Neuromorphic computing based on stochastic spiking reservoir for heartbeat classification

Heart disease is the leading cause of mortality worldwide. The precise heartbeat classification usually requires a higher number of extracted features and heartbeats of the same class may also behave differently in patients. This will lead to computation overhead and challenges in hardware implementation due to the large number of nodes utilized in reservoir computing (RC) networks. In this work, a reservoir computing-based stochastic spiking neural network (SSNN) has been proposed for heartbeat rhythm classification, enabling a patient adaptable and more efficient hardware implementation with low computation overhead caused by minimum extracted features. Only a single feature is employed in template matching to achieve patient adaptability with minimal computation overhead. The single feature, QRS complexes, was extracted and fed into the neural reservoir with 20 neurons in a cyclic topology for arrhythmia similarity calculation and classification. 43 recordings of Electrocardiogram (ECG) signals that included both normal and arrhythmic beats from MIT-BIH arrhythmia database obtained from Physio-Net were used in this work. The proposed stochastic spiking reservoir achieves a sensitivity of 99.6% and an accuracy of 96.91%, signifying that the system is accurate and efficient in classifying normal and abnormal arrhythmias

Contribuciones de las técnicas machine learning a la cardiología. Predicción de reestenosis tras implante de stent coronario

[ES]Antecedentes: Existen pocos temas de actualidad equiparables a la posibilidad de la tecnología actual para desarrollar las mismas capacidades que el ser humano, incluso en medicina. Esta capacidad de simular los procesos de inteligencia humana por parte de máquinas o sistemas informáticos es lo que conocemos hoy en día como inteligencia artificial. Uno de los campos de la inteligencia artificial con mayor aplicación a día de hoy en medicina es el de la predicción, recomendación o diagnóstico, donde se aplican las técnicas machine learning. Asimismo, existe un creciente interés en las técnicas de medicina de precisión, donde las técnicas machine learning pueden ofrecer atención médica individualizada a cada paciente. El intervencionismo coronario percutáneo (ICP) con stent se ha convertido en una práctica habitual en la revascularización de los vasos coronarios con enfermedad aterosclerótica obstructiva significativa. El ICP es asimismo patrón oro de tratamiento en pacientes con infarto agudo de miocardio; reduciendo las tasas de muerte e isquemia recurrente en comparación con el tratamiento médico. El éxito a largo plazo del procedimiento está limitado por la reestenosis del stent, un proceso patológico que provoca un estrechamiento arterial recurrente en el sitio de la ICP. Identificar qué pacientes harán reestenosis es un desafío clínico importante; ya que puede manifestarse como un nuevo infarto agudo de miocardio o forzar una nueva resvascularización del vaso afectado, y que en casos de reestenosis recurrente representa un reto terapéutico. Objetivos: Después de realizar una revisión de las técnicas de inteligencia artificial aplicadas a la medicina y con mayor profundidad, de las técnicas machine learning aplicadas a la cardiología, el objetivo principal de esta tesis doctoral ha sido desarrollar un modelo machine learning para predecir la aparición de reestenosis en pacientes con infarto agudo de miocardio sometidos a ICP con implante de un stent. Asimismo, han sido objetivos secundarios comparar el modelo desarrollado con machine learning con los scores clásicos de riesgo de reestenosis utilizados hasta la fecha; y desarrollar un software que permita trasladar esta contribución a la práctica clínica diaria de forma sencilla. Para desarrollar un modelo fácilmente aplicable, realizamos nuestras predicciones sin variables adicionales a las obtenidas en la práctica rutinaria. Material: El conjunto de datos, obtenido del ensayo GRACIA-3, consistió en 263 pacientes con características demográficas, clínicas y angiográficas; 23 de ellos presentaron reestenosis a los 12 meses después de la implantación del stent. Todos los desarrollos llevados a cabo se han hecho en Python y se ha utilizado computación en la nube, en concreto AWS (Amazon Web Services). Metodología: Se ha utilizado una metodología para trabajar con conjuntos de datos pequeños y no balanceados, siendo importante el esquema de validación cruzada anidada utilizado, así como la utilización de las curvas PR (precision-recall, exhaustividad-sensibilidad), además de las curvas ROC, para la interpretación de los modelos. Se han entrenado los algoritmos más habituales en la literatura para elegir el que mejor comportamiento ha presentado. Resultados: El modelo con mejores resultados ha sido el desarrollado con un clasificador extremely randomized trees; que superó significativamente (0,77; área bajo la curva ROC a los tres scores clínicos clásicos; PRESTO-1 (0,58), PRESTO-2 (0,58) y TLR (0,62). Las curvas exhaustividad sensibilidad ofrecieron una imagen más precisa del rendimiento del modelo extremely randomized trees que muestra un algoritmo eficiente (0,96) para no reestenosis, con alta exhaustividad y alta sensibilidad. Para un umbral considerado óptimo, de 1,000 pacientes sometidos a implante de stent, nuestro modelo machine learning predeciría correctamente 181 (18%) más casos en comparación con el mejor score de riesgo clásico (TLR). Las variables más importantes clasificadas según su contribución a las predicciones fueron diabetes, enfermedad coronaria en 2 ó más vasos, flujo TIMI post-ICP, plaquetas anormales, trombo post-ICP y colesterol anormal. Finalmente, se ha desarrollado una calculadora para trasladar el modelo a la práctica clínica. La calculadora permite estimar el riesgo individual de cada paciente y situarlo en una zona de riesgo, facilitando la toma de decisión al médico en cuanto al seguimiento adecuado para el mismo. Conclusiones: Aplicado inmediatamente después de la implantación del stent, un modelo machine learning diferencia mejor a aquellos pacientes que presentarán o no reestenosis respecto a los discriminadores clásicos actuales

Cardiovascular data analytics for real time patient monitoring

Improvements in wearable sensor devices make it possible to constantly monitor physiological parameters such as electrocardiograph (ECG) signals for long periods. Remote patient monitoring with wearable sensors has an important role to play in health care, particularly given the prevalence of chronic conditions such as cardiovascular disease (CVD)—one of the prominent causes of morbidity and mortality worldwide. Approximately 4.2 million Australians suffer from long-term CVD with approximately one death every 12 minutes. The assessment of ECG features, especially heart rate variability (HRV), represents a non-invasive technique which provides an indication of the autonomic nervous system (ANS) function. Conditions such as sudden cardiac death, hypertension, heart failure, myocardial infarction, ischaemia, and coronary heart disease can be detected from HRV analysis. In addition, the analysis of ECG features can also be used to diagnose many types of life-threatening arrhythmias, including ventricular fibrillation and ventricular tachycardia. Non-cardiac conditions, such as diabetes, obesity, metabolic syndrome, insulin resistance, irritable bowel syndrome, dyspepsia, anorexia nervosa, anxiety, and major depressive disorder have also been shown to be associated with HRV. The analysis of ECG features from real time ECG signals generated from wearable sensors provides distinctive challenges. The sensors that receive and process the signals have limited power, storage and processing capacity. Consequently, algorithms that process ECG signals need to be lightweight, use minimal storage resources and accurately detect abnormalities so that alarms can be raised. The existing literature details only a few algorithms which operate within the constraints of wearable sensor networks. This research presents four novel techniques that enable ECG signals to be processed within the limitations of resource constraints on devices to detect some key abnormalities in heart function. - The first technique is a novel real-time ECG data reduction algorithm, which detects and transmits only those key points that are critical for the generation of ECG features for diagnoses. - The second technique accurately predicts the five-minute HRV measure using only three minutes of data with an algorithm that executes in real-time using minimal computational resources. - The third technique introduces a real-time ECG feature recognition system that can be applied to diagnose life threatening conditions such as premature ventricular contractions (PVCs). - The fourth technique advances a classification algorithm to enhance the performance of automated ECG classification to determine arrhythmic heart beats based on noisy ECG signals. The four novel techniques are evaluated in comparison with benchmark algorithms for each task on the standard MIT-BIH Arrhythmia Database and with data generated from patients in a major hospital using Shimmer3 wearable ECG sensors. The four techniques are integrated to demonstrate that remote patient monitoring of ECG using HRV and ECG features is feasible in real time using minimal computational resources. The evaluation show that the ECG reduction algorithm is significantly better than existing algorithms that can be applied within sensor nodes, such as time-domain methods, transformation methods and compressed sensing methods. Furthermore, the proposed ECG reduction is found to be computationally less complex for resource constrained sensors and achieves higher compression ratios than existing algorithms. The prediction of a common HRV measure, the five-minute standard deviation of inter-beat variations (SDNN) and the accurate detection of PVC beats was achieved using a Count Data Model, combined with a Poisson-generated function from three-minute ECG recordings. This was achieved with minimal computational resources and was well suited to remote patient monitoring with wearable sensors. The PVC beats detection was implemented using the same count data model together with knowledge-based rules derived from clinical knowledge. A real-time cardiac patient monitoring system was implemented using an ECG sensor and smartphone to detect PVC beats within a few seconds using artificial neural networks (ANN), and it was proven to provide highly accurate results. The automated detection and classification were implemented using a new wrapper-based hybrid approach that utilized t-distributed stochastic neighbour embedding (t-SNE) in combination with self-organizing maps (SOM) to improve classification performance. The t-SNE-SOM hybrid resulted in improved sensitivity, specificity and accuracy compared to most common hybrid methods in the presence of noise. It also provided a better, more accurate identification for the presence of many types of arrhythmias from the ECG recordings, leading to a more timely diagnosis and treatment outcome.Doctor of Philosoph