Type-2 fuzzy sets applied to multivariable self-organizing fuzzy logic controllers for regulating anesthesia

In this paper, novel interval and general type-2 self-organizing fuzzy logic controllers (SOFLCs) are proposed for the automatic control of anesthesia during surgical procedures. The type-2 SOFLC is a hierarchical adaptive fuzzy controller able to generate and modify its rule-base in response to the controller's performance. The type-2 SOFLC uses type-2 fuzzy sets derived from real surgical data capturing patient variability in monitored physiological parameters during anesthetic sedation, which are used to define the footprint of uncertainty (FOU) of the type-2 fuzzy sets. Experimental simulations were carried out to evaluate the performance of the type-2 SOFLCs in their ability to control anesthetic delivery rates for maintaining desired physiological set points for anesthesia (muscle relaxation and blood pressure) under signal and patient noise. Results show that the type-2 SOFLCs can perform well and outperform previous type-1 SOFLC and comparative approaches for anesthesia control producing lower performance errors while using better defined rules in regulating anesthesia set points while handling the control uncertainties. The results are further supported by statistical analysis which also show that zSlices general type-2 SOFLCs are able to outperform interval type-2 SOFLC in terms of their steady state performance

An Optimized Type-2 Self-Organizing Fuzzy Logic Controller Applied in Anesthesia for Propofol Dosing to Regulate BIS

During general anesthesia, anesthesiologists who provide anesthetic dosage traditionally play a fundamental role to regulate Bispectral Index (BIS). However, in this paper, an optimized type-2 Self-Organizing Fuzzy Logic Controller (SOFLC) is designed for Target Controlled Infusion (TCI) pump related to propofol dosing guided by BIS, to realize automatic control of general anesthesia. The type-2 SOFLC combines a type-2 fuzzy logic controller with a self-organizing (SO) mechanism to facilitate online training while able to contend with operational uncertainties. A novel data driven Surrogate Model (SM) and Genetic Programming (GP) based strategy is introduced for optimizing the type-2 SOFLC parameters offline to handle inter-patient variability. A pharmacological model is built for simulation in which different optimization strategies are tested and compared. Simulation results are presented to demonstrate the applicability of our approach and show that the proposed optimization strategy can achieve better control performance in terms of steady state error and robustness

Performance Analysis of Extracted Rule-Base Multivariable Type-2 Self-Organizing Fuzzy Logic Controller Applied to Anesthesia

We compare type-1 and type-2 self-organizing fuzzy logic controller (SOFLC) using expert initialized and pretrained extracted rule-bases applied to automatic control of anaesthesia during surgery. We perform experimental simulations using a nonfixed patient model and signal noise to account for environmental and patient drug interaction uncertainties. The simulations evaluate the performance of the SOFLCs in their ability to control anesthetic delivery rates for maintaining desired physiological set points for muscle relaxation and blood pressure during a multistage surgical procedure. The performances of the SOFLCs are evaluated by measuring the steady state errors and control stabilities which indicate the accuracy and precision of control task. Two sets of comparisons based on using expert derived and extracted rule-bases are implemented as Wilcoxon signed-rank tests. Results indicate that type-2 SOFLCs outperform type-1 SOFLC while handling the various sources of uncertainties. SOFLCs using the extracted rules are also shown to outperform those using expert derived rules in terms of improved control stability

Advanced Signal Processing and Control in Anaesthesia

This thesis comprises three major stages: classification of depth of anaesthesia (DOA); modelling a typical patient’s behaviour during a surgical procedure; and control of DOAwith simultaneous administration of propofol and remifentanil. Clinical data gathered in theoperating theatre was used in this project. Multiresolution wavelet analysis was used to extract meaningful features from the auditory evoked potentials (AEP). These features were classified into different DOA levels using a fuzzy relational classifier (FRC). The FRC uses fuzzy clustering and fuzzy relational composition. The FRC had a good performance and was able to distinguish between the DOA levels. A hybrid patient model was developed for the induction and maintenance phase of anaesthesia. An adaptive network-based fuzzy inference system was used to adapt Takagi-Sugeno-Kang (TSK) fuzzy models relating systolic arterial pressure (SAP), heart rate (HR), and the wavelet extracted AEP features with the effect concentrations of propofol and remifentanil. The effect of surgical stimuli on SAP and HR, and the analgesic properties of remifentanil were described by Mamdani fuzzy models, constructed with anaesthetist cooperation. The model proved to be adequate, reflecting the effect of drugs and surgical stimuli. A multivariable fuzzy controller was developed for the simultaneous administration of propofol and remifentanil. The controller is based on linguistic rules that interact with three decision tables, one of which represents a fuzzy PI controller. The infusion rates of the two drugs are determined according to the DOA level and surgical stimulus. Remifentanil is titrated according to the required analgesia level and its synergistic interaction with propofol. The controller was able to adequately achieve and maintain the target DOA level, under different conditions. Overall, it was possible to model the interaction between propofol and remifentanil, and to successfully use this model to develop a closed-loop system in anaesthesia

An Adaptive Monitoring Scheme for Automatic Control of Anaesthesia in dynamic surgical environments based on Bispectral Index and Blood Pressure.

During surgical procedures, bispectral index (BIS) is a well-known measure used to determine the patient's depth of anesthesia (DOA). However, BIS readings can be subject to interference from many factors during surgery, and other parameters such as blood pressure (BP) and heart rate (HR) can provide more stable indicators. However, anesthesiologist still consider BIS as a primary measure to determine if the patient is correctly anaesthetized while relaying on the other physiological parameters to monitor and ensure the patient's status is maintained. The automatic control of administering anesthesia using intelligent control systems has been the subject of recent research in order to alleviate the burden on the anesthetist to manually adjust drug dosage in response physiological changes for sustaining DOA. A system proposed for the automatic control of anesthesia based on type-2 Self Organizing Fuzzy Logic Controllers (T2-SOFLCs) has been shown to be effective in the control of DOA under simulated scenarios while contending with uncertainties due to signal noise and dynamic changes in pharmacodynamics (PD) and pharmacokinetic (PK) effects of the drug on the body. This study considers both BIS and BP as part of an adaptive automatic control scheme, which can adjust to the monitoring of either parameter in response to changes in the availability and reliability of BIS signals during surgery. The simulation of different control schemes using BIS data obtained during real surgical procedures to emulate noise and interference factors have been conducted. The use of either or both combined parameters for controlling the delivery Propofol to maintain safe target set points for DOA are evaluated. The results show that combing BIS and BP based on the proposed adaptive control scheme can ensure the target set points and the correct amount of drug in the body is maintained even with the intermittent loss of BIS signal that could otherwise disrupt an automated control system

Closed-loop control of anesthesia : survey on actual trends, challenges and perspectives

Automation empowers self-sustainable adaptive processes and personalized services in many industries. The implementation of the integrated healthcare paradigm built on Health 4.0 is expected to transform any area in medicine due to the lightning-speed advances in control, robotics, artificial intelligence, sensors etc. The two objectives of this article, as addressed to different entities, are: i) to raise awareness throughout the anesthesiologists about the usefulness of integrating automation and data exchange in their clinical practice for providing increased attention to alarming situations, ii) to provide the actualized insights of drug-delivery research in order to create an opening horizon towards precision medicine with significantly improved human outcomes. This article presents a concise overview on the recent evolution of closed-loop anesthesia delivery control systems by means of control strategies, depth of anesthesia monitors, patient modelling, safety systems, and validation in clinical trials. For decades, anesthesia control has been in the midst of transformative changes, going from simple controllers to integrative strategies of two or more components, but not achieving yet the breakthrough of an integrated system. However, the scientific advances that happen at high speed need a modern review to identify the current technological gaps, societal implications, and implementation barriers. This article provides a good basis for control research in clinical anesthesia to endorse new challenges for intelligent systems towards individualized patient care. At this connection point of clinical and engineering frameworks through (semi-) automation, the following can be granted: patient safety, economical efficiency, and clinicians' efficacy

Big data analytics:Computational intelligence techniques and application areas

Big Data has significant impact in developing functional smart cities and supporting modern societies. In this paper, we investigate the importance of Big Data in modern life and economy, and discuss challenges arising from Big Data utilization. Different computational intelligence techniques have been considered as tools for Big Data analytics. We also explore the powerful combination of Big Data and Computational Intelligence (CI) and identify a number of areas, where novel applications in real world smart city problems can be developed by utilizing these powerful tools and techniques. We present a case study for intelligent transportation in the context of a smart city, and a novel data modelling methodology based on a biologically inspired universal generative modelling approach called Hierarchical Spatial-Temporal State Machine (HSTSM). We further discuss various implications of policy, protection, valuation and commercialization related to Big Data, its applications and deployment

Decision-Oriented Multi-Outcome Modeling for Anesthesia Patients

Anesthesia drugs have impact on multiple outcomes of an anesthesia patient. Most typical outcomes include anesthesia depth, blood pressures, heart rates, etc. Traditional diagnosis and control in anesthesia focus on a one-drug-one-outcome scenario. This paper studies the problem of real-time modeling for monitoring, diagnosing, and predicting multiple outcomes of anesthesia patients. It is shown that consideration of multiple outcomes is necessary and beneficial for anesthesia managements. Due to limited real-time data, real-time modeling in multi-outcome modeling requires low-complexity model strucrtures. This paper introduces a method of decision-oriented modeling that significantly reduces the complexity of the problem. The method employs simplified and combined model functions in a Wiener structure to contain model complexity. The ideas of drug impact prediction and reachable sets are introduced for utility of the models in diagnosis, outcome prediction, and decision assistance. Clinical data are used to evaluate the effectiveness of the method

A novel Big Data analytics and intelligent technique to predict driver's intent

Modern age offers a great potential for automatically predicting the driver's intent through the increasing miniaturization of computing technologies, rapid advancements in communication technologies and continuous connectivity of heterogeneous smart objects. Inside the cabin and engine of modern cars, dedicated computer systems need to possess the ability to exploit the wealth of information generated by heterogeneous data sources with different contextual and conceptual representations. Processing and utilizing this diverse and voluminous data, involves many challenges concerning the design of the computational technique used to perform this task. In this paper, we investigate the various data sources available in the car and the surrounding environment, which can be utilized as inputs in order to predict driver's intent and behavior. As part of investigating these potential data sources, we conducted experiments on e-calendars for a large number of employees, and have reviewed a number of available geo referencing systems. Through the results of a statistical analysis and by computing location recognition accuracy results, we explored in detail the potential utilization of calendar location data to detect the driver's intentions. In order to exploit the numerous diverse data inputs available in modern vehicles, we investigate the suitability of different Computational Intelligence (CI) techniques, and propose a novel fuzzy computational modelling methodology. Finally, we outline the impact of applying advanced CI and Big Data analytics techniques in modern vehicles on the driver and society in general, and discuss ethical and legal issues arising from the deployment of intelligent self-learning cars