An intelligent recommender system based on short-term disease risk prediction for patients with chronic diseases in a telehealth environment

Clinical decisions are usually made based on the practitioners' experiences with limited support from data-centric analytic processes from medical databases. This often leads to undesirable biases, human errors and high medical costs affecting the quality of services provided to patients. Recently, the use of intelligent technologies in clinical decision making in the telehealth environment has begun to play a vital role in improving the quality of patients' lives and reducing the costs and workload involved in their daily healthcare. In the telehealth environment, patients suffering from chronic diseases such as heart disease or diabetes have to take various medical tests such as measuring blood pressure, blood sugar and blood oxygen, etc. This practice adversely affects the overall convenience and quality of their everyday living. In this PhD thesis, an effective recommender system is proposed utilizing a set of innovative disease risk prediction algorithms and models for short-term disease risk prediction to provide chronic disease patients with appropriate recommendations regarding the need to take a medical test on the coming day. The input sequence of sliding windows based on the patient's time series data, is analyzed in both the time domain and the frequency domain. The time series medical data obtained for each chronicle disease patient is partitioned into consecutive sliding windows for analysis in both the time and the frequency domains. The available time series data are readily available in time domains which can be used for analysis without any further conversion. For data analysis in the frequency domain, Fast Fourier Transformation (FFT) and Dual-Tree Complex Wavelet Transformation (DTCWT) are applied to convert the data into the frequency domain and extract the frequency information. In the time domain, four innovative predictive algorithms, Basic Heuristic Algorithm (BHA), Regression-Based Algorithm (RBA) and Hybrid Algorithm (HA) as well as a structural graph-based method (SG), are proposed to study the time series data for producing recommendations. While, in the frequency domain, three predictive classifiers, Artificial Neural Network, Least Squares-Support Vector Machine, and Naïve Bayes, are used to produce the recommendations. An ensemble machine learning model is utilized to combine all the used predictive models and algorithms in both the time and frequency domains to produce the final recommendation. Two real-life telehealth datasets collected from chronic disease patients (i.e., heart disease and diabetes patients) are utilized for a comprehensive experimental evaluation in this study. The results show that the proposed system is effective in analysing time series medical data and providing accurate and reliable (very low risk) recommendations to patients suffering from chronic diseases such as heart disease and diabetes. This research work will help provide high-quality evidence-based intelligent decision support to clinical disease patients that significantly reduces workload associated with medical checkups would otherwise have to be conducted every day in a telehealth environment

Prediction Of Heart Failure Decompensations Using Artificial Intelligence - Machine Learning Techniques

Los apartados 4.41, 4.4.2 y 4.4.3 del capítulo 4 están sujetos a confidencialidad por la autora. 203 p.Heart failure (HF) is a major concern in public health. Its total impact is increased by its high incidence and prevalence and its unfavourable medium-term prognosis. In addition, HF leads to huge health care resource consumption. Moreover, efforts to develop a deterministic understanding of rehospitalization have been difficult, as no specific patient or hospital factors have been shown to consistently predict 30-day readmission after hospitalization for HF.Taking all these facts into account, we wanted to develop a project to improve the assistance care of patients with HF. Up to know, we were using telemonitoring with a codification system that generated alarms depending on the received values. However, these simple rules generated large number of false alerts being, hence, not trustworthy. The final aims of this work are: (i) asses the benefits of remote patient telemonitoring (RPT), (ii) improve the results obtained with RPT using ML techniques, detecting which parameters measured by telemonitoring best predict HF decompensations and creating predictive models that will reduce false alerts and detect early decompensations that otherwise will lead to hospital admissions and (iii) determine the influence of environmental factors on HF decompensations.All in all, the conclusions of this study are:1. Asses the benefits of RPT: Telemonitoring has not shown a statistically significant reduction in the number of HF-related hospital admissions. Nevertheless, we have observed a statistically significant reduction in mortality in the intervention group with a considerable percentage of deaths from non-cardiovascular causes. Moreover, patients have considered the RPT programme as a tool that can help them in the control of their chronic disease and in the relationship with health professionals.2. Improve the results obtained with RPT using machine learning techniques: Significant weight increases, desaturation below 90%, perception of clinical worsening, including development of oedema, worsening of functional class and orthopnoea are good predictors of heart failure decompensation. In addition, machine learning techniques have improved the current alerts system implemented in our hospital. The system reduces the number of false alerts notably although it entails a decrement on sensitivity values. The best results are achieved with the predictive model built by applying NB with Bernoulli to the combination of telemonitoring alerts and questionnaire alerts (Weight + Ankle + well-being plus the yellow alerts of systolic blood pressure, diastolic blood pressure, O2Sat and heart rate). 3. Determine the influence of environmental factors on HF decompensations: Air temperature is the most significant environmental factor (negative correlation) in our study, although some other attributes, such as precipitation, are also relevant. This work also shows a consistent association between increasing levels SO2 and NOX air and HF hospitalizations

Prediction Of Heart Failure Decompensations Using Artificial Intelligence - Machine Learning Techniques

Los apartados 4.41, 4.4.2 y 4.4.3 del capítulo 4 están sujetos a confidencialidad por la autora. 203 p.Heart failure (HF) is a major concern in public health. Its total impact is increased by its high incidence and prevalence and its unfavourable medium-term prognosis. In addition, HF leads to huge health care resource consumption. Moreover, efforts to develop a deterministic understanding of rehospitalization have been difficult, as no specific patient or hospital factors have been shown to consistently predict 30-day readmission after hospitalization for HF.Taking all these facts into account, we wanted to develop a project to improve the assistance care of patients with HF. Up to know, we were using telemonitoring with a codification system that generated alarms depending on the received values. However, these simple rules generated large number of false alerts being, hence, not trustworthy. The final aims of this work are: (i) asses the benefits of remote patient telemonitoring (RPT), (ii) improve the results obtained with RPT using ML techniques, detecting which parameters measured by telemonitoring best predict HF decompensations and creating predictive models that will reduce false alerts and detect early decompensations that otherwise will lead to hospital admissions and (iii) determine the influence of environmental factors on HF decompensations.All in all, the conclusions of this study are:1. Asses the benefits of RPT: Telemonitoring has not shown a statistically significant reduction in the number of HF-related hospital admissions. Nevertheless, we have observed a statistically significant reduction in mortality in the intervention group with a considerable percentage of deaths from non-cardiovascular causes. Moreover, patients have considered the RPT programme as a tool that can help them in the control of their chronic disease and in the relationship with health professionals.2. Improve the results obtained with RPT using machine learning techniques: Significant weight increases, desaturation below 90%, perception of clinical worsening, including development of oedema, worsening of functional class and orthopnoea are good predictors of heart failure decompensation. In addition, machine learning techniques have improved the current alerts system implemented in our hospital. The system reduces the number of false alerts notably although it entails a decrement on sensitivity values. The best results are achieved with the predictive model built by applying NB with Bernoulli to the combination of telemonitoring alerts and questionnaire alerts (Weight + Ankle + well-being plus the yellow alerts of systolic blood pressure, diastolic blood pressure, O2Sat and heart rate). 3. Determine the influence of environmental factors on HF decompensations: Air temperature is the most significant environmental factor (negative correlation) in our study, although some other attributes, such as precipitation, are also relevant. This work also shows a consistent association between increasing levels SO2 and NOX air and HF hospitalizations

Characterizing the Information Needs of Rural Healthcare Practitioners with Language Agnostic Automated Text Analysis

Objectives – Previous research has characterized urban healthcare providers\u27 information needs, using various qualitative methods. However, little is known about the needs of rural primary care practitioners in Brazil. Communication exchanged during tele-consultations presents a unique data source for the study of these information needs. In this study, I characterize rural healthcare providers\u27 information needs expressed electronically, using automated methods. Methods – I applied automated methods to categorize messages obtained from the telehealth system from two regions in Brazil. A subset of these messages, annotated with top-level categories in the DeCS terminology (the regional equivalent of MeSH), was used to train text categorization models, which were then applied to a larger, unannotated data set. On account of their more granular nature, I focused on answers provided to the queries sent by rural healthcare providers. I studied these answers, as surrogates for the information needs they met. Message representations were generated using methods of distributional semantics, permitting the application of k-Nearest Neighbor classification for category assignment. The resulting category assignments were analyzed to determine differences across regions, and healthcare providers. Results – Analysis of the assigned categories revealed differences in information needs across regions, corresponding to known differences in the distributions of diseases and tele-consultant expertise across these regions. Furthermore, information needs of rural nurses were observed to be different from those documented in qualitative studies of their urban counterparts, and the distribution of expressed information needs categories differed across types of providers (e.g. nurses vs. physicians). Discussion – The automated analysis of large amounts of digitally-captured tele-consultation data suggests that rural healthcare providers\u27 information needs in Brazil are different than those of their urban counterparts in developed countries. The observed disparities in information needs correspond to known differences in the distribution of illness and expertise in these regions, supporting the applicability of my methods in this context. In addition, these methods have the potential to mediate near real-time monitoring of information needs, without imposing a direct burden upon healthcare providers. Potential applications include automated delivery of needed information at the point of care, needs-based deployment of tele-consultation resources and syndromic surveillance. Conclusion – I used automated text categorization methods to assess the information needs expressed at the point of care in rural Brazil. My findings reveal differences in information needs across regions, and across practitioner types, demonstrating the utility of these methods and data as a means to characterize information needs

Automated Smartphone based System for Diagnosis of Diabetic Retinopathy

Early diagnosis of diabetic retinopathy for treatment of the disease has been failing to reach diabetic people living in rural areas. Shortage of trained ophthalmologists, limited availability of healthcare centers, and expensiveness of diagnostic equipment are among the reasons. Although many deep learning-based automatic diagnosis of diabetic retinopathy techniques have been implemented in the literature, these methods still fail to provide a point-of-care diagnosis. This raises the need for an independent diagnostic of diabetic retinopathy that can be used by a non-expert. Recently the usage of smartphones has been increasing across the world. Automated diagnoses of diabetic retinopathy can be deployed on smartphones in order to provide an instant diagnosis to diabetic people residing in remote areas. In this paper, inception based convolutional neural network and binary decision tree-based ensemble of classifiers have been proposed and implemented to detect and classify diabetic retinopathy. The proposed method was further imported into a smartphone application for mobile-based classification, which provides an offline and automatic system for diagnosis of diabetic retinopathy.Comment: 12 pages, 4 figures, 4 tables, 1 appendix. Copyright \copyright 2019, IEEE. Published in: 2019 International Conference on Computing, Communication, and Intelligent Systems (ICCCIS

Enhanced heart rate prediction model using damped least-squares algorithm

Monitoring a patient’s vital signs is considered one of the most challenging problems in telehealth systems, especially when patients reside in remote locations. Companies now use IoT devices such as wearable devices to participate in telehealth systems. However, the steady adoption of wearables can result in a significant increase in the volume of data being collected and transmitted. As these devices run on limited battery power, they can run out of power quickly due to the high processing requirements of the device for data collection and transmission. Given the importance of medical data, it is imperative that all transmitted data adhere to strict integrity and availability requirements. Reducing the volume of healthcare data and the frequency of transmission can improve a device’s battery life via an inference algorithm. Furthermore, this approach creates issues for improving transmission metrics related to accuracy and efficiency, which are traded-off against each other, with increasing accuracy reducing efficiency. This paper demonstrates that machine learning (ML) can be used to overcome the trade-off problem. The damped least-squares algorithm (DLSA) is used to enhance both metrics by taking fewer samples for transmission whilst maintaining accuracy. The algorithm is tested with a standard heart rate dataset to compare the metrics. The results showed that the DLSA provides the best performance, with an efficiency of 3.33 times for reduced sample data size and an accuracy of 95.6 %, with similar accuracies observed in seven different sampling cases adopted for testing that demonstrate improved efficiency. This proposed method significantly improve both metrics using ML without sacrificing one metric over the other compared to existing methods with high efficiency

Optimization of the Decision Tree Method using Pruning on Liver Disease Classification

The amount of data about liver disease can be used to become information that can be extracted using the decision tree data mining method. However, there is a weakness in the decision tree method, namely over-fitting the resulting tree can produce a good model in training data but normally cannot produce a good tree model when applied to unseen data. Based on experiments conducted using datasets taken from The UCI Machine Learning Repository database is the ILPD dataset which contains 583 clinical data with 10 attributes with a target output of 416 positive liver and 167 negative liver. The results show that the decision tree algorithm using pruning and without pruning has been tested showing an increase in accuracy. The results of the decision tree performance without pruning generated in the confusion matrix for the accuracy measure, which is 73.58 %. While the results of the system performance using the pruning method have an accuracy of 73.76%. Although the accuracy value is slightly adrift, it can prove that the decision tree method using the pruning method has much better accuracy. In addition, the models and rules generated by the decision tree can be used as the basis for developing a prototype application for liver disease classification

Distributed Online Machine Learning for Mobile Care Systems

Appendix D: Wavecomm Tech Docs removed for copyright reasonsTelecare and especially Mobile Care Systems are getting more and more popular. They have two major benefits: first, they drastically improve the living standards and even health outcomes for patients. In addition, they allow significant cost savings for adult care by reducing the needs for medical staff. A common drawback of current Mobile Care Systems is that they are rather stationary in most cases and firmly installed in patients’ houses or flats, which makes them stay very near to or even in their homes. There is also an upcoming second category of Mobile Care Systems which are portable without restricting the moving space of the patients, but with the major drawback that they have either very limited computational abilities and only a rather low classification quality or, which is most frequently, they only have a very short runtime on battery and therefore indirectly restrict the freedom of moving of the patients once again. These drawbacks are inherently caused by the restricted computational resources and mainly the limitations of battery based power supply of mobile computer systems. This research investigates the application of novel Artificial Intelligence (AI) and Machine Learning (ML) techniques to improve the operation of 2 Mobile Care Systems. As a result, based on the Evolving Connectionist Systems (ECoS) paradigm, an innovative approach for a highly efficient and self-optimising distributed online machine learning algorithm called MECoS - Moving ECoS - is presented. It balances the conflicting needs of providing a highly responsive complex and distributed online learning classification algorithm by requiring only limited resources in the form of computational power and energy. This approach overcomes the drawbacks of current mobile systems and combines them with the advantages of powerful stationary approaches. The research concludes that the practical application of the presented MECoS algorithm offers substantial improvements to the problems as highlighted within this thesis