Designing and Implementing an ANFIS Based Medical Decision Support System to Predict Chronic Kidney Disease Progression

Background and objective: Chronic kidney disease (CKD) has a covert nature in its early stages that could postpone its diagnosis. Early diagnosis can reduce or prevent the progression of renal damage. The present study introduces an expert medical decision support system (MDSS) based on adaptive neuro-fuzzy inference system (ANFIS) to predict the timeframe of renal failure.Methods: The core system of the MDSS is a Takagi-Sugeno type ANFIS model that predicts the glomerular filtration rate (GFR) values as the biological marker of the renal failure. The model uses 10-year clinical records of newly diagnosed CKD patients and considers the threshold value of 15 cc/kg/min/1.73 m2 of GFR as the marker of renal failure. Following the evaluation of 10 variables, the ANFIS model uses the weight, diastolic blood pressure, and diabetes mellitus as underlying disease, and current GFR(t) as the inputs of the predicting model to predict the GFR values at future intervals. Then, a user-friendly graphical user interface of the model was built in MATLAB, in which the user can enter the physiological parameters obtained from patient recordings to determine the renal failure time as the output.Results: Assessing the performance of the MDSS against the real data of male and female CKD patients showed that this decision support model could accurately estimate GFR variations in all sequential periods of 6, 12, and 18 months, with a normalized mean absolute error lower than 5%. Despite the high uncertainties of the human body and the dynamic nature of CKD progression, our model can accurately predict the GFR variations at long future periods.Conclusions: The MDSS GUI could be useful in medical centers and used by experts to predict renal failure progression and, through taking effective actions, CKD can be prevented or effectively delayed

<span style="font-size:10.0pt;font-family: "Times New Roman";mso-fareast-font-family:"Times New Roman";mso-bidi-font-family: Mangal;mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language: HI" lang="EN-US">Flipped voltage follower based low noise amplifier with 640 MHz BW at 2.26 GHz, 1.3 dB NF, 1.2V V_dd, and up to 10 dBm IIP3</span>

546-552The design, implementation and characterization of four Low Noise Amplifier architectures in a double poly, four metal layers, 0.35 mm CMOS technology from AMS AG biased at 1.2 V with a power consumption as low as 2.73 mW operating in a frequency band ranging from 1.94 to 2.58 GHz with Noise Figure around 1.3 dB and input intercept point up to 10 dBm are presented. With the performance exhibited by the proposed topologies, it is demonstrated that the use of the Flipped Voltage Follower structure is feasible to realize amplifiers at radio frequencies with low noise figure and good linearity performance preserving its characteristic low power consumption. </span