DIAGNOSA STATUS RESIKO JANTUNG KORONER MENGGUNAKAN METODE FUZZY NON STATIONARY

Penyakit jantung koroner (PJK) merupakan penyakit yang apabila sudah terdiagnosa perlu sekali diawasi karena beresiko tinggi terhadap kematian. Resiko kematian tersebut perlu diminimalisasi dengan membuat sebuah media konsultasi dan monitoring terhadap penderita sesuai gejala yang dialami. Dokter dan paramedis adalah pakar yang berkompeten untuk mediagnosa tingkat resiko penyakit jantung koroner, namun dalam pengambilan keputusan yang sulit terdapat keragaman opini pakar (inter-expert) dan seiring waktu opini pakar pun berubah (intra-expert) karena pengetahuannya terus bertambah berdasarkan adanya gejala baru dari penelitian yang dilakukan, kebiasaan baru, atau dipengaruhi keadaanemosi.Model fuzzy mengatasi permasalahan ketidakpastian. Model fuzzy yang menggunakan himpunan fuzzy non-stationary (FNIS) mereplikasi keragaman pada manusia sehingga mampu mengatasi permasalahan kegaraman opini pada pakar baik inter-expert maupun intra-expert. Sistem yang dibangun menggunakan model fuzzy non-stationary untuk mendiagnosa tingkat resiko jantung koroner berdasarkan 5 input yakni umur, tekanan darah, gula darah, status BMI, dan kolesterol. Fuzzy sistem pada penelitian ini menggunakan mamdani inferensi. Dua fungsi perturbation function yang digunakan sistem adalah fungsi distribusi acak normal pada variabel input dan fungsi sinusoidal pada variabel output untukmeng-generate membership function untuk 5 kali perulangan. Hasil perbandingan diagnosa antara pakar, FIS, dan FNIS didapati bahwa FNIS lebih tepat dibandingkan FIS sesuai diagnosa pakar secara manual

The need for fuzzy AI

Artificial intelligence (AI) is once again a topic of huge interest for computer scientists around the world. Whilst advances in the capability of machines are being made all around the world at an incredible rate, there is also increasing focus on the need for computerised systems to be able to explain their decisions, at least to some degree. It is also clear that data and knowledge in the real world are characterised by uncertainty. Fuzzy systems can provide decision support, which both handle uncertainty and have explicit representations of uncertain knowledge and inference processes. However, it is not yet clear how any decision support systems, including those featuring fuzzy methods, should be evaluated as to whether their use is permitted. This paper presents a conceptual framework of indistinguishability as the key component of the evaluation of computerised decision support systems. Case studies are presented in which it has been clearly demonstrated that human expert performance is less than perfect, together with techniques that may enable fuzzy systems to emulate human-level performance including variability. In conclusion, this paper argues for the need for 'fuzzy AI' in two senses: (i) the need for fuzzy methodologies (in the technical sense of Zadeh's fuzzy sets and systems) as knowledge-based systems to represent and reason with uncertainty; and (ii) the need for fuzziness (in the non-technical sense) with an acceptance of imperfect performance in evaluating AI systems

Prediction of O3 Concentration Level Using Fuzzy Non-Stationary Method

The composition of air concentration is not constant. It constantly changes with minor changes at any time, so more than one measurement is needed to represent the air concentration level for a full day. The fuzzy non-stationary method can overcome uncertainty in an environment that is not constant or caused by minor temporal changes based on time variables. This study uses a non-stationary fuzzy method to determine the level of O3 concentration based on the input variables of temperature, humidity, and wind speed. The tests were conducted in September, October, and November using four types of implication process interpretation, namely interpretation 1 (classical logic), interpretation 2 (classical logic), interpretation 3 (algebraic), and interpretation 3 (standard). The test results in September showed a tendency for error percentage using the MAPE amount of 19, October's amount of 25, and November's amount of 18

Towards Interpretable Machine Learning in Medical Image Analysis

Over the past few years, ML has demonstrated human expert level performance in many medical image analysis tasks. However, due to the black-box nature of classic deep ML models, translating these models from the bench to the bedside to support the corresponding stakeholders in the desired tasks brings substantial challenges. One solution is interpretable ML, which attempts to reveal the working mechanisms of complex models. From a human-centered design perspective, interpretability is not a property of the ML model but an affordance, i.e., a relationship between algorithm and user. Thus, prototyping and user evaluations are critical to attaining solutions that afford interpretability. Following human-centered design principles in highly specialized and high stakes domains, such as medical image analysis, is challenging due to the limited access to end users. This dilemma is further exacerbated by the high knowledge imbalance between ML designers and end users. To overcome the predicament, we first define 4 levels of clinical evidence that can be used to justify the interpretability to design ML models. We state that designing ML models with 2 levels of clinical evidence: 1) commonly used clinical evidence, such as clinical guidelines, and 2) iteratively developed clinical evidence with end users are more likely to design models that are indeed interpretable to end users. In this dissertation, we first address how to design interpretable ML in medical image analysis that affords interpretability with these two different levels of clinical evidence. We further highly recommend formative user research as the first step of the interpretable model design to understand user needs and domain requirements. We also indicate the importance of empirical user evaluation to support transparent ML design choices to facilitate the adoption of human-centered design principles. All these aspects in this dissertation increase the likelihood that the algorithms afford interpretability and enable stakeholders to capitalize on the benefits of interpretable ML. In detail, we first propose neural symbolic reasoning to implement public clinical evidence into the designed models for various routinely performed clinical tasks. We utilize the routinely applied clinical taxonomy for abnormality classification in chest x-rays. We also establish a spleen injury grading system by strictly following the clinical guidelines for symbolic reasoning with the detected and segmented salient clinical features. Then, we propose the entire interpretable pipeline for UM prognostication with cytopathology images. We first perform formative user research and found that pathologists believe cell composition is informative for UM prognostication. Thus, we build a model to analyze cell composition directly. Finally, we conduct a comprehensive user study to assess the human factors of human-machine teaming with the designed model, e.g., whether the proposed model indeed affords interpretability to pathologists. The human-centered design process is proven to be truly interpretable to pathologists for UM prognostication. All in all, this dissertation introduces a comprehensive human-centered design for interpretable ML solutions in medical image analysis that affords interpretability to end users

Mining Primary Care Electronic Health Records for Automatic Disease Phenotyping: A Transparent Machine Learning Framework

(1) Background: We aimed to develop a transparent machine-learning (ML) framework to automatically identify patients with a condition from electronic health records (EHRs) via a parsimonious set of features. (2) Methods: We linked multiple sources of EHRs, including 917,496,869 primary care records and 40,656,805 secondary care records and 694,954 records from specialist surgeries between 2002 and 2012, to generate a unique dataset. Then, we treated patient identification as a problem of text classification and proposed a transparent disease-phenotyping framework. This framework comprises a generation of patient representation, feature selection, and optimal phenotyping algorithm development to tackle the imbalanced nature of the data. This framework was extensively evaluated by identifying rheumatoid arthritis (RA) and ankylosing spondylitis (AS). (3) Results: Being applied to the linked dataset of 9657 patients with 1484 cases of rheumatoid arthritis (RA) and 204 cases of ankylosing spondylitis (AS), this framework achieved accuracy and positive predictive values of 86.19% and 88.46%, respectively, for RA and 99.23% and 97.75% for AS, comparable with expert knowledge-driven methods. (4) Conclusions: This framework could potentially be used as an efficient tool for identifying patients with a condition of interest from EHRs, helping clinicians in clinical decision-support process

Personalized Medicine Support System for Chronic Myeloid Leukemia Patients

Personalized medicine offers the most effective treatment protocols to the individual Chronic Myeloid Leukemia (CML) patients. Understanding the molecular biology that causes CML assists in providing efficient treatment. After the identification of an activated tyrosine kinase BCR-ABL1 as the causative lesion in CML, the first-generation Tyrosine Kinase inhibitors (TKI) imatinib (Glivec®), were developed to inhibit BCR-ABL1 activity and approved as a treatment for CML. Despite the remarkable increase in the survival rate of CML patients treated with imatinib, some patients discontinued imatinib therapy due to intolerance, resistance or progression. These patients may benefit from the use of secondgeneration TKIs, such as nilotinib (Tasigna®) and dasatinib (Sprycel®). All three of these TKIs are currently approved for use as frontline treatments. Prognostic scores and molecularbased predictive assays are used to personalize the care of CML patients by allocating risk groups and predicting responses to therapy. Although prognostic scores remain in use today, they are often inadequate for three main reasons. Firstly, since each prognostic score may generate conflicting prognoses for the risk index and it can be difficult to know how to treat patients with conflicting prognoses. Secondly, since prognostic score systems are developed over time, patients can benefit from newly developed systems and information. Finally, the earlier scores use mostly clinically oriented factors instead of those directly related to genetic or molecular indicators. As the current CML treatment guidelines recommend the use of TKI therapy, a new tool that combines the well-known, molecular-based predictive assays to predict molecular response to TKI has not been considered in previous research. Therefore, the main goal of this research is to improve the ability to manage CML disease in individual CML patients and support CML physicians in TKI therapy treatment selection by correctly allocating patients to risk groups and predicting their molecular response to the selected treatment. To achieve this objective, the research detailed here focuses on developing a prognostic model and a predictive model for use as a personalized medicine support system. The system will be considered a knowledge-based clinical decision support system that includes two models embedded in a decision tree. The main idea is to classify patients into risk groups using the prognostic model, while the patients identified as part of the high-risk group should be considered for more aggressive imatinib therapy or switched to secondgeneration TKI with close monitoring. For patients assigned to the low-risk group to imatinib should be predicted using the predictive model. The outcomes should be evaluated by comparing the results of these models with the actual responses to imatinib in patients from a previous medical trial and from patients admitted to hospitals. Validating such a predictive system could greatly assist clinicians in clinical decision-making geared toward individualized medicine. Our findings suggest that the system provides treatment recommendations that could help improve overall healthcare for CML patients. Study limitations included the impact of diversity on human expertise, changing predictive factors, population and prediction endpoints, the impact of time and patient personal issues. Further intensive research activities based on the development of a new predictive model and the method for selecting predictive factors and validation can be expanded to other health organizations and the development of models to predict responses to other TKIs.Thesis (Ph.D.) -- University of Adelaide, School of Computer Science, 201

Novel techniques for modelling uncertain human reasoning in explainable artificial intelligence

In recent years, there has been a growing need for intelligent systems that not only are able to provide reliable predictions but can also produce explanations for their outputs. The demand for increased explainability has led to the emergence of explainable artificial intelligence (XAI) as a specific research field. In this context, fuzzy logic systems represent a promising tool thanks to their inherently interpretable structure. The use of a rule-base and linguistic terms, in fact, have allowed researchers to design models with a transparent decision process, from which it is possible to extract human-understandable explanations. The use of interval type-2 fuzzy logic in the XAI field, however, is limited: the improved performances of interval type-2 fuzzy systems and their ability to handle a higher degree of uncertainty comes at the cost of increased complexity that makes the semantic mapping between the input and outputs harder to understand intuitively. The presence of type-reduction, in some contexts fail to preserve the semantic value of the fuzzy sets and rules involved in the decision process. By semantic value, we specifically refer to the capacity of interpreting the output of the fuzzy system in respect to the pre-defined and thus understood linguistic variables used for the antecedents and consequents of the system. An attempt at increasing the explainability of interval type-2 fuzzy logic was first established by Garibaldi and Guadarrama in 2011, with the introduction of constrained type-2 fuzzy sets. However, extensive work needs to be carried out to develop the algorithms necessary for their practical use in fuzzy systems. The aim of this thesis is to extend the initial work on constrained interval type-2 fuzzy sets to develop a framework that preserves the semantic value throughout the modelling and decision process. Achieving this goal would allow the creation of a new class of fuzzy systems that show additional interpretable properties, and could further encourage the use of interval type-2 fuzzy logic in XAI. After the formal definition of the required components and theorems, different approaches are explored to develop inference algorithms that preserve the semantic value of the sets during the input-output mapping, while keeping reasonable run-times on modern computer hardware. The novel frameworks are then tested in a series of practical applications from the real world, in order to assess both their prediction performances and show the quality of the explanations these models can generate. Finally, the original definitions of constrained intervals type-2 fuzzy sets are refined to produce a novel approach which combines uncertain data and represents them using intuitive constrained interval type-2 fuzzy sets. Overall, as a result of the work presented here, it is now possible to design constrained interval type-2 fuzzy systems that preserve the enhanced semantic value provided by constrained interval-type-2 fuzzy sets throughout the inference, type-reduction and defuzzification stages. This characteristic is then used to improve the semantic interpretability of the system outputs, making constrained interval type-2 fuzzy systems a valuable alternative to interval type-2 fuzzy systems in XAI. The research presented here has resulted in three journal articles, two of which have already been published in IEEE Transactions on Fuzzy Systems, and four papers presented at the FUZZ-IEEE international conference between 2018 and 2020