Deep learning for healthcare applications based on physiological signals: A review

Background and objective: We have cast the net into the ocean of knowledge to retrieve the latest scientific research on deep learning methods for physiological signals. We found 53 research papers on this topic, published from 01.01.2008 to 31.12.2017. Methods: An initial bibliometric analysis shows that the reviewed papers focused on Electromyogram(EMG), Electroencephalogram(EEG), Electrocardiogram(ECG), and Electrooculogram(EOG). These four categories were used to structure the subsequent content review. Results: During the content review, we understood that deep learning performs better for big and varied datasets than classic analysis and machine classification methods. Deep learning algorithms try to develop the model by using all the available input. Conclusions: This review paper depicts the application of various deep learning algorithms used till recently, but in future it will be used for more healthcare areas to improve the quality of diagnosi

Optimal Multi-Stage Arrhythmia Classification Approach

Arrhythmia constitutes a problem with the rate or rhythm of the heartbeat, and an early diagnosis is essential for the timely inception of successful treatment. We have jointly optimized the entire multi-stage arrhythmia classification scheme based on 12-lead surface ECGs that attains the accuracy performance level of professional cardiologists. The new approach is comprised of a three-step noise reduction stage, a novel feature extraction method and an optimal classification model with finely tuned hyperparameters. We carried out an exhaustive study comparing thousands of competing classification algorithms that were trained on our proprietary, large and expertly labeled dataset consisting of 12-lead ECGs from 40,258 patients with four arrhythmia classes: atrial fibrillation, general supraventricular tachycardia, sinus bradycardia and sinus rhythm including sinus irregularity rhythm. Our results show that the optimal approach consisted of Low Band Pass filter, Robust LOESS, Non Local Means smoothing, a proprietary feature extraction method based on percentiles of the empirical distribution of ratios of interval lengths and magnitudes of peaks and valleys, and Extreme Gradient Boosting Tree classifier, achieved an F1-Score of 0.988 on patients without additional cardiac conditions. The same noise reduction and feature extraction methods combined with Gradient Boosting Tree classifier achieved an F1-Score of 0.97 on patients with additional cardiac conditions. Our method achieved the highest classification accuracy (average 10-fold cross-validation F1-Score of 0.992) using an external validation data, MIT-BIH arrhythmia database. The proposed optimal multi-stage arrhythmia classification approach can dramatically benefit automatic ECG data analysis by providing cardiologist level accuracy and robust compatibility with various ECG data sources

Automated and Interpretable Patient ECG Profiles for Disease Detection, Tracking, and Discovery

The electrocardiogram or ECG has been in use for over 100 years and remains the most widely performed diagnostic test to characterize cardiac structure and electrical activity. We hypothesized that parallel advances in computing power, innovations in machine learning algorithms, and availability of large-scale digitized ECG data would enable extending the utility of the ECG beyond its current limitations, while at the same time preserving interpretability, which is fundamental to medical decision-making. We identified 36,186 ECGs from the UCSF database that were 1) in normal sinus rhythm and 2) would enable training of specific models for estimation of cardiac structure or function or detection of disease. We derived a novel model for ECG segmentation using convolutional neural networks (CNN) and Hidden Markov Models (HMM) and evaluated its output by comparing electrical interval estimates to 141,864 measurements from the clinical workflow. We built a 725-element patient-level ECG profile using downsampled segmentation data and trained machine learning models to estimate left ventricular mass, left atrial volume, mitral annulus e' and to detect and track four diseases: pulmonary arterial hypertension (PAH), hypertrophic cardiomyopathy (HCM), cardiac amyloid (CA), and mitral valve prolapse (MVP). CNN-HMM derived ECG segmentation agreed with clinical estimates, with median absolute deviations (MAD) as a fraction of observed value of 0.6% for heart rate and 4% for QT interval. Patient-level ECG profiles enabled quantitative estimates of left ventricular and mitral annulus e' velocity with good discrimination in binary classification models of left ventricular hypertrophy and diastolic function. Models for disease detection ranged from AUROC of 0.94 to 0.77 for MVP. Top-ranked variables for all models included known ECG characteristics along with novel predictors of these traits/diseases.Comment: 13 pages, 6 figures, 1 Table + Supplemen

Risk of Arrhythmia and Mortality from Macrolide Antibiotic Prescription: A Population-Based Cohort Study

Many respiratory tract infections are treated with macrolide antibiotics. Regulatory agencies warn that these antibiotics increase the risk of ventricular arrhythmia. This population-based retrospective cohort study examined the 30-day risk of a hospital encounter with ventricular arrhythmia and all-cause mortality in 503,612 matched pairs of older adults who received a new outpatient prescription for an oral macrolide antibiotic and those prescribed referent antibiotics from 2002 to 2013 in Ontario. Conditional logistic regression was used to measure the association between macrolide exposure and outcomes. Macrolide antibiotics compared with referent antibiotics were not associated with a higher 30-day risk of ventricular arrhythmia (0.03% vs. 0.03%, relative risk [RR] 1.06, 95% confidence interval [CI] 0.83- 1.36), and were associated with a lower risk of 30-day all-cause mortality (0.62% vs. 0.76%, RR 0.82, 95% CI 0.78-0.86). These findings suggest that current warnings from Health Canada and the U.S. Food and Drug Administration may be overstated