Development of machine learning schemes for use in non-invasive and continuous patient health monitoring

Stephanie Baker developed machine learning schemes for the non-invasive and continuous measurement of blood pressure and respiratory rate from heart activity waveforms. She also constructed machine learning models for mortality risk assessment from vital sign variations. This research contributes several tools that offer significant advancements in patient monitoring and wearable healthcare

BEst (Biomarker Estimation): Health Biomarker Estimation Non-invasively and Ubiquitously

This dissertation focuses on the non-invasive assessment of blood-hemoglobin levels. The primary goal of this research is to investigate a reliable, affordable, and user-friendly point-of-care solution for hemoglobin-level determination using fingertip videos captured by a smartphone. I evaluated videos obtained from five patient groups, three from the United States and two from Bangladesh, under two sets of lighting conditions. In the last group, based on human tissue optical transmission modeling data, I used near-infrared light-emitting diode sources of three wavelengths. I developed novel image processing techniques for fingertip video analysis to estimate hemoglobin levels. I studied video images creating image histogram and subdividing each image into multiple blocks. I determined the region of interest in a video and created photoplethysmogram signals. I created features from image histograms and PPG signals. I used the Partial Least Squares Regression and Support Vector Machine Regression tools to analyze input features and to build hemoglobin prediction models. Using data from the last and largest group of patients studied, I was able to develop a model with a strong linear correlation between estimated and clinically-measured hemoglobin levels. With further data and methodological refinements, the approach I have developed may be able to define a clinically accurate public health applicable tool for hemoglobin level and other blood constituent assessment

Blood pressure estimation with complexity features from electrocardiogram and photoplethysmogram signals

A novel method for the continual, cuff-less estimation of the systolic blood pressure (SBP) and diastolic blood pressure (DBP) values based on signal complexity analysis of the photoplethysmogram (PPG) and the electrocardiogram (ECG) is reported. The proposed framework estimates the blood pressure (BP) values obtained from signals generated from 14 volunteers subjected to a series of exercise routines. Herein, the physiological signals were first pre-processed, followed by the extraction of complexity features from both the PPG and ECG. Subsequently the complexity features were used in regression models (artificial neural network (ANN), support vector machine (SVM) and LASSO) to predict the BP. The performance of the approach was evaluated by calculating the mean absolute error and the standard deviation of the predicted results and compared with the recommendations made by the British Hypertension Society (BHS) and Association for the Advancement of Medical Instrumentation. Complexity features from the ECG and PPG were investigated independently, along with the combined dataset. It was observed that the complexity features obtained from the combination of ECG and PPG signals resulted to an improved estimation accuracy for the BP. The most accurate DBP result of 5.15 ± 6.46 mmHg was obtained from ANN model, and SVM generated the most accurate prediction for the SBP which was estimated as 7.33 ± 9.53 mmHg. Results for DBP fall within recommended performance of the BHS but SBP is outside the range. Although initial results are promising, further improvements are required before the potential of this approach is fully realised

CardioCam: Leveraging Camera on Mobile Devices to Verify Users While Their Heart is Pumping

With the increasing prevalence of mobile and IoT devices (e.g., smartphones, tablets, smart-home appliances), massive private and sensitive information are stored on these devices. To prevent unauthorized access on these devices, existing user verification solutions either rely on the complexity of user-defined secrets (e.g., password) or resort to specialized biometric sensors (e.g., fingerprint reader), but the users may still suffer from various attacks, such as password theft, shoulder surfing, smudge, and forged biometrics attacks. In this paper, we propose, CardioCam, a low-cost, general, hard-to-forge user verification system leveraging the unique cardiac biometrics extracted from the readily available built-in cameras in mobile and IoT devices. We demonstrate that the unique cardiac features can be extracted from the cardiac motion patterns in fingertips, by pressing on the built-in camera. To mitigate the impacts of various ambient lighting conditions and human movements under practical scenarios, CardioCam develops a gradient-based technique to optimize the camera configuration, and dynamically selects the most sensitive pixels in a camera frame to extract reliable cardiac motion patterns. Furthermore, the morphological characteristic analysis is deployed to derive user-specific cardiac features, and a feature transformation scheme grounded on Principle Component Analysis (PCA) is developed to enhance the robustness of cardiac biometrics for effective user verification. With the prototyped system, extensive experiments involving 25 subjects are conducted to demonstrate that CardioCam can achieve effective and reliable user verification with over 99% average true positive rate (TPR) while maintaining the false positive rate (FPR) as low as 4%

ARTIFICIAL INTELLIGENCE-ENABLED EDGE-CENTRIC SOLUTION FOR AUTOMATED ASSESSMENT OF SLEEP USING WEARABLES IN SMART HEALTH

ARTIFICIAL INTELLIGENCE-ENABLED EDGE-CENTRIC SOLUTION FOR AUTOMATED ASSESSMENT OF SLEEP USING WEARABLES IN SMART HEALT

Continuous vital monitoring during sleep and light activity using carbon-black elastomer sensors

The comfortable, continuous monitoring of vital parameters is still a challenge. The long-term measurement of respiration and cardiovascular signals is required to diagnose cardiovascular and respiratory diseases. Similarly, sleep quality assessment and the recovery period following acute treatments require long-term vital parameter datalogging. To address these requirements, we have developed “VitalCore”, a wearable continuous vital parameter monitoring device in the form of a T-shirt targeting the uninterrupted monitoring of respiration, pulse, and actigraphy. VitalCore uses polymer-based stretchable resistive bands as the primary sensor to capture breathing and pulse patterns from chest expansion. The carbon black-impregnated polymer is implemented in a U-shaped configuration and attached to the T-shirt with “interfacing” material along with the accompanying electronics. In this paper, VitalCore is bench tested and compared to gold standard respiration and pulse measurements to verify its functionality and further to assess the quality of data captured during sleep and during light exercise (walking). We show that these polymer-based sensors could identify respiratory peaks with a sensitivity of 99.44%, precision of 96.23%, and false-negative rate of 0.557% during sleep. We also show that this T-shirt configuration allows the wearer to sleep in all sleeping positions with a negligible difference of data quality. The device was also able to capture breathing during gait with 88.9%–100% accuracy in respiratory peak detection

Quantitative Multidimensional Stress Assessment from Facial Videos

Stress has a significant impact on the physical and mental health of an individual and is a growing concern for society, especially during the COVID-19 pandemic. Facial video-based stress evaluation from non-invasive cameras has proven to be a significantly more efficient method to evaluate stress in comparison to approaches that use questionnaires or wearable sensors. Plenty of classification models have been built for stress detection. However, most do not consider individual differences. Also, the results for such models are limited by a uni-dimensional definition of stress levels lacking a comprehensive quantitative definition of stress. The dissertation focuses on building a framework that utilizes the multilevel video frame representations from deep learning and the remote photoplethysmography signals extracted from the facial videos for stress assessment. The fusion model takes the inputs of a baseline video and a target video of the subject. The physiological features such as heart rate and heart rate variability are used with the initial stress scores generated from deep learning are used to predict the stress scores in cognitive anxiety, somatic anxiety, and self-confidence. To generate stress scores with better accuracy, the signal extraction method is improved by introducing the CWT-SNR method that uses the signal-to-noise ratio to assist the adaptive bandpass filtering in the post-processing of the signals. A study on phase space reconstruction features is performed and the results show the potential for additional accuracy improvement for the heart rate variability detection. To select the best deep learning architecture, multiple deep learning architectures are tested to build the deep learning model. Support Vector Regression is used to generate the output stress score results. Testing with the data from the UBFC-Phys dataset, the fusion model shows a strong correlation between ground truth and the predicted results

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

Multidimensional embedded MEMS motion detectors for wearable mechanocardiography and 4D medical imaging

Background: Cardiovascular diseases are the number one cause of death. Of these deaths, almost 80% are due to coronary artery disease (CAD) and cerebrovascular disease. Multidimensional microelectromechanical systems (MEMS) sensors allow measuring the mechanical movement of the heart muscle offering an entirely new and innovative solution to evaluate cardiac rhythm and function. Recent advances in miniaturized motion sensors present an exciting opportunity to study novel device-driven and functional motion detection systems in the areas of both cardiac monitoring and biomedical imaging, for example, in computed tomography (CT) and positron emission tomography (PET). Methods: This Ph.D. work describes a new cardiac motion detection paradigm and measurement technology based on multimodal measuring tools — by tracking the heart’s kinetic activity using micro-sized MEMS sensors — and novel computational approaches — by deploying signal processing and machine learning techniques—for detecting cardiac pathological disorders. In particular, this study focuses on the capability of joint gyrocardiography (GCG) and seismocardiography (SCG) techniques that constitute the mechanocardiography (MCG) concept representing the mechanical characteristics of the cardiac precordial surface vibrations. Results: Experimental analyses showed that integrating multisource sensory data resulted in precise estimation of heart rate with an accuracy of 99% (healthy, n=29), detection of heart arrhythmia (n=435) with an accuracy of 95-97%, ischemic disease indication with approximately 75% accuracy (n=22), as well as significantly improved quality of four-dimensional (4D) cardiac PET images by eliminating motion related inaccuracies using MEMS dual gating approach. Tissue Doppler imaging (TDI) analysis of GCG (healthy, n=9) showed promising results for measuring the cardiac timing intervals and myocardial deformation changes. Conclusion: The findings of this study demonstrate clinical potential of MEMS motion sensors in cardiology that may facilitate in time diagnosis of cardiac abnormalities. Multidimensional MCG can effectively contribute to detecting atrial fibrillation (AFib), myocardial infarction (MI), and CAD. Additionally, MEMS motion sensing improves the reliability and quality of cardiac PET imaging.Moniulotteisten sulautettujen MEMS-liiketunnistimien käyttö sydänkardiografiassa sekä lääketieteellisessä 4D-kuvantamisessa Tausta: Sydän- ja verisuonitaudit ovat yleisin kuolinsyy. Näistä kuolemantapauksista lähes 80% johtuu sepelvaltimotaudista (CAD) ja aivoverenkierron häiriöistä. Moniulotteiset mikroelektromekaaniset järjestelmät (MEMS) mahdollistavat sydänlihaksen mekaanisen liikkeen mittaamisen, mikä puolestaan tarjoaa täysin uudenlaisen ja innovatiivisen ratkaisun sydämen rytmin ja toiminnan arvioimiseksi. Viimeaikaiset teknologiset edistysaskeleet mahdollistavat uusien pienikokoisten liiketunnistusjärjestelmien käyttämisen sydämen toiminnan tutkimuksessa sekä lääketieteellisen kuvantamisen, kuten esimerkiksi tietokonetomografian (CT) ja positroniemissiotomografian (PET), tarkkuuden parantamisessa. Menetelmät: Tämä väitöskirjatyö esittelee uuden sydämen kineettisen toiminnan mittaustekniikan, joka pohjautuu MEMS-anturien käyttöön. Uudet laskennalliset lähestymistavat, jotka perustuvat signaalinkäsittelyyn ja koneoppimiseen, mahdollistavat sydämen patologisten häiriöiden havaitsemisen MEMS-antureista saatavista signaaleista. Tässä tutkimuksessa keskitytään erityisesti mekanokardiografiaan (MCG), joihin kuuluvat gyrokardiografia (GCG) ja seismokardiografia (SCG). Näiden tekniikoiden avulla voidaan mitata kardiorespiratorisen järjestelmän mekaanisia ominaisuuksia. Tulokset: Kokeelliset analyysit osoittivat, että integroimalla usean sensorin dataa voidaan mitata syketiheyttä 99% (terveillä n=29) tarkkuudella, havaita sydämen rytmihäiriöt (n=435) 95-97%, tarkkuudella, sekä havaita iskeeminen sairaus noin 75% tarkkuudella (n=22). Lisäksi MEMS-kaksoistahdistuksen avulla voidaan parantaa sydämen 4D PET-kuvan laatua, kun liikeepätarkkuudet voidaan eliminoida paremmin. Doppler-kuvantamisessa (TDI, Tissue Doppler Imaging) GCG-analyysi (terveillä, n=9) osoitti lupaavia tuloksia sydänsykkeen ajoituksen ja intervallien sekä sydänlihasmuutosten mittaamisessa. Päätelmä: Tämän tutkimuksen tulokset osoittavat, että kardiologisilla MEMS-liikeantureilla on kliinistä potentiaalia sydämen toiminnallisten poikkeavuuksien diagnostisoinnissa. Moniuloitteinen MCG voi edistää eteisvärinän (AFib), sydäninfarktin (MI) ja CAD:n havaitsemista. Lisäksi MEMS-liiketunnistus parantaa sydämen PET-kuvantamisen luotettavuutta ja laatua