Fuzzy Logic in Clinical Practice Decision Support Systems

Computerized clinical guidelines can provide significant benefits to health outcomes and costs, however, their effective implementation presents significant problems. Vagueness and ambiguity inherent in natural (textual) clinical guidelines is not readily amenable to formulating automated alerts or advice. Fuzzy logic allows us to formalize the treatment of vagueness in a decision support architecture. This paper discusses sources of fuzziness in clinical practice guidelines. We consider how fuzzy logic can be applied and give a set of heuristics for the clinical guideline knowledge engineer for addressing uncertainty in practice guidelines. We describe the specific applicability of fuzzy logic to the decision support behavior of Care Plan On-Line, an intranet-based chronic care planning system for General Practitioners

Fuzzy rule-based system applied to risk estimation of cardiovascular patients

Cardiovascular decision support is one area of increasing research interest. On-going collaborations between clinicians and computer scientists are looking at the application of knowledge discovery in databases to the area of patient diagnosis, based on clinical records. A fuzzy rule-based system for risk estimation of cardiovascular patients is proposed. It uses a group of fuzzy rules as a knowledge representation about data pertaining to cardiovascular patients. Several algorithms for the discovery of an easily readable and understandable group of fuzzy rules are formalized and analysed. The accuracy of risk estimation and the interpretability of fuzzy rules are discussed. Our study shows, in comparison to other algorithms used in knowledge discovery, that classifcation with a group of fuzzy rules is a useful technique for risk estimation of cardiovascular patients. © 2013 Old City Publishing, Inc

PRE-ECLAMPSIA DIAGNOSIS EXPERT SYSTEM USING FUZZY INFERENCE SYSTEM MAMDANI

Various institutions utilize computer information systems to analyze and process data. An expert system is an information system that is used to help analyze and determine decisions on a problem based on rules determined by experts. This research focuses on creating a prototype expert system for diagnosing pre-eclampsia or pregnancy poisoning in pregnant women based on measuring blood pressure and checking proteinuria. The existing data is then analyzed using the Mamdani system's fuzzy inference method. Supporting theory regarding the fuzzy inference system of Mamdani, pre-eclampsia and its examination indicators will be used as a basis for creating this expert system prototype. The data used were secondary data on preeclampsia patients in the form of medical records of blood pressure measurements, proteinuria examinations and doctor diagnoses of preeclampsia patients at two Regional General Hospitals (RSUD), namely Atambua and Kefamenanu, totaling 20 samples. The interface or user interface of this prototype system is made as simple as possible so that it can be operated by all ordinary people. The programming language used is Visual Basic (VB) with the Visual Studio 2010 developer application. The initial prototype of this system will continue to be developed until it can become a Information systems or real applications used in hospitals. The results of this research are that the expert system for diagnosing preclampsia can be used well and easily by hospital staff and show congruence between the system diagnosis results and the diagnosis results from obstetricians or experts in the 20 processed data

Application of Mamdani’s Fuzzy Inference System in The Diagnosis of Pre-eclampsia

Pre-eclampsia is the second of the top three causes of death in pregnant women after bleeding and followed by infection. By knowing the risk factors, early detection of pre-eclampsia in pregnant womenneeds to be done so that later it can be treated more quickly to prevent further complications. This studyaims to design a practical application of a decision-making system for the diagnosis of pre-eclampsia inpregnant women using the Fuzzy Inference System (FIS) method so it can be used efficiently and effectively for the early diagnosis of pre-eclampsia. The method used in data analysis is the FIS Mamdanimethod with defuzzification using the centroid method. The designed system considers blood pressureand proteinuria as input variables and pre-eclampsia status as output variables. The research resultsshow that the system has 7.27% of Mean Absolute Percentage Error (MAPE) value and when comparing the final diagnosis of the system and expert diagnoses (doctors) from 20 patients at two hospitals, itwas found that the system diagnosis was 100% in accordance with the expert diagnoses

Does health information affect lifestyle behaviours? The impact of a diabetes diagnosis

Despite an increasing interest in the effect of health information on health-behaviours, evidence on the causal impact of a diagnosis on lifestyle factors is still mixed and does not often account for long-term effects. We explore the role of health information in individual health-related decisions by identifying the causal impact of a type-2 diabetes diagnosis on body mass index (BMI) and lifestyle behaviours. We employ a fuzzy regression discontinuity design (RDD) exploiting the exogenous cut-off value in the diagnosis of type-2 diabetes provided by a biomarker (glycated haemoglobin) drawn from unique administrative longitudinal data from Spain. We find that following a type-2 diabetes diagnosis individuals appear to reduce their weight in the short-term. Differently from previous studies, we also provide evidence of statistically significant long-term impacts of a type-2 diabetes diagnosis on BMI up to three years from the diagnosis. We do not find perceivable effects of a type-2 diabetes diagnosis on quitting smoking or drinking. Overall, health information appears to have a sustained causal impact on weight reduction, a key lifestyle and risk factor among individuals with type-2 diabetes.Ministry of Science, Innovation and Universities PID2019-105688RB-I00Ministry of Economics and Competitiveness PID2020-114040RB-100Tomas y Valiente Fellowship - Madrid Institute for Advanced Study (MIAS) Comunidad de Madrid SI1/PJI/2019-0032

Ensuring patients privacy in a cryptographic-based-electronic health records using bio-cryptography

Several recent works have proposed and implemented cryptography as a means to preserve privacy and security of patients health data. Nevertheless, the weakest point of electronic health record (EHR) systems that relied on these cryptographic schemes is key management. Thus, this paper presents the development of privacy and security system for cryptography-based-EHR by taking advantage of the uniqueness of fingerprint and iris characteristic features to secure cryptographic keys in a bio-cryptography framework. The results of the system evaluation showed significant improvements in terms of time efficiency of this approach to cryptographic-based-EHR. Both the fuzzy vault and fuzzy commitment demonstrated false acceptance rate (FAR) of 0%, which reduces the likelihood of imposters gaining successful access to the keys protecting patients protected health information. This result also justifies the feasibility of implementing fuzzy key binding scheme in real applications, especially fuzzy vault which demonstrated a better performance during key reconstruction

Fuzzy logic as a decision-making support system for the indication of bariatric surgery based on an index (OBESINDEX) generated by the association between body fat and body mass index

Background: A Fuzzy Obesity Index (OBESINDEX) for use as an alternative in bariatric surgery indication (BSI) is presented. The search for a more accurate method to evaluate obesity and to indicate a better treatment is important in the world health context. BMI (body mass index) is considered the main criteria for obesity treatment and BSI. Nevertheless, the fat excess related to the percentage of Body Fat (%BF) is actually the principal harmful factor in obesity disease that is usually neglected. This paper presents a new fuzzy mechanism for evaluating obesity by associating BMI with %BF that yields a fuzzy obesity index for obesity evaluation and treatment and allows building up a Fuzzy Decision Support System (FDSS) for BSI.

Methods: Seventy-two patients were evaluated for both BMI and %BF. These data are modified and treated as fuzzy sets. Afterwards, the BMI and %BF classes are aggregated yielding a new index (OBESINDEX) for input linguistic variable are considered the BMI and %BF, and as output linguistic variable is employed the OBESINDEX, an obesity classification with entirely new classes of obesity in the fuzzy context as well is used for BSI.

Results: There is a gradual, smooth obesity classification and BSI when using the proposed fuzzy obesity index when compared with other traditional methods for dealing with obesity.

Conclusion: The BMI is not adequate for surgical indication in all the conditions and fuzzy logic becomes an alternative for decision making in bariatric surgery indication based on the OBESINDEX

Fuzzy logic as a decision-making support system for the indication of bariatric surgery based on an index (MAFOI) generated by the association between body fat and body mass index.

Background: A fuzzy obesity index (MAFOI) for use as an alternative to bariatric surgery indication (BSI) is presented. The search for a more accurate method to evaluate obesity and to indicate a better treatment is important in the world health context. BMI (body mass index) is considered the main criteria for obesity treatment and BSI. Nevertheless, the fat excess related to the percentage of Body Fat (%BF) is actually the principal harmful factor in obesity disease that is usually neglected. This paper presents a new fuzzy mechanism for evaluating obesity by associating BMI with %BF that yields a fuzzy obesity index for obesity evaluation and treatment and allows building up a Fuzzy Decision Support System (FDSS) for BSI. Methods: Seventy-two patients were evaluated for both BMI and %BF. These data are modified and treated as fuzzy sets. Afterwards, the BMI and %BF classes are aggregated yielding a new index (MAFOI) for input linguistic variable are considered the BMI and %BF, and as output linguistic variable is employed the MAFOI, an obesity classification with entirely new classes of obesity in the fuzzy context as well as is used for BSI. Results: There is gradual, smooth obesity classification and BSI when using the proposed fuzzy obesity index when compared with other traditional methods for dealing with obesity.
Conclusion: The BMI is not adequate for surgical indication in all the conditions and fuzzy logic becomes an alternative for decision making in bariatric surgery indication based on the MAFOI