used for medical follow- up and diagnosis of patients with suspected cardiac ar- rhythmia such as heart rhythm irregularities that can be missed during classical electrocardiogram recording (ECG). However, these long-term continuous recordings represent a large amount of data that cannot be processed by hand. In this article, we present a new method based on Non-negative Matrix Factorization (NMF) to detect R- peaks in Holter signals. The approach consists in two stages: source separation based on the different time- frequency patterns of the QRS complexes and the other waves of the signal (P and T waves) and R-peak detection using Automatic Objective Thresholding (AOT). The pro- posed approach is validated on the MIT-BIH Arrhythmia database and achieves an average sensitivity of 99.59% and a precision of 99.69%. Using the MIT-BIH Noise Stress Test database, we also show the ability of our ap- proach to discriminate R-peaks in signals contaminated with different noises

ASCNet-ECG: Deep Autoencoder based Attention aware Skip Connection network for ECG filtering

Currently, the telehealth monitoring field has gained huge attention due to its noteworthy use in day-to-day life. This advancement has led to an increase in the data collection of electrophysiological signals. Due to this advancement, electrocardiogram (ECG) signal monitoring has become a leading task in the medical field. ECG plays an important role in the medical field by analysing cardiac physiology and abnormalities. However, these signals are affected due to numerous varieties of noises, such as electrode motion, baseline wander and white noise etc., which affects the diagnosis accuracy. Therefore, filtering ECG signals became an important task. Currently, deep learning schemes are widely employed in signal-filtering tasks due to their efficient architecture of feature learning. This work presents a deep learning-based scheme for ECG signal filtering, which is based on the deep autoencoder module. According to this scheme, the data is processed through the encoder and decoder layer to reconstruct by eliminating noises. The proposed deep learning architecture uses a modified ReLU function to improve the learning of attributes because standard ReLU cannot adapt to huge variations. Further, a skip connection is also incorporated in the proposed architecture, which retains the key feature of the encoder layer while mapping these features to the decoder layer. Similarly, an attention model is also included, which performs channel and spatial attention, which generates the robust map by using channel and average pooling operations, resulting in improving the learning performance. The proposed approach is tested on a publicly available MIT-BIH dataset where different types of noise, such as electrode motion, baseline water and motion artifacts, are added to the original signal at varied SNR levels

Novel Low Complexity Biomedical Signal Processing Techniques for Online Applications

Biomedical signal processing has become a very active domain of research nowadays. With the advent of portable monitoring devices, from accelerometer-enabled bracelets and smart-phones to more advanced vital sign tracking body area networks, this field has been receiving unprecedented attention. Indeed, portable health monitoring can help uncover the underlying dynamics of human health in a way that has not been possible before. Several challenges have emerged however, as these devices present key differences in terms of signal acquisition and processing in comparison with conventional methods. Hardware constraints such as processing power and limited battery capacity make most established techniques unsuitable and therefore, the need for low-complexity yet robust signal processing methods has appeared. Another issue that needs to be addressed is the quality of the signals captured by these devices. Unlike in clinical scenarios, in portable health monitoring subjects are constantly performing their daily activities. Moreover, signals maybe captured from unconventional locations and subsequently, be prone to perturbations. In order to obtain reliable measures from these monitoring devices, one needs to acquire dependable signal quality measures, to avoid false alarms. Indeed, hardware limitations and low-quality signals can greatly influence the performance of portable monitoring devices. Nevertheless, most devices offer simultaneous acquisition of multiple physiological parameters, such as electrocardiogram (ECG) and photoplethysmogram (PPG). Through multi-modal signal processing the overall performance can be improved, for instance by deriving parameters such as heart rate estimation from the most reliable and uncontaminated source. This thesis is therefore, dedicated to propose novel low-complexity biomedical processing techniques for real-time/online applications. Throughout this dissertation, several bio-signals such as the ECG, PPG, and electroencephalogram (EEG) are investigated. %There is an emphasis on ECG processing techniques, as most of the bio-signals recorded today reflect information about the heart. The main contribution of this dissertation consists in two signal processing techniques: 1) a novel ECG QRS-complex detection and delineation technique, and 2) a short-term event extraction technique for biomedical signals. The former is based on a processing technique called mathematical morphology (MM), and adaptively uses subject QRS-complex amplitude- and morphological attributes for a robust detection and delineation. This method is generalized to intra-cardiac electrograms for atrial activation detection during atrial fibrillation. The second method, called the Relative-Energy algorithm, uses short- and long-term signal energies to highlight events of interest and discard unwanted activities. Collectively, the results obtained by these methods suggest that while presenting low-computational costs, they can efficiently and robustly extract biomedical events of interest. Using the relative energy algorithm, a continuous non-binary ECG signal quality index is presented. The ECG quality is determined by creating a cleaned-up version of the input ECG and calculating the correlation coefficient between the cleaned-up and the original ECG. The proposed quality index is fast and can be implemented online, making it suitable for portable monitoring scenarios

Deep Learning in Cardiology

The medical field is creating large amount of data that physicians are unable to decipher and use efficiently. Moreover, rule-based expert systems are inefficient in solving complicated medical tasks or for creating insights using big data. Deep learning has emerged as a more accurate and effective technology in a wide range of medical problems such as diagnosis, prediction and intervention. Deep learning is a representation learning method that consists of layers that transform the data non-linearly, thus, revealing hierarchical relationships and structures. In this review we survey deep learning application papers that use structured data, signal and imaging modalities from cardiology. We discuss the advantages and limitations of applying deep learning in cardiology that also apply in medicine in general, while proposing certain directions as the most viable for clinical use.Comment: 27 pages, 2 figures, 10 table

The Application of Computer Techniques to ECG Interpretation

This book presents some of the latest available information on automated ECG analysis written by many of the leading researchers in the field. It contains a historical introduction, an outline of the latest international standards for signal processing and communications and then an exciting variety of studies on electrophysiological modelling, ECG Imaging, artificial intelligence applied to resting and ambulatory ECGs, body surface mapping, big data in ECG based prediction, enhanced reliability of patient monitoring, and atrial abnormalities on the ECG. It provides an extremely valuable contribution to the field