Automatic analysis and classification of cardiac acoustic signals for long term monitoring

Objective: Cardiovascular diseases are the leading cause of death worldwide resulting in over 17.9 million deaths each year. Most of these diseases are preventable and treatable, but their progression and outcomes are significantly more positive with early-stage diagnosis and proper disease management. Among the approaches available to assist with the task of early-stage diagnosis and management of cardiac conditions, automatic analysis of auscultatory recordings is one of the most promising ones, since it could be particularly suitable for ambulatory/wearable monitoring. Thus, proper investigation of abnormalities present in cardiac acoustic signals can provide vital clinical information to assist long term monitoring. Cardiac acoustic signals, however, are very susceptible to noise and artifacts, and their characteristics vary largely with the recording conditions which makes the analysis challenging. Additionally, there are challenges in the steps used for automatic analysis and classification of cardiac acoustic signals. Broadly, these steps are the segmentation, feature extraction and subsequent classification of recorded signals using selected features. This thesis presents approaches using novel features with the aim to assist the automatic early-stage detection of cardiovascular diseases with improved performance, using cardiac acoustic signals collected in real-world conditions. Methods: Cardiac auscultatory recordings were studied to identify potential features to help in the classification of recordings from subjects with and without cardiac diseases. The diseases considered in this study for the identification of the symptoms and characteristics are the valvular heart diseases due to stenosis and regurgitation, atrial fibrillation, and splitting of fundamental heart sounds leading to additional lub/dub sounds in the systole or diastole interval of a cardiac cycle. The localisation of cardiac sounds of interest was performed using an adaptive wavelet-based filtering in combination with the Shannon energy envelope and prior information of fundamental heart sounds. This is a prerequisite step for the feature extraction and subsequent classification of recordings, leading to a more precise diagnosis. Localised segments of S1 and S2 sounds, and artifacts, were used to extract a set of perceptual and statistical features using wavelet transform, homomorphic filtering, Hilbert transform and mel-scale filtering, which were then fed to train an ensemble classifier to interpret S1 and S2 sounds. Once sound peaks of interest were identified, features extracted from these peaks, together with the features used for the identification of S1 and S2 sounds, were used to develop an algorithm to classify recorded signals. Overall, 99 features were extracted and statistically analysed using neighborhood component analysis (NCA) to identify the features which showed the greatest ability in classifying recordings. Selected features were then fed to train an ensemble classifier to classify abnormal recordings, and hyperparameters were optimized to evaluate the performance of the trained classifier. Thus, a machine learning-based approach for the automatic identification and classification of S1 and S2, and normal and abnormal recordings, in real-world noisy recordings using a novel feature set is presented. The validity of the proposed algorithm was tested using acoustic signals recorded in real-world, non-controlled environments at four auscultation sites (aortic valve, tricuspid valve, mitral valve, and pulmonary valve), from the subjects with and without cardiac diseases; together with recordings from the three large public databases. The performance metrics of the methodology in relation to classification accuracy (CA), sensitivity (SE), precision (P+), and F1 score, were evaluated. Results: This thesis proposes four different algorithms to automatically classify fundamental heart sounds – S1 and S2; normal fundamental sounds and abnormal additional lub/dub sounds recordings; normal and abnormal recordings; and recordings with heart valve disorders, namely the mitral stenosis (MS), mitral regurgitation (MR), mitral valve prolapse (MVP), aortic stenosis (AS) and murmurs, using cardiac acoustic signals. The results obtained from these algorithms were as follows: • The algorithm to classify S1 and S2 sounds achieved an average SE of 91.59% and 89.78%, and F1 score of 90.65% and 89.42%, in classifying S1 and S2, respectively. 87 features were extracted and statistically studied to identify the top 14 features which showed the best capabilities in classifying S1 and S2, and artifacts. The analysis showed that the most relevant features were those extracted using Maximum Overlap Discrete Wavelet Transform (MODWT) and Hilbert transform. • The algorithm to classify normal fundamental heart sounds and abnormal additional lub/dub sounds in the systole or diastole intervals of a cardiac cycle, achieved an average SE of 89.15%, P+ of 89.71%, F1 of 89.41%, and CA of 95.11% using the test dataset from the PASCAL database. The top 10 features that achieved the highest weights in classifying these recordings were also identified. • Normal and abnormal classification of recordings using the proposed algorithm achieved a mean CA of 94.172%, and SE of 92.38%, in classifying recordings from the different databases. Among the top 10 acoustic features identified, the deterministic energy of the sound peaks of interest and the instantaneous frequency extracted using the Hilbert Huang-transform, achieved the highest weights. • The machine learning-based approach proposed to classify recordings of heart valve disorders (AS, MS, MR, and MVP) achieved an average CA of 98.26% and SE of 95.83%. 99 acoustic features were extracted and their abilities to differentiate these abnormalities were examined using weights obtained from the neighborhood component analysis (NCA). The top 10 features which showed the greatest abilities in classifying these abnormalities using recordings from the different databases were also identified. The achieved results demonstrate the ability of the algorithms to automatically identify and classify cardiac sounds. This work provides the basis for measurements of many useful clinical attributes of cardiac acoustic signals and can potentially help in monitoring the overall cardiac health for longer duration. The work presented in this thesis is the first-of-its-kind to validate the results using both, normal and pathological cardiac acoustic signals, recorded for a long continuous duration of 5 minutes at four different auscultation sites in non-controlled real-world conditions.Open Acces

Assessment of Dual-Tree Complex Wavelet Transform to improve SNR in collaboration with Neuro-Fuzzy System for Heart Sound Identification

none6siThe research paper proposes a novel denoising method to improve the outcome of heartsound (HS)-based heart-condition identification by applying the dual-tree complex wavelet transform (DTCWT) together with the adaptive neuro-fuzzy inference System (ANFIS) classifier. The method consists of three steps: first, preprocessing to eliminate 50 Hz noise; second, applying four successive levels of DTCWT to denoise and reconstruct the time-domain HS signal; third, to evaluate ANFIS on a total of 2735 HS recordings from an international dataset (PhysioNet Challenge 2016). The results show that the signal-to-noise ratio (SNR) with DTCWT was significantly improved (p < 0.001) as compared to original HS recordings. Quantitatively, there was an 11% to many decibel (dB)-fold increase in SNR after DTCWT, representing a significant improvement in denoising HS. In addition, the ANFIS, using six time-domain features, resulted in 55–86% precision, 51–98% recall, 53–86% f-score, and 54–86% MAcc compared to other attempts on the same dataset. Therefore, DTCWT is a successful technique in removing noise from biosignals such as HS recordings. The adaptive property of ANFIS exhibited capability in classifying HS recordings.Special Issue “Biomedical Signal Processing”, Section BioelectronicsopenBassam Al-Naami, Hossam Fraihat, Jamal Al-Nabulsi, Nasr Y. Gharaibeh, Paolo Visconti, Abdel-Razzak Al-HinnawiAl-Naami, Bassam; Fraihat, Hossam; Al-Nabulsi, Jamal; Gharaibeh, Nasr Y.; Visconti, Paolo; Al-Hinnawi, Abdel-Razza

Hybrid ACO and SVM algorithm for pattern classification

Ant Colony Optimization (ACO) is a metaheuristic algorithm that can be used to solve a variety of combinatorial optimization problems. A new direction for ACO is to optimize continuous and mixed (discrete and continuous) variables. Support Vector Machine (SVM) is a pattern classification approach originated from statistical approaches. However, SVM suffers two main problems which include feature subset selection and parameter tuning. Most approaches related to tuning SVM parameters discretize the continuous value of the parameters which will give a negative effect on the classification performance. This study presents four algorithms for tuning the SVM parameters and selecting feature subset which improved SVM classification accuracy with smaller size of feature subset. This is achieved by performing the SVM parameters’ tuning and feature subset selection processes simultaneously. Hybridization algorithms between ACO and SVM techniques were proposed. The first two algorithms, ACOR-SVM and IACOR-SVM, tune the SVM parameters while the second two algorithms, ACOMV-R-SVM and IACOMV-R-SVM, tune the SVM parameters and select the feature subset simultaneously. Ten benchmark datasets from University of California, Irvine, were used in the experiments to validate the performance of the proposed algorithms. Experimental results obtained from the proposed algorithms are better when compared with other approaches in terms of classification accuracy and size of the feature subset. The average classification accuracies for the ACOR-SVM, IACOR-SVM, ACOMV-R and IACOMV-R algorithms are 94.73%, 95.86%, 97.37% and 98.1% respectively. The average size of feature subset is eight for the ACOR-SVM and IACOR-SVM algorithms and four for the ACOMV-R and IACOMV-R algorithms. This study contributes to a new direction for ACO that can deal with continuous and mixed-variable ACO

Deep learning for automated sleep monitoring

Wearable electroencephalography (EEG) is a technology that is revolutionising the longitudinal monitoring of neurological and mental disorders, improving the quality of life of patients and accelerating the relevant research. As sleep disorders and other conditions related to sleep quality affect a large part of the population, monitoring sleep at home, over extended periods of time could have significant impact on the quality of life of people who suffer from these conditions. Annotating the sleep architecture of patients, known as sleep stage scoring, is an expensive and time-consuming process that cannot scale to a large number of people. Using wearable EEG and automating sleep stage scoring is a potential solution to this problem. In this thesis, we propose and evaluate two deep learning algorithms for automated sleep stage scoring using a single channel of EEG. In our first method, we use time-frequency analysis for extracting features that closely follow the guidelines that human experts follow, combined with an ensemble of stacked sparse autoencoders as our classification algorithm. In our second method, we propose a convolutional neural network (CNN) architecture for automatically learning filters that are specific to the problem of sleep stage scoring. We achieved state-of-the-art results (mean F1-score 84%; range 82-86%) with our first method and comparably good results with the second (mean F1-score 81%; range 79-83%). Both our methods effectively account for the skewed performance that is usually found in the literature due to sleep stage duration imbalance. We propose a filter analysis and visualisation methodology for CNNs to understand the filters that CNNs learn. Our results indicate that our CNN was able to robustly learn filters that closely follow the sleep scoring guidelines.Open Acces

An image processing decisional system for the Achilles tendon using ultrasound images

The Achilles Tendon (AT) is described as the largest and strongest tendon in the human body. As for any other organs in the human body, the AT is associated with some medical problems that include Achilles rupture and Achilles tendonitis. AT rupture affects about 1 in 5,000 people worldwide. Additionally, AT is seen in about 10 percent of the patients involved in sports activities. Today, ultrasound imaging plays a crucial role in medical imaging technologies. It is portable, non-invasive, free of radiation risks, relatively inexpensive and capable of taking real-time images. There is a lack of research that looks into the early detection and diagnosis of AT abnormalities from ultrasound images. This motivated the researcher to build a complete system which enables one to crop, denoise, enhance, extract the important features and classify AT ultrasound images. The proposed application focuses on developing an automated system platform. Generally, systems for analysing ultrasound images involve four stages, pre-processing, segmentation, feature extraction and classification. To produce the best results for classifying the AT, SRAD, CLAHE, GLCM, GLRLM, KPCA algorithms have been used. This was followed by the use of different standard and ensemble classifiers trained and tested using the dataset samples and reduced features to categorize the AT images into normal or abnormal. Various classifiers have been adopted in this research to improve the classification accuracy. To build an image decisional system, a 57 AT ultrasound images has been collected. These images were used in three different approaches where the Region of Interest (ROI) position and size are located differently. To avoid the imbalanced misleading metrics, different evaluation metrics have been adapted to compare different classifiers and evaluate the whole classification accuracy. The classification outcomes are evaluated using different metrics in order to estimate the decisional system performance. A high accuracy of 83% was achieved during the classification process. Most of the ensemble classifies worked better than the standard classifiers in all the three ROI approaches. The research aim was achieved and accomplished by building an image processing decisional system for the AT ultrasound images. This system can distinguish between normal and abnormal AT ultrasound images. In this decisional system, AT images were improved and enhanced to achieve a high accuracy of classification without any user intervention