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

Improving Maternal and Fetal Cardiac Monitoring Using Artificial Intelligence

Early diagnosis of possible risks in the physiological status of fetus and mother during pregnancy and delivery is critical and can reduce mortality and morbidity. For example, early detection of life-threatening congenital heart disease may increase survival rate and reduce morbidity while allowing parents to make informed decisions. To study cardiac function, a variety of signals are required to be collected. In practice, several heart monitoring methods, such as electrocardiogram (ECG) and photoplethysmography (PPG), are commonly performed. Although there are several methods for monitoring fetal and maternal health, research is currently underway to enhance the mobility, accuracy, automation, and noise resistance of these methods to be used extensively, even at home. Artificial Intelligence (AI) can help to design a precise and convenient monitoring system. To achieve the goals, the following objectives are defined in this research: The first step for a signal acquisition system is to obtain high-quality signals. As the first objective, a signal processing scheme is explored to improve the signal-to-noise ratio (SNR) of signals and extract the desired signal from a noisy one with negative SNR (i.e., power of noise is greater than signal). It is worth mentioning that ECG and PPG signals are sensitive to noise from a variety of sources, increasing the risk of misunderstanding and interfering with the diagnostic process. The noises typically arise from power line interference, white noise, electrode contact noise, muscle contraction, baseline wandering, instrument noise, motion artifacts, electrosurgical noise. Even a slight variation in the obtained ECG waveform can impair the understanding of the patient's heart condition and affect the treatment procedure. Recent solutions, such as adaptive and blind source separation (BSS) algorithms, still have drawbacks, such as the need for noise or desired signal model, tuning and calibration, and inefficiency when dealing with excessively noisy signals. Therefore, the final goal of this step is to develop a robust algorithm that can estimate noise, even when SNR is negative, using the BSS method and remove it based on an adaptive filter. The second objective is defined for monitoring maternal and fetal ECG. Previous methods that were non-invasive used maternal abdominal ECG (MECG) for extracting fetal ECG (FECG). These methods need to be calibrated to generalize well. In other words, for each new subject, a calibration with a trustable device is required, which makes it difficult and time-consuming. The calibration is also susceptible to errors. We explore deep learning (DL) models for domain mapping, such as Cycle-Consistent Adversarial Networks, to map MECG to fetal ECG (FECG) and vice versa. The advantages of the proposed DL method over state-of-the-art approaches, such as adaptive filters or blind source separation, are that the proposed method is generalized well on unseen subjects. Moreover, it does not need calibration and is not sensitive to the heart rate variability of mother and fetal; it can also handle low signal-to-noise ratio (SNR) conditions. Thirdly, AI-based system that can measure continuous systolic blood pressure (SBP) and diastolic blood pressure (DBP) with minimum electrode requirements is explored. The most common method of measuring blood pressure is using cuff-based equipment, which cannot monitor blood pressure continuously, requires calibration, and is difficult to use. Other solutions use a synchronized ECG and PPG combination, which is still inconvenient and challenging to synchronize. The proposed method overcomes those issues and only uses PPG signal, comparing to other solutions. Using only PPG for blood pressure is more convenient since it is only one electrode on the finger where its acquisition is more resilient against error due to movement. The fourth objective is to detect anomalies on FECG data. The requirement of thousands of manually annotated samples is a concern for state-of-the-art detection systems, especially for fetal ECG (FECG), where there are few publicly available FECG datasets annotated for each FECG beat. Therefore, we will utilize active learning and transfer-learning concept to train a FECG anomaly detection system with the least training samples and high accuracy. In this part, a model is trained for detecting ECG anomalies in adults. Later this model is trained to detect anomalies on FECG. We only select more influential samples from the training set for training, which leads to training with the least effort. Because of physician shortages and rural geography, pregnant women's ability to get prenatal care might be improved through remote monitoring, especially when access to prenatal care is limited. Increased compliance with prenatal treatment and linked care amongst various providers are two possible benefits of remote monitoring. If recorded signals are transmitted correctly, maternal and fetal remote monitoring can be effective. Therefore, the last objective is to design a compression algorithm that can compress signals (like ECG) with a higher ratio than state-of-the-art and perform decompression fast without distortion. The proposed compression is fast thanks to the time domain B-Spline approach, and compressed data can be used for visualization and monitoring without decompression owing to the B-spline properties. Moreover, the stochastic optimization is designed to retain the signal quality and does not distort signal for diagnosis purposes while having a high compression ratio. In summary, components for creating an end-to-end system for day-to-day maternal and fetal cardiac monitoring can be envisioned as a mix of all tasks listed above. PPG and ECG recorded from the mother can be denoised using deconvolution strategy. Then, compression can be employed for transmitting signal. The trained CycleGAN model can be used for extracting FECG from MECG. Then, trained model using active transfer learning can detect anomaly on both MECG and FECG. Simultaneously, maternal BP is retrieved from the PPG signal. This information can be used for monitoring the cardiac status of mother and fetus, and also can be used for filling reports such as partogram

An Effective Disease Prediction System using CRF based Butterfly Optimization, Fuzzy Decision Tree and DBN

Diabetes is a seriously deadly disease today. It is necessary to enable patients to control their blood glucose levels. Even though, in the past, various researchers proposed numerous diabetic detection and prediction systems they are not fulfilling the requirements in terms of detection and prediction accuracy. Nowadays, diabetes patients are utilizing the gadgets like Wireless Insulin Pump that passes into the body instead of syringes for filling insulin. Within this context, insulin treatment is necessary for avoiding life-threatening. Toward this mission, a new deep learning approach-based disease detection system is introduced which takes care of identifying Type-1 and Type-2 diabetes, heart diseases, and breast cancer. In this system, a new Conditional Random Field based Butterfly Optimization Algorithm (CRF-BOA) is developedto select the important features for identifying the Type-1 and Type-2 diabetic disease. Besides, a new fuzzy ID3 classification method is developed for classifying the patient's datasets either normal or abnormal and disease affected. Ultimately, by applying the deep belief network (DBN) the classified patient records are involved with training to identify the relevant symptoms of similarity and glucose status of various patient records. These experiments are being conducted for proving the efficiency of the proposed deep learning approach in terms of glucose monitoring efficiency and disease prediction accuracy.The proposed approach achieved high detection accuracy than the current deep learning approaches in this directionbased on error rate and accuracy

Antepartum fetal heart rate feature extraction and classification using empirical mode decomposition and support vector machine

<p>Abstract</p> <p>Background</p> <p>Cardiotocography (CTG) is the most widely used tool for fetal surveillance. The visual analysis of fetal heart rate (FHR) traces largely depends on the expertise and experience of the clinician involved. Several approaches have been proposed for the effective interpretation of FHR. In this paper, a new approach for FHR feature extraction based on empirical mode decomposition (EMD) is proposed, which was used along with support vector machine (SVM) for the classification of FHR recordings as 'normal' or 'at risk'.</p> <p>Methods</p> <p>The FHR were recorded from 15 subjects at a sampling rate of 4 Hz and a dataset consisting of 90 randomly selected records of 20 minutes duration was formed from these. All records were labelled as 'normal' or 'at risk' by two experienced obstetricians. A training set was formed by 60 records, the remaining 30 left as the testing set. The standard deviations of the EMD components are input as features to a support vector machine (SVM) to classify FHR samples.</p> <p>Results</p> <p>For the training set, a five-fold cross validation test resulted in an accuracy of 86% whereas the overall geometric mean of sensitivity and specificity was 94.8%. The Kappa value for the training set was .923. Application of the proposed method to the testing set (30 records) resulted in a geometric mean of 81.5%. The Kappa value for the testing set was .684.</p> <p>Conclusions</p> <p>Based on the overall performance of the system it can be stated that the proposed methodology is a promising new approach for the feature extraction and classification of FHR signals.</p

Personalized data analytics for internet-of-things-based health monitoring

The Internet-of-Things (IoT) has great potential to fundamentally alter the delivery of modern healthcare, enabling healthcare solutions outside the limits of conventional clinical settings. It can offer ubiquitous monitoring to at-risk population groups and allow diagnostic care, preventive care, and early intervention in everyday life. These services can have profound impacts on many aspects of health and well-being. However, this field is still at an infancy stage, and the use of IoT-based systems in real-world healthcare applications introduces new challenges. Healthcare applications necessitate satisfactory quality attributes such as reliability and accuracy due to their mission-critical nature, while at the same time, IoT-based systems mostly operate over constrained shared sensing, communication, and computing resources. There is a need to investigate this synergy between the IoT technologies and healthcare applications from a user-centered perspective. Such a study should examine the role and requirements of IoT-based systems in real-world health monitoring applications. Moreover, conventional computing architecture and data analytic approaches introduced for IoT systems are insufficient when used to target health and well-being purposes, as they are unable to overcome the limitations of IoT systems while fulfilling the needs of healthcare applications. This thesis aims to address these issues by proposing an intelligent use of data and computing resources in IoT-based systems, which can lead to a high-level performance and satisfy the stringent requirements. For this purpose, this thesis first delves into the state-of-the-art IoT-enabled healthcare systems proposed for in-home and in-hospital monitoring. The findings are analyzed and categorized into different domains from a user-centered perspective. The selection of home-based applications is focused on the monitoring of the elderly who require more remote care and support compared to other groups of people. In contrast, the hospital-based applications include the role of existing IoT in patient monitoring and hospital management systems. Then, the objectives and requirements of each domain are investigated and discussed. This thesis proposes personalized data analytic approaches to fulfill the requirements and meet the objectives of IoT-based healthcare systems. In this regard, a new computing architecture is introduced, using computing resources in different layers of IoT to provide a high level of availability and accuracy for healthcare services. This architecture allows the hierarchical partitioning of machine learning algorithms in these systems and enables an adaptive system behavior with respect to the user's condition. In addition, personalized data fusion and modeling techniques are presented, exploiting multivariate and longitudinal data in IoT systems to improve the quality attributes of healthcare applications. First, a real-time missing data resilient decision-making technique is proposed for health monitoring systems. The technique tailors various data resources in IoT systems to accurately estimate health decisions despite missing data in the monitoring. Second, a personalized model is presented, enabling variations and event detection in long-term monitoring systems. The model evaluates the sleep quality of users according to their own historical data. Finally, the performance of the computing architecture and the techniques are evaluated in this thesis using two case studies. The first case study consists of real-time arrhythmia detection in electrocardiography signals collected from patients suffering from cardiovascular diseases. The second case study is continuous maternal health monitoring during pregnancy and postpartum. It includes a real human subject trial carried out with twenty pregnant women for seven months

Phonocardiogram Signal Analysis Based Premature Cardiac Influence Detection using Resnet50 CNN for Public Health Protection

Phonocardiogram (PCG) signal analysis plays a crucial role in the early detection of cardiac abnormalities, which is essential for public health protection. The premature disease prediction is tedious because the feature analysis takes place dimensionality problems which leads poor accuracy. The prevailing ensemble learning models’ methods doesn’t concentrate disease margin facts and properties during classification produce higher false rate because for adjusting feature margins gets lower accuracy.&nbsp; To resolve this problem, we propose a efficient Fuzzy c-means feature modality based Resnet50-RNN to detect premature cardiac influence detection for improving public health. The research proposes a method for premature cardiac influence detection using a ResNet50 Convolutional Neural Network (CNN) model for early prediction of heart disease. To address the issue of imbalanced data, Synthetic Minority Oversampling Technique (SMOTE) is employed for preprocessing. The Cardiac Disease Influence Rate (CDIR) is then used to identify the maximum deficiency-affected feature margins. Fuzzy c-means is utilized to select the mutual features associated with the heart disease influence rate. The ResNet50 CNN model is employed for classification, enabling the prediction of disease margins by risk category. The proposed system effectively identifies the disease based on the disease-affected scaling margin, leading to early disease impact prediction with higher accuracy, specificity, F1-measure, and lower false rates compared to other existing systems. The implementation also demonstrates reduced time complexity

Predicting complex system behavior using hybrid modeling and computational intelligence

“Modeling and prediction of complex systems is a challenging problem due to the sub-system interactions and dependencies. This research examines combining various computational intelligence algorithms and modeling techniques to provide insights into these complex processes and allow for better decision making. This hybrid methodology provided additional capabilities to analyze and predict the overall system behavior where a single model cannot be used to understand the complex problem. The systems analyzed here are flooding events and fetal health care. The impact of floods on road infrastructure is investigated using graph theory, agent-based traffic simulation, and Long Short-Term Memory deep learning to predict water level rise from river gauge height. Combined with existing infrastructure models, these techniques provide a 15-minute interval for making closure decisions rather than the current 6-hour interval. The second system explored is fetal monitoring, which is essential to diagnose severe fetal conditions such as acidosis. Support Vector Machine and Random Forest were compared to identify the best model for classification of fetal state. This model provided a more accurate classification than existing research on the CTG. A deep learning forecasting model was developed to predict the future values for fetal heart rate and uterine contractions. The forecasting and classification algorithms are then integrated to evaluate the future condition of the fetus. The final model can predict the fetal state 4 minutes ahead to help the obstetricians to plan necessary interventions for preventing acidosis and asphyxiation. In both cases, time series predictions using hybrid modeling provided superior results to existing methods to predict complex behaviors”--Abstract, page iv

mHealth Engineering: A Technology Review

In this paper, we review the technological bases of mobile health (mHealth). First, we derive a component-based mHealth architecture prototype from an Institute of Electrical and Electronics Engineers (IEEE)-based multistage research and filter process. Second, we analyze medical databases with regard to these prototypic mhealth system components.. We show the current state of research literature concerning portable devices with standard and additional equipment, data transmission technology, interface, operating systems and software embedment, internal and external memory, and power-supply issues. We also focus on synergy effects by combining different mHealth technologies (e.g., BT-LE combined with RFID link technology). Finally, we also make suggestions for future improvements in mHealth technology (e.g., data-protection issues, energy supply, data processing and storage)

Disease diagnosis in smart healthcare: Innovation, technologies and applications

To promote sustainable development, the smart city implies a global vision that merges artificial intelligence, big data, decision making, information and communication technology (ICT), and the internet-of-things (IoT). The ageing issue is an aspect that researchers, companies and government should devote efforts in developing smart healthcare innovative technology and applications. In this paper, the topic of disease diagnosis in smart healthcare is reviewed. Typical emerging optimization algorithms and machine learning algorithms are summarized. Evolutionary optimization, stochastic optimization and combinatorial optimization are covered. Owning to the fact that there are plenty of applications in healthcare, four applications in the field of diseases diagnosis (which also list in the top 10 causes of global death in 2015), namely cardiovascular diseases, diabetes mellitus, Alzheimer’s disease and other forms of dementia, and tuberculosis, are considered. In addition, challenges in the deployment of disease diagnosis in healthcare have been discussed

A Review on the Development of Fuzzy Classifiers with Improved Interpretability and Accuracy Parameters

This review paper of fuzzy classifiers with improved interpretability and accuracy param-eter discussed the most fundamental aspect of very effective and powerful tools in form of probabilistic reasoning, The fuzzy logic concept allows the effective realization of ap-proximate, vague, uncertain, dynamic, and more realistic conditions, which is closer to the actual physical world and human thinking. The fuzzy theory has the competency to catch the lack of preciseness of linguistic terms in a speech of natural language. The fuzzy theory provides a more significant competency to model humans like com-mon-sense reasoning and conclusion making to fuzzy set and rules as good membership function. Also, in this paper reviews discussed the evaluation of the fuzzy set, type-1, type-2, and interval type-2 fuzzy system from traditional Boolean crisp set logic along with interpretability and accuracy issues in the fuzzy system