Fog Computing in Medical Internet-of-Things: Architecture, Implementation, and Applications

In the era when the market segment of Internet of Things (IoT) tops the chart in various business reports, it is apparently envisioned that the field of medicine expects to gain a large benefit from the explosion of wearables and internet-connected sensors that surround us to acquire and communicate unprecedented data on symptoms, medication, food intake, and daily-life activities impacting one's health and wellness. However, IoT-driven healthcare would have to overcome many barriers, such as: 1) There is an increasing demand for data storage on cloud servers where the analysis of the medical big data becomes increasingly complex, 2) The data, when communicated, are vulnerable to security and privacy issues, 3) The communication of the continuously collected data is not only costly but also energy hungry, 4) Operating and maintaining the sensors directly from the cloud servers are non-trial tasks. This book chapter defined Fog Computing in the context of medical IoT. Conceptually, Fog Computing is a service-oriented intermediate layer in IoT, providing the interfaces between the sensors and cloud servers for facilitating connectivity, data transfer, and queryable local database. The centerpiece of Fog computing is a low-power, intelligent, wireless, embedded computing node that carries out signal conditioning and data analytics on raw data collected from wearables or other medical sensors and offers efficient means to serve telehealth interventions. We implemented and tested an fog computing system using the Intel Edison and Raspberry Pi that allows acquisition, computing, storage and communication of the various medical data such as pathological speech data of individuals with speech disorders, Phonocardiogram (PCG) signal for heart rate estimation, and Electrocardiogram (ECG)-based Q, R, S detection.Comment: 29 pages, 30 figures, 5 tables. Keywords: Big Data, Body Area Network, Body Sensor Network, Edge Computing, Fog Computing, Medical Cyberphysical Systems, Medical Internet-of-Things, Telecare, Tele-treatment, Wearable Devices, Chapter in Handbook of Large-Scale Distributed Computing in Smart Healthcare (2017), Springe

A lightweight QRS detector for single lead ECG signals using a max-min difference algorithm

Background and objectives - Detection of the R-peak pertaining to the QRS complex of an ECG signal plays an important role for the diagnosis of a patient's heart condition. To accurately identify the QRS locations from the acquired raw ECG signals, we need to handle a number of challenges, which include noise, baseline wander, varying peak amplitudes, and signal abnormality. This research aims to address these challenges by developing an efficient lightweight algorithm for QRS (i.e., R-peak) detection from raw ECG signals. Methods - A lightweight real-time sliding window-based Max-Min Difference (MMD) algorithm for QRS detection from Lead II ECG signals is proposed. Targeting to achieve the best trade-off between computational efficiency and detection accuracy, the proposed algorithm consists of five key steps for QRS detection, namely, baseline correction, MMD curve generation, dynamic threshold computation, R-peak detection, and error correction. Five annotated databases from Physionet are used for evaluating the proposed algorithm in R-peak detection. Integrated with a feature extraction technique and a neural network classifier, the proposed ORS detection algorithm has also been extended to undertake normal and abnormal heartbeat detection from ECG signals. Results - The proposed algorithm exhibits a high degree of robustness in QRS detection and achieves an average sensitivity of 99.62% and an average positive predictivity of 99.67%. Its performance compares favorably with those from the existing state-of-the-art models reported in the literature. In regards to normal and abnormal heartbeat detection, the proposed QRS detection algorithm in combination with the feature extraction technique and neural network classifier achieves an overall accuracy rate of 93.44% based on an empirical evaluation using the MIT-BIH Arrhythmia data set with 10-fold cross validation. Conclusions - In comparison with other related studies, the proposed algorithm offers a lightweight adaptive alternative for R-peak detection with good computational efficiency. The empirical results indicate that it not only yields a high accuracy rate in QRS detection, but also exhibits efficient computational complexity at the order of O(n), where n is the length of an ECG signal

Empowering AI-Diagnosis: Deep Learning Abilities for Accurate Atrial Fibrillation Classification

Artificial intelligence (AI) is a powerful technology that can enhance clinical decision-making and the efficiency of global health systems. An AI-enabled electrocardiogram (ECG) is an essential tool for diagnosing heart abnormalities such as arrhythmias. The most prevalent arrhythmia globally is atrial fibrillation (AF), which is an irregular heart rhythm that originates in the atria and can lead to other heart-related complications. A trusted AI classification of AF is explored in this study. Deep learning (DL) has been used to analyze large amounts of publicly available ECG datasets in order to classify normal sinus rhythm (NSR), AF, and other types of arrhythmias. A convolutional neural network (CNN) has been proposed to extract ECG features and classify ECG signals. Based on a 10-fold cross-validation strategy, we conducted experiments involving three scenarios for AF classification: (i) a balanced set, an imbalanced set, and an extremely imbalanced set; (ii) a comparison of ECG denoising algorithms; and (iii) the classification of AF, NSR, and other arrhythmia types (15 classes). As a result, we have achieved 100% accuracy, sensitivity, specificity, precision, and F1-score for the AF, NSR, and non-AF classifications, both for balanced and imbalanced sets. In addition, for the classification of AF, NSR, and other types of arrhythmia (15 classes), the performance results achieved an accuracy of 99.77%, sensitivity of 96.48%, specificity of 99.87%, precision of 97.03%, and F1-score of 96.68%. The results can empower AI diagnosis and assist clinicians in classifying AF on routine screening ECGs

Algorithms design for improving homecare using Electrocardiogram (ECG) signals and Internet of Things (IoT)

Due to the fast growing of population, a lot of hospitals get crowded from the huge amount of patients visits. Moreover, during COVID-19 a lot of patients prefer staying at home to minimize the spread of the virus. The need for providing care to patients at home is essential. Internet of Things (IoT) is widely known and used by different fields. IoT based homecare will help in reducing the burden upon hospitals. IoT with homecare bring up several benefits such as minimizing human exertions, economical savings and improved efficiency and effectiveness. One of the important requirement on homecare system is the accuracy because those systems are dealing with human health which is sensitive and need high amount of accuracy. Moreover, those systems deal with huge amount of data due to the continues sensing that need to be processed well to provide fast response regarding the diagnosis with minimum cost requirements. Heart is one of the most important organ in the human body that requires high level of caring. Monitoring heart status can diagnose disease from the early stage and find the best medication plan by health experts. Continues monitoring and diagnosis of heart could exhaust caregivers efforts. Having an IoT heart monitoring model at home is the solution to this problem. Electrocardiogram (ECG) signals are used to track heart condition using waves and peaks. Accurate and efficient IoT ECG monitoring at home can detect heart diseases and save human lives. As a consequence, an IoT ECG homecare monitoring model is designed in this thesis for detecting Cardiac Arrhythmia and diagnosing heart diseases. Two databases of ECG signals are used; one online which is old and limited, and another huge, unique and special from real patients in hospital. The raw ECG signal for each patient is passed through the implemented Low Pass filter and Savitzky Golay filter signal processing techniques to remove the noise and any external interference. The clear signal in this model is passed through feature extraction stage to extract number of features based on some metrics and medical information along with feature extraction algorithm to find peaks and waves. Those features are saved in the local database to apply classification on them. For the diagnosis purpose a classification stage is made using three classification ways; threshold values, machine learning and deep learning to increase the accuracy. Threshold values classification technique worked based on medical values and boarder lines. In case any feature goes above or beyond these ranges, a warning message appeared with expected heart disease. The second type of classification is by using machine learning to minimize the human efforts. A Support Vector Machine (SVM) algorithm is proposed by running the algorithm on the features extracted from both databases. The classification accuracy for online and hospital databases was 91.67% and 94% respectively. Due to the non-linearity of the decision boundary, a third way of classification using deep learning is presented. A full Multilayer Perceptron (MLP) Neural Network is implemented to improve the accuracy and reduce the errors. The number of errors reduced to 0.019 and 0.006 using online and hospital databases. While using hospital database which is huge, there is a need for a technique to reduce the amount of data. Furthermore, a novel adaptive amplitude threshold compression algorithm is proposed. This algorithm is able to make diagnosis of heart disease from the reduced size using compressed ECG signals with high level of accuracy and low cost. The extracted features from compressed and original are similar with only slight differences of 1%, 2% and 3% with no effects on machine learning and deep learning classification accuracy without the need for any reconstructions. The throughput is improved by 43% with reduced storage space of 57% when using data compression. Moreover, to achieve fast response, the amount of data should be reduced further to provide fast data transmission. A compressive sensing based cardiac homecare system is presented. It gives the channel between sender and receiver the ability to carry small amount of data. Experiment results reveal that the proposed models are more accurate in the classification of Cardiac Arrhythmia and in the diagnosis of heart diseases. The proposed models ensure fast diagnosis and minimum cost requirements. Based on the experiments on classification accuracy, number of errors and false alarms, the dictionary of the compressive sensing selected to be 900. As a result, this thesis provided three different scenarios that achieved IoT homecare Cardiac monitoring to assist in further research for designing homecare Cardiac monitoring systems. The experiment results reveal that those scenarios produced better results with high level of accuracy in addition to minimizing data and cost requirements

Heart Abnormality Detection Technique using PPG Signal

Cardiovascular disease (CVD) is the major cause of death in the world. Previous works have been performed to overcome this issue, however, a simple yet effective detection technique scarce. Thus, in this study, photoplethysmogram (PPG) signal which are easily acquired from the fingertip, low cost, and requires low power consumption, is used. These biosignals were obtained from MIMIC II Waveform Database, Version 3 Part 1 with sampling frequency of 200 Hz with the duration of 10 seconds each. The feature of the PPG signals were then extracted using MATLAB and the peak-to-peak intervals (PPI) of PPG signals were calculated and evaluated to differentiate between the normal and abnormal PPG signals. Based on the experimentation results, PPI values between the systolic peaks of abnormal PPG signals are larger than the normal PPG signals. The significant difference between the PPI values of normal and abnormal signals indicates the reliability of the proposed method as a technique to detect heart abnormalities

Intelligent Pattern Analysis of the Foetal Electrocardiogram

The aim of the project on which this thesis is based is to develop reliable techniques for foetal electrocardiogram (ECG) based monitoring, to reduce incidents of unnecessary medical intervention and foetal injury during labour. World-wide electronic foetal monitoring is based almost entirely on the cardiotocogram (CTG), which is a continuous display of the foetal heart rate (FHR) pattern together with the contraction of the womb. Despite the widespread use of the CTG, there is no significant improvement in foetal outcome. In the UK alone it is estimated that birth related negligence claims cost the health authorities over £400M per-annum. An expert system, known as INFANT, has recently been developed to assist CTG interpretation. However, the CTG alone does not always provide all the information required to improve the outcome of labour. The widespread use of ECG analysis has been hindered by the difficulties with poor signal quality and the difficulties in applying the specialised knowledge required for interpreting ECG patterns, in association with other events in labour, in an objective way. A fundamental investigation and development of optimal signal enhancement techniques that maximise the available information in the ECG signal, along with different techniques for detecting individual waveforms from poor quality signals, has been carried out. To automate the visual interpretation of the ECG waveform, novel techniques have been developed that allow reliable extraction of key features and hence allow a detailed ECG waveform analysis. Fuzzy logic is used to automatically classify the ECG waveform shape using these features by using knowledge that was elicited from expert sources and derived from example data. This allows the subtle changes in the ECG waveform to be automatically detected in relation to other events in labour, and thus improve the clinicians position for making an accurate diagnosis. To ensure the interpretation is based on reliable information and takes place in the proper context, a new and sensitive index for assessing the quality of the ECG has been developed. New techniques to capture, for the first time in machine form, the clinical expertise / guidelines for electronic foetal monitoring have been developed based on fuzzy logic and finite state machines, The software model provides a flexible framework to further develop and optimise rules for ECG pattern analysis. The signal enhancement, QRS detection and pattern recognition of important ECG waveform shapes have had extensive testing and results are presented. Results show that no significant loss of information is incurred as a result of the signal enhancement and feature extraction techniques

A Cluster-Based Opposition Differential Evolution Algorithm Boosted by a Local Search for ECG Signal Classification

Electrocardiogram (ECG) signals, which capture the heart's electrical activity, are used to diagnose and monitor cardiac problems. The accurate classification of ECG signals, particularly for distinguishing among various types of arrhythmias and myocardial infarctions, is crucial for the early detection and treatment of heart-related diseases. This paper proposes a novel approach based on an improved differential evolution (DE) algorithm for ECG signal classification for enhancing the performance. In the initial stages of our approach, the preprocessing step is followed by the extraction of several significant features from the ECG signals. These extracted features are then provided as inputs to an enhanced multi-layer perceptron (MLP). While MLPs are still widely used for ECG signal classification, using gradient-based training methods, the most widely used algorithm for the training process, has significant disadvantages, such as the possibility of being stuck in local optimums. This paper employs an enhanced differential evolution (DE) algorithm for the training process as one of the most effective population-based algorithms. To this end, we improved DE based on a clustering-based strategy, opposition-based learning, and a local search. Clustering-based strategies can act as crossover operators, while the goal of the opposition operator is to improve the exploration of the DE algorithm. The weights and biases found by the improved DE algorithm are then fed into six gradient-based local search algorithms. In other words, the weights found by the DE are employed as an initialization point. Therefore, we introduced six different algorithms for the training process (in terms of different local search algorithms). In an extensive set of experiments, we showed that our proposed training algorithm could provide better results than the conventional training algorithms.Comment: 44 pages, 9 figure

Classification of Arrhythmia from ECG Signals using MATLAB

An Electrocardiogram (ECG) is defined as a test that is performed on the heart to detect any abnormalities in the cardiac cycle. Automatic classification of ECG has evolved as an emerging tool in medical diagnosis for effective treatments. The work proposed in this paper has been implemented using MATLAB. In this paper, we have proposed an efficient method to classify the ECG into normal and abnormal as well as classify the various abnormalities. To brief it, after the collection and filtering the ECG signal, morphological and dynamic features from the signal were obtained which was followed by two step classification method based on the traits and characteristic evaluation. ECG signals in this work are collected from MIT-BIH, AHA, ESC, UCI databases. In addition to this, this paper also provides a comparative study of various methods proposed via different techniques. The proposed technique used helped us process, analyze and classify the ECG signals with an accuracy of 97% and with good convenience

Generalised and Versatile Connected Health Solution on the Zynq SoC

This chapter presents a generalized and versatile connected health solution for patient monitoring. It consists of a mobile system that can be used at home, an ambulance and a hospital. The system uses the Shimmer sensor device to collect three axes (x, y and z) accelerometer data as well as electrocardiogram signals. The accelerometer data is used to implement a fall detection system using the k-Nearest Neighbors classifier. The classification algorithm is implemented on various platform including a PC and the Zynq system on chip platform where both programmable logic and processing system of the Zynq are explored. In addition, the electrocardiogram signals are used to extract vital information, the signals are also encrypted using the Advanced Encryption Standard and sent wirelessly using Wi-Fi for further processing. Implementation results have shown that the best overall accuracy reaches 90% for the fall detection while meeting real-time performances when implemented on the Zynq and while using only 48% of Look-up Tables and 22% of Flip-Flops available on chip