The methods of duo output neural network ensemble for prediction of coronary heart disease

The occurrence of Coronary heart disease (CHD) is hard to predict yet, but the assessment of CHD risk for the next ten years is possible. The prediction of coronary heart disease can be modelled using multi-layer perceptron neural network (MLP-ANN). Prediction model with MLP-ANN has either positive or negative CHD output, which is a binary classification. A prediction model with binary classification requires determination of threshold value before the classification process which increases the uncertainty in the classification process. Another weakness of the MLP-ANN model is the presence of overfitting. This study proposes a prediction model for coronary heart disease using the duo output artificial neural network ensemble (DOANNE) method to overcome the problems of overfitting and uncertainty of classification in MLP-ANN. This research method was divided into several stages, namely data acquisition, pre-processing, modelling into DOANNE, neural network ensemble training with Levenberg-Marquard (LM) algorithm, system performance testing, and evaluation. The results of the study showed that the use of DOANNE-LM method was able to provide a significant improvement from the MLP-ANN method, indicated by the results of statistical tests with p-value <0.05

Prediction model for coronary artery disease using neural networks and feature selection based on classification and regression tree

Background and aims: Risk of implementing invasive diagnostic procedures for coronary artery disease (CAD) such as angiography is considerable. On the other hand, Successful experience has been achieved in medical data mining approaches. Therefore this study has been done to produce a model based on data mining techniques of neural networks that can predict coronary artery disease. Methods: In this descriptive- analytical study, the data set includes nine risk factors of 13228 participants who were undergone angiography at Tehran Heart Center. (4059 participants were not suffering from CAD but 9169 were suffering from CAD). Producing model for predicting coronary artery disease was done based on multilayer perceptron neural networks and variable selection based on classification and regression tree (CART) using of Statistica software. For comparison and selection of best model, the ROC curve analysis was used. Results: After seven-time modeling and comparing the generated models, the final model consists of all existing risk factors obtained with the area under ROC curve of 0.754, accuracy of 74.19%, sensitivity of 92.41% and specificity of 33.25% .Also, variable selection results in producing a model consists of four risk factors with area under ROC curve of 0.737, accuracy of 74.19%, sensitivity of 93.34% and specificity of 31.17% was produced. Conclusion: The obtained model is produced based on neural networks. The model is able to identify both high risk patients and acceptable number of healthy subjects. Also, utilizing the feature selection in this study ends up in production of a model which consists of only four risk factors as: age, sex, diabetes and high blood pressure

Development and external validation of a deep learning algorithm for prognostication of cardiovascular outcomes

Background and Objectives: We aim to explore the additional discriminative accuracy of a deep learning (DL) algorithm using repeated-measures data for identifying people at high risk for cardiovascular disease (CVD), compared to Cox hazard regression. Methods: Two CVD prediction models were developed from National Health Insurance Service-Health Screening Cohort (NHIS-HEALS): A Cox regression model and a DL model. Performance of each model was assessed in the internal and 2 external validation cohorts in Koreans (National Health Insurance Service-National Sample Cohort; NHIS-NSC) and in Europeans (Rotterdam Study). A total of 412,030 adults in the NHIS-HEALS; 178,875 adults in the NHIS-NSC; and the 4,296 adults in Rotterdam Study were included. Results: Mean ages was 52 years (46% women) and there were 25,777 events (6.3%) in NHIS-HEALS during the follow-up. In internal validation, the DL approach demonstrated a C-statistic of 0.896 (95% confidence interval, 0.886-0.907) in men and 0.921 (0.908-0.934) in women and improved reclassification compared with Cox regression (net reclassification index [NRI], 24.8% in men, 29.0% in women). In external validation with NHIS-NSC, DL demonstrated a C-statistic of 0.868 (0.860-0.876) in men and 0.889 (0.876-0.898) in women, and improved reclassification compared with Cox regression (NRI, 24.9% in men, 26.2% in women). In external validation applied to the Rotterdam Study, DL demonstrated a C-statistic of 0.860 (0.824-0.897) in men and 0.867 (0.830-0.903) in women, and improved reclassification compared with Cox regression (NRI, 36.9% in men, 31.8% in women). Conclusions: A DL algorithm exhibited greater discriminative accuracy than Cox model approaches

Development and External Validation of a Deep Learning Algorithm for Prognostication of Cardiovascular Outcomes

BACKGROUND AND OBJECTIVES: We aim to explore the additional discriminative accuracy of a deep learning (DL) algorithm using repeated-measures data for identifying people at high risk for cardiovascular disease (CVD), compared to Cox hazard regression. METHODS: Two CVD prediction models were developed from National Health Insurance Service-Health Screening Cohort (NHIS-HEALS): a Cox regression model and a DL model. Performance of each model was assessed in the internal and 2 external validation cohorts in Koreans (National Health Insurance Service-National Sample Cohort; NHIS-NSC) and in Europeans (Rotterdam Study). A total of 412,030 adults in the NHIS-HEALS; 178,875 adults in the NHIS-NSC; and the 4,296 adults in Rotterdam Study were included. RESULTS: Mean ages was 52 years (46% women) and there were 25,777 events (6.3%) in NHIS-HEALS during the follow-up. In internal validation, the DL approach demonstrated a C-statistic of 0.896 (95% confidence interval, 0.886-0.907) in men and 0.921 (0.908-0.934) in women and improved reclassification compared with Cox regression (net reclassification index [NRI], 24.8% in men, 29.0% in women). In external validation with NHIS-NSC, DL demonstrated a C-statistic of 0.868 (0.860-0.876) in men and 0.889 (0.876-0.898) in women, and improved reclassification compared with Cox regression (NRI, 24.9% in men, 26.2% in women). In external validation applied to the Rotterdam Study, DL demonstrated a C-statistic of 0.860 (0.824-0.897) in men and 0.867 (0.830-0.903) in women, and improved reclassification compared with Cox regression (NRI, 36.9% in men, 31.8% in women). CONCLUSIONS: A DL algorithm exhibited greater discriminative accuracy than Cox model approaches. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02931500.ope

Development and verification of prediction models for preventing cardiovascular diseases

OBJECTIVES: Cardiovascular disease (CVD) is one of the major causes of death worldwide. For improved accuracy of CVD prediction, risk classification was performed using national time-series health examination data. The data offers an opportunity to access deep learning (RNN-LSTM), which is widely known as an outstanding algorithm for analyzing time-series datasets. The objective of this study was to show the improved accuracy of deep learning by comparing the performance of a Cox hazard regression and RNN-LSTM based on survival analysis. METHODS AND FINDINGS: We selected 361,239 subjects (age 40 to 79 years) with more than two health examination records from 2002-2006 using the National Health Insurance System-National Health Screening Cohort (NHIS-HEALS). The average number of health screenings (from 2002-2013) used in the analysis was 2.9 ± 1.0. Two CVD prediction models were developed from the NHIS-HEALS data: a Cox hazard regression model and a deep learning model. In an internal validation of the NHIS-HEALS dataset, the Cox regression model showed a highest time-dependent area under the curve (AUC) of 0.79 (95% CI 0.70 to 0.87) for in females and 0.75 (95% CI 0.70 to 0.80) in males at 2 years. The deep learning model showed a highest time-dependent AUC of 0.94 (95% CI 0.91 to 0.97) for in females and 0.96 (95% CI 0.95 to 0.97) in males at 2 years. Layer-wise Relevance Propagation (LRP) revealed that age was the variable that had the greatest effect on CVD, followed by systolic blood pressure (SBP) and diastolic blood pressure (DBP), in that order. CONCLUSION: The performance of the deep learning model for predicting CVD occurrences was better than that of the Cox regression model. In addition, it was confirmed that the known risk factors shown to be important by previous clinical studies were extracted from the study results using LRP.ope

Development and verification of prediction models for preventing cardiovascular diseases

Objectives Cardiovascular disease (CVD) is one of the major causes of death worldwide. For improved accuracy of CVD prediction, risk classification was performed using national time-series health examination data. The data offers an opportunity to access deep learning (RNN-LSTM), which is widely known as an outstanding algorithm for analyzing time-series datasets. The objective of this study was to show the improved accuracy of deep learning by comparing the performance of a Cox hazard regression and RNN-LSTM based on survival analysis. Methods and findings We selected 361,239 subjects (age 40 to 79 years) with more than two health examination records from 2002–2006 using the National Health Insurance System-National Health Screening Cohort (NHIS-HEALS). The average number of health screenings (from 2002–2013) used in the analysis was 2.9 ± 1.0. Two CVD prediction models were developed from the NHIS-HEALS data: a Cox hazard regression model and a deep learning model. In an internal validation of the NHIS-HEALS dataset, the Cox regression model showed a highest time-dependent area under the curve (AUC) of 0.79 (95% CI 0.70 to 0.87) for in females and 0.75 (95% CI 0.70 to 0.80) in males at 2 years. The deep learning model showed a highest time-dependent AUC of 0.94 (95% CI 0.91 to 0.97) for in females and 0.96 (95% CI 0.95 to 0.97) in males at 2 years. Layer-wise Relevance Propagation (LRP) revealed that age was the variable that had the greatest effect on CVD, followed by systolic blood pressure (SBP) and diastolic blood pressure (DBP), in that order. Conclusion The performance of the deep learning model for predicting CVD occurrences was better than that of the Cox regression model. In addition, it was confirmed that the known risk factors shown to be important by previous clinical studies were extracted from the study results using LRP

Fuzzy decision support systems to diagnose musculoskeletal disorders: A systematic literature review

Abstract Background and objective Musculoskeletal disorders (MSDs) are one of the most important causes of disability with a high prevalence. The accurate and timely diagnosis of these disorders is often difficult. Clinical decision support systems (CDSSs) can help physicians to diagnose diseases quickly and accurately. Given the ambiguous nature of MSDs, fuzzy logic can be helpful in designing the CDSSs knowledge bases. The present study aimed to review the studies on fuzzy CDSSs to diagnose MSDs. Methods A comprehensive search was conducted in Medline, Scopus, Cochrane Library, and ISI Web of Science databases to identify relevant studies published until March 15, 2016. Studies were included in which CDSSs were developed using fuzzy logic to diagnose MSDs, and tested their accuracy using real data from patients. Results Of the 3188 papers examined, 23 papers included according to the inclusion criteria. The results showed that among all the designed CDSSs only one (CADIAG-2) was implemented in the clinical environment. In about half of the included studies (52%), CDSSs were designed to diagnose inflammatory/infectious disorder of the bone and joint. In most of the included studies (70%), the knowledge was extracted using a combination of three methods (acquiring from experts, analyzing the data, and reviewing the literature). The median accuracy of fuzzy rule-based CDSSs was 91% and it was 90% for other fuzzy models. The most frequently used membership functions were triangular and trapezoidal functions, and the most used method for inference was the Mamdani. Conclusions In general, fuzzy CDSSs have a high accuracy to diagnose MSDs. Despite the high accuracy, these systems have been used to a limited extent in the clinical environments. To design of knowledge base for CDSSs to diagnose MSDs, rule-based methods are used more than other fuzzy methods. Keywords Musculoskeletal disorders Decision support systems Fuzzy logic Diagnose Revie

Framework para el desarrollo y entrenamiento de sistemas de indeferencia difusa siguiendo métodos de desarrollo dirigido por modelos

224 p.Este trabajo de tesis doctoral presenta un modelo independiente de la computación de un Diagnóstico Diferencial (DD), así como un modelo independiente de la plataforma de un Sistema de Inferencia Difusa. Se han utilizado los Métodos de Desarrollo Dirigido por Modelos (MDDM) en la concepción de los modelos, los cuales, además de facilitar la definición de los modelos, ofrecen herramientas para la realización de transformaciones entre ellos. Así, en el presente trabajo también se exponen las transformaciones entre los modelos de DD y SID y las transformaciones para la generación automática de SID expresados en lenguajes concretos a partir de los modelos de SID independientes de la plataforma. Los SID dependientes de la plataforma pueden ser incluidos en el formalismo de representación de Guías Clínicas Informatizadas (GCI) Aide. Así mismo, en la tesis también se incluye una descripción de las herramientas que facilitan la definición de modelos de DD y SID, así como la generación automática de SID en lenguajes concretos utilizables en distintos motores de razonamiento. Es de reseñar la adición de un módulo de aprendizaje automático mediante un Algoritmo Genético que permite adaptar algunas características de los modelos de SID a los datos reales de entrenamiento. Las herramientas y modelos se han validado en dos ámbitos. Por un lado, se han utilizado en el cribado neonatal, una prueba diagnóstica dirigida a la identificación presintomática de enfermedades graves con el fin de tratarlas precozmente y así prevenir y minimizar minusvalías neurológicas, orgánicas y psíquicas. Por otro lado, se han utilizado en el diagnóstico de la hiperamonemia, una Enfermedad Rara que se debe tratar de forma urgente para evitar graves secuelas neurológicas e incluso la muerte. En ambos casos, los SID creados se han integrado en unas GCI para ser evaluados