Precision medicine and artificial intelligence : a pilot study on deep learning for hypoglycemic events detection based on ECG

Tracking the fluctuations in blood glucose levels is important for healthy subjects and crucial diabetic patients. Tight glucose monitoring reduces the risk of hypoglycemia, which can result in a series of complications, especially in diabetic patients, such as confusion, irritability, seizure and can even be fatal in specific conditions. Hypoglycemia affects the electrophysiology of the heart. However, due to strong inter-subject heterogeneity, previous studies based on a cohort of subjects failed to deploy electrocardiogram (ECG)-based hypoglycemic detection systems reliably. The current study used personalised medicine approach and Artificial Intelligence (AI) to automatically detect nocturnal hypoglycemia using a few heartbeats of raw ECG signal recorded with non-invasive, wearable devices, in healthy individuals, monitored 24 hours for 14 consecutive days. Additionally, we present a visualisation method enabling clinicians to visualise which part of the ECG signal (e.g., T-wave, ST-interval) is significantly associated with the hypoglycemic event in each subject, overcoming the intelligibility problem of deep-learning methods. These results advance the feasibility of a real-time, non-invasive hypoglycemia alarming system using short excerpts of ECG signal

Precision medicine and artificial intelligence : a pilot study on deep learning for hypoglycemic events detection based on ECG

Tracking the fluctuations in blood glucose levels is important for healthy subjects and crucial diabetic patients. Tight glucose monitoring reduces the risk of hypoglycemia, which can result in a series of complications, especially in diabetic patients, such as confusion, irritability, seizure and can even be fatal in specific conditions. Hypoglycemia affects the electrophysiology of the heart. However, due to strong inter-subject heterogeneity, previous studies based on a cohort of subjects failed to deploy electrocardiogram (ECG)-based hypoglycemic detection systems reliably. The current study used personalised medicine approach and Artificial Intelligence (AI) to automatically detect nocturnal hypoglycemia using a few heartbeats of raw ECG signal recorded with non-invasive, wearable devices, in healthy individuals, monitored 24 hours for 14 consecutive days. Additionally, we present a visualisation method enabling clinicians to visualise which part of the ECG signal (e.g., T-wave, ST-interval) is significantly associated with the hypoglycemic event in each subject, overcoming the intelligibility problem of deep-learning methods. These results advance the feasibility of a real-time, non-invasive hypoglycemia alarming system using short excerpts of ECG signal

Self-adjustable domain adaptation in personalized ECG monitoring integrated with IR-UWB radar

To enhance electrocardiogram (ECG) monitoring systems in personalized detections, deep neural networks (DNNs) are applied to overcome individual differences by periodical retraining. As introduced previously [4], DNNs relieve individual differences by fusing ECG with impulse radio ultra-wide band (IR-UWB) radar. However, such DNN-based ECG monitoring system tends to overfit into personal small datasets and is difficult to generalize to newly collected unlabeled data. This paper proposes a self-adjustable domain adaptation (SADA) strategy to prevent from overfitting and exploit unlabeled data. Firstly, this paper enlarges the database of ECG and radar data with actual records acquired from 28 testers and expanded by the data augmentation. Secondly, to utilize unlabeled data, SADA combines self organizing maps with the transfer learning in predicting labels. Thirdly, SADA integrates the one-class classification with domain adaptation algorithms to reduce overfitting. Based on our enlarged database and standard databases, a large dataset of 73200 records and a small one of 1849 records are built up to verify our proposal. Results show SADA\u27s effectiveness in predicting labels and increments in the sensitivity of DNNs by 14.4% compared with existing domain adaptation algorithms

Hyperglycemia identification using ECG in deep learning era

A growing number of smart wearable biosensors are operating in the medical IoT environment and those that capture physiological signals have received special attention. Electrocardiogram (ECG) is one of the physiological signals used in the cardiovascular and medical fields that has encouraged researchers to discover new non-invasive methods to diagnose hyperglycemia as a personal variable. Over the years, researchers have proposed different techniques to detect hyperglycemia using ECG. In this paper, we propose a novel deep learning architecture that can identify hyperglycemia using heartbeats from ECG signals. In addition, we introduce a new fiducial feature extraction technique that improves the performance of the deep learning classifier. We evaluate the proposed method with ECG data from 1119 different subjects to assess the efficiency of hyperglycemia detection of the proposed work. The result indicates that the proposed algorithm is effective in detecting hyperglycemia with a 94.53% area under the curve (AUC), 87.57% sensitivity, and 85.04% specificity. That performance represents an relative improvement of 53% versus the best model found in the literature. The high sensitivity and specificity achieved by the 10-layer deep neural network proposed in this work provide an excellent indication that ECG possesses intrinsic information that can indicate the level of blood glucose concentration

Detection and analysis of heartbeats in seismocardiogram signals

This paper presents an unsupervised methodology to analyze SeismoCardioGram (SCG) signals. Starting from raw accelerometric data, heartbeat complexes are extracted and annotated, using a two-step procedure. An unsupervised calibration procedure is added to better adapt to different user patterns. Results show that the performance scores achieved by the proposed methodology improve over related literature: on average, 98.5% sensitivity and 98.6% precision are achieved in beat detection, whereas RMS (Root Mean Square) error in heartbeat interval estimation is as low as 4.6 ms. This allows SCG heartbeat complexes to be reliably extracted. Then, the morphological information of such waveforms is further processed by means of a modular Convolutional Variational AutoEncoder network, aiming at extracting compressed, meaningful representation. After unsupervised training, the VAE network is able to recognize different signal morphologies, associating each user to its specific patterns with high accuracy, as indicated by specific performance metrics (including adjusted random and mutual information score, completeness, and homogeneity). Finally, a Linear Model is used to interpret the results of clustering in the learned latent space, highlighting the impact of different VAE architectural parameters (i.e., number of stacked convolutional units and dimension of latent space)

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