A Biomedical System Based on Artificial Neural Network and Principal Component Analysis for Diagnosis of the Heart Valve Diseases

A Review of Machine Learning Algorithms for Biomedical Applications

As the amount and complexity of biomedical data continue to increase, machine learning methods are becoming a popular tool in creating prediction models for the underlying biomedical processes. Although all machine learning methods aim to fit models to data, the methodologies used can vary greatly and may seem daunting at first. A comprehensive review of various machine learning algorithms per biomedical applications is presented. The key concepts of machine learning are supervised and unsupervised learning, feature selection, and evaluation metrics. Technical insights on the major machine learning methods such as decision trees, random forests, support vector machines, and k-nearest neighbors are analyzed. Next, the dimensionality reduction methods like principal component analysis and t-distributed stochastic neighbor embedding methods, and their applications in biomedical data analysis were reviewed. Moreover, in biomedical applications predominantly feedforward neural networks, convolutional neural networks, and recurrent neural networks are utilized. In addition, the identification of emerging directions in machine learning methodology will serve as a useful reference for individuals involved in biomedical research, clinical practice, and related professions who are interested in understanding and applying machine learning algorithms in their research or practice.

A CFD-FFT approach to hemoacoustics that enables degree of stenosis prediction from stethoscopic signals

In this paper, we identify a new (acoustic) frequency-stenosis relation whose frequencies lie within the recommended auscultation threshold of stethoscopy (< 120 Hz). We show that this relation can be used to extend the application of phonoangiography (quantifying the degree of stenosis from bruits) to widely accessible stethoscopes. The relation is successfully identified from an analysis restricted to the acoustic signature of the von Karman vortex street, which we automatically single out by means of a metric we propose that is based on an area-weighted average of the Q-criterion for the post-stenotic region. Specifically, we perform CFD simulations on internal flow geometries that represent stenotic blood vessels of different severities. We then extract their emitted acoustic signals using the Ffowcs Williams-Hawkings equation, which we subtract from a clean signal (stenosis free) at the same heart rate. Next, we transform this differential signal to the frequency domain and carefully classify its acoustic signatures per six (stenosis-)invariant flow phases of a cardiac cycle that are newly identified in this paper. We then automatically restrict our acoustic analysis to the sounds emitted by the von Karman vortex street (phase 4) by means of our Q-criterion-based metric. Our analysis of its acoustic signature reveals a strong linear relationship between the degree of stenosis and its dominant frequency, which differs considerably from the break frequency and the heart rate (known dominant frequencies in the literature). Applying our new relation to available stethoscopic data, we find that its predictions are consistent with clinical assessment. Our finding of this linear correlation is also unlike prevalent scaling laws in the literature, which feature a small exponent (i.e., low stenosis percentage sensitivity over much of the clinical range). They hence can only distinguish mild, moderate, and severe cases. Conversely, our linear law can identify variations in the degree of stenosis sensitively and accurately for the full clinical range, thus significantly improving the utility of the relevant scaling laws... Future research will investigate incorporating the vibroacoustic role of adjacent organs to expand the clinical applicability of our findings. Extending our approach to more complex 3D stenotic morphologies and including the vibroacoustic role of surrounding organs will be explored in future research to advance the clinical reach of our findings.

Recognition of Pediatric Congenital Heart Diseases by Using Phonocardiogram Signals and Transformer-Based Neural Networks

The phonocardiogram (PCG) or heart sound auscultation is a low-cost and non-invasive method to diagnose Congenital Heart Disease (CHD). However, recognizing CHD in the pediatric population based on heart sounds is difficult because it requires high medical training and skills. Also, the dependency of PCG signal quality on sensor location and developing heart in children are challenging. This study proposed a deep learning model that classifies unprocessed or raw PCG signals to diagnose CHD using a one-dimensional Convolution Neural Network (1D-CNN) with an attention transformer. The model was built on the raw PCG data of 484 patients. The results showed that the attention transformer model had a good balance of accuracy of 0.923, a sensitivity of 0.973, and a specificity of 0.833. The Receiver Operating Characteristic (ROC) plot generated an Area Under Curve (AUC) value of 0.964, and the F1-score was 0.939. The suggested model could provide quick and appropriate real-time remote diagnosis application in classifying PCG of CHD from non-CHD subjects.Clinical Relevance- The suggested methodology can be utilized to analyze PCG signals more quickly and affordably for rural doctors as a first screening tool before sending the cases to experts.

Aerial Separation and Receiver Arrangements on Identifying Lung Syndromes Using the Artificial Neural Network

Lung disease is one of the most harmful diseases in traditional days and is the same nowadays. Early detection is one of the most crucial ways to prevent a human from developing these types of diseases. Many researchers are involved in finding various techniques for predicting the accuracy of the diseases. On the basis of the machine learning algorithm, it was not possible to predict the better accuracy when compared to the deep learning technique; this work has proposed enhanced artificial neural network approaches for the accuracy of lung diseases. Here, the discrete Fourier transform and the Burg auto-regression techniques are used for extracting the computed tomography (CT) scan images, and feature reduction takes place by using principle component analysis (PCA). This proposed work has used the 120 subjective datasets from public landmarks with and without lung diseases. The given dataset is trained by using an enhanced artificial neural network (ANN). The preprocessing techniques are handled by using a Gaussian filter; thus, our proposed approach provides enhanced classification accuracy. Finally, our proposed method is compared with the existing machine learning approach based on its accuracy.

CNN-Based Heart Sound Classification with an Imbalance-Compensating Weighted Loss Function

Heart sound auscultation is an effective method for early-stage diagnosis of heart disease. The application of deep neural networks is gaining increasing attention in automated heart sound classification. This paper proposes deep Convolutional Neural Networks (CNNs) to classify normal/abnormal heart sounds, which takes two-dimensional Mel-scale features as input, including Mel frequency cepstral coefficients (MFCCs) and the Log Mel spectrum. We employ two weighted loss functions during the training to mitigate the class imbalance issue. The model was developed on the public PhysioNet/Computing in Cardiology Challenge (CinC) 2016 heart sound database. On the considered test set, the proposed model with Log Mel spectrum as features achieves an Unweighted Average Recall (UAR) of 89.6%, with sensitivity and specificity being 89.5% and 89.7% respectively. This work proposes a CNN-based model to enable automated heart sound classification, which can provide auxiliary assistance for heart auscultation and has the potential to screen for heart pathologies in clinical applications at a relatively low cost.

Automatic Classification of Normal–Abnormal Heart Sounds Using Convolution Neural Network and Long-Short Term Memory

The phonocardiogram (PCG) is an important analysis method for the diagnosis of cardiovascular disease, which is usually performed by experienced medical experts. Due to the high ratio of patients to doctors, there is a pressing need for a real-time automated phonocardiogram classification system for the diagnosis of cardiovascular disease. This paper proposes a deep neural-network structure based on a one-dimensional convolutional neural network (1D-CNN) and a long short-term memory network (LSTM), which can directly classify unsegmented PCG to identify abnormal signal. The PCG data were filtered and put into the model for analysis. A total of 3099 pieces of heart-sound recordings were used, while another 100 patients’ heart-sound data collected by our group and diagnosed by doctors were used to test and verify the model. Results show that the CNN-LSTM model provided a good overall balanced accuracy of 0.86 ± 0.01 with a sensitivity of 0.87 ± 0.02, and specificity of 0.89 ± 0.02. The F1-score was 0.91 ± 0.01, and the receiver-operating characteristic (ROC) plot produced an area under the curve (AUC) value of 0.92 ± 0.01. The sensitivity, specificity and accuracy of the 100 patients’ data were 0.83 ± 0.02, 0.80 ± 0.02 and 0.85 ± 0.03, respectively. The proposed model does not require feature engineering and heart-sound segmentation, which possesses reliable performance in classification of abnormal PCG; and is fast and suitable for real-time diagnosis application.

Big data and artificial intelligence (AI) methodologies for computer-aided drug design (CADD)

There have been numerous advances in the development of computational and statistical methods and applications of big data and artificial intelligence (AI) techniques for computer-aided drug design (CADD). Drug design is a costly and laborious process considering the biological complexity of diseases. To effectively and efficiently design and develop a new drug, CADD can be used to apply cutting-edge techniques to various limitations in the drug design field. Data pre-processing approaches, which clean the raw data for consistent and reproducible applications of big data and AI methods are introduced. We include the current status of the applicability of big data and AI methods to drug design areas such as the identification of binding sites in target proteins, structure-based virtual screening (SBVS), and absorption, distribution, metabolism, excretion and toxicity (ADMET) property prediction. Data pre-processing and applications of big data and AI methods enable the accurate and comprehensive analysis of massive biomedical data and the development of predictive models in the field of drug design. Understanding and analyzing biological, chemical, or pharmaceutical architectures of biomedical entities related to drug design will provide beneficial information in the biomedical big data era.

Cardiovascular Disease Recognition Based on Heartbeat Segmentation and Selection Process

Assessment of heart sounds which are generated by the beating heart and the resultant blood flow through it provides a valuable tool for cardiovascular disease (CVD) diagnostics. The cardiac auscultation using the classical stethoscope phonological cardiogram is known as the most famous exam method to detect heart anomalies. This exam requires a qualified cardiologist, who relies on the cardiac cycle vibration sound (heart muscle contractions and valves closure) to detect abnormalities in the heart during the pumping action. Phonocardiogram (PCG) signal represents the recording of sounds and murmurs resulting from the heart auscultation, typically with a stethoscope, as a part of medical diagnosis. For the sake of helping physicians in a clinical environment, a range of artificial intelligence methods was proposed to automatically analyze PCG signal to help in the preliminary diagnosis of different heart diseases. The aim of this research paper is providing an accurate CVD recognition model based on unsupervised and supervised machine learning methods relayed on convolutional neural network (CNN). The proposed approach is evaluated on heart sound signals from the well-known, publicly available PASCAL and PhysioNet datasets. Experimental results show that the heart cycle segmentation and segment selection processes have a direct impact on the validation accuracy, sensitivity (TPR), precision (PPV), and specificity (TNR). Based on PASCAL dataset, we obtained encouraging classification results with overall accuracy 0.87, overall precision 0.81, and overall sensitivity 0.83. Concerning Micro classification results, we obtained Micro accuracy 0.91, Micro sensitivity 0.83, Micro precision 0.84, and Micro specificity 0.92. Using PhysioNet dataset, we achieved very good results: 0.97 accuracy, 0.946 sensitivity, 0.944 precision, and 0.946 specificity.

The use of an artificial neural network in the evaluation of the extracorporeal shockwave lithotripsy as a treatment of choice for urinary lithiasis

Objective

Artificial neural networks (ANNs) are widely applied in medicine, since they substantially increase the sensitivity and specificity of the diagnosis, classification, and the prognosis of a medical condition. In this study, we constructed an ANN to evaluate several parameters of extracorporeal shockwave lithotripsy (ESWL), such as the outcome and safety of the procedure.

Methods

Patients with urinary lithiasis suitable for ESWL treatment were enrolled. An ANN was designed using MATLAB. Medical data were collected from all patients and 12 nodes were used as inputs. Conventional statistical analysis was also performed.

Results

Finally, 716 patients were included in our study. Univariate analysis revealed that diabetes and hydronephrosis were positively correlated with ESWL complications. Regarding efficacy, univariate analysis revealed that stone location, stone size, the number and density of shockwaves delivered, and the presence of a stent in the ureter were independent factors of the ESWL outcome. This was further confirmed when adjusted for sex and age in a multivariate analysis. The performance of the ANN at the end of the training state reached 98.72%. The four basic ratios (sensitivity, specificity, positive predictive value, and negative predictive value) were calculated for both training and evaluation data sets. The performance of the ANN at the end of the evaluation state was 81.43%.

Conclusion

Our ANN achieved high score in predicting the outcome and the side effects of the ESWL treatment for urinary stones.

Machine Learning Assisted Classification of Aluminum Nitride Thin Film Stress via In-Situ Optical Emission Spectroscopy Data

In this study, we submit a complex set of in-situ data collected by optical emission spectroscopy (OES) during the process of aluminum nitride (AlN) thin film. Changing the sputtering power and nitrogen(N₂) flow rate, AlN film was deposited on Si substrate using a superior sputtering with a pulsed direct current (DC) method. The correlation between OES data and deposited film residual stress (tensile vs. compressive) associated with crystalline status by X-ray diffraction spectroscopy (XRD), scanning electron microscope (SEM), and transmission electron microscope (TEM) measurements were investigated and established throughout the machine learning exercise. An important answer to know is whether the stress of the processing film is compressive or tensile. To answer this question, we can access as many optical spectra data as we need, record the data to generate a library, and exploit principal component analysis (PCA) to reduce complexity from complex data. After preprocessing through PCA, we demonstrated that we could apply standard artificial neural networks (ANNs), and we could obtain a machine learning classification method to distinguish the stress types of the AlN thin films obtained by analyzing XRD results and correlating with TEM microstructures. Combining PCA with ANNs, an accurate method for in-situ stress prediction and classification was created to solve the semiconductor process problems related to film property on deposited films more efficiently. Therefore, methods for machine learning-assisted classification can be further extended and applied to other semiconductors or related research of interest in the future.

Automatic diagnosis of multiple cardiac diseases from PCG signals using convolutional neural network

BACKGROUND AND OBJECTIVES

Cardiovascular diseases are critical diseases and need to be diagnosed as early as possible. There is a lack of medical professionals in remote areas to diagnose these diseases. Artificial intelligence-based automatic diagnostic tools can help to diagnose cardiac diseases. This work presents an automatic classification method using machine learning to diagnose multiple cardiac diseases from phonocardiogram signals.

METHODS

The proposed system involves a convolutional neural network (CNN) model because of its high accuracy and robustness to automatically diagnose the cardiac disorders from the heart sounds. To improve the accuracy in a noisy environment and make the method robust, the proposed method has used data augmentation techniques for training and multi-classification of multiple cardiac diseases.

RESULTS

The model has been validated both heart sound data and augmented data using n-fold cross-validation. Results of all fold have been shown reported in this work. The model has achieved accuracy on the test set up to 98.60% to diagnose multiple cardiac diseases.

CONCLUSIONS

The proposed model can be ported to any computing devices like computers, single board computing processors, android handheld devices etc. To make a stand-alone diagnostic tool that may be of help in remote primary health care centres. The proposed method is non-invasive, efficient, robust, and has low time complexity making it suitable for real-time applications.

Coronary artery disease detection using artificial intelligence techniques: A survey of trends, geographical differences and diagnostic features 1991-2020

While coronary angiography is the gold standard diagnostic tool for coronary artery disease (CAD), but it is associated with procedural risk, it is an invasive technique requiring arterial puncture, and it subjects the patient to radiation and iodinated contrast exposure. Artificial intelligence (AI) can provide a pretest probability of disease that can be used to triage patients for angiography. This review comprehensively investigates published papers in the domain of CAD detection using different AI techniques from 1991 to 2020, in order to discern broad trends and geographical differences. Moreover, key decision factors affecting CAD diagnosis are identified for different parts of the world by aggregating the results from different studies. In this study, all datasets that have been used for the studies for CAD detection, their properties, and achieved performances using various AI techniques, are presented, compared, and analyzed. In particular, the effectiveness of machine learning (ML) and deep learning (DL) techniques to diagnose and predict CAD are reviewed. From PubMed, Scopus, Ovid MEDLINE, and Google Scholar search, 500 papers were selected to be investigated. Among these selected papers, 256 papers met our criteria and hence were included in this study. Our findings demonstrate that AI-based techniques have been increasingly applied for the detection of CAD since 2008. AI-based techniques that utilized electrocardiography (ECG), demographic characteristics, symptoms, physical examination findings, and heart rate signals, reported high accuracy for the detection of CAD. In these papers, the authors ranked the features based on their assessed clinical importance with ML techniques. The results demonstrate that the attribution of the relative importance of ML features for CAD diagnosis is different among countries. More recently, DL methods have yielded high CAD detection performance using ECG signals, which drives its burgeoning adoption.

Artificial intelligence and automation in valvular heart diseases

Artificial intelligence (AI) is gradually changing every aspect of social life, and healthcare is no exception. The clinical procedures that were supposed to, and could previously only be handled by human experts can now be carried out by machines in a more accurate and efficient way. The coming era of big data and the advent of supercomputers provides great opportunities to the development of AI technology for the enhancement of diagnosis and clinical decision-making. This review provides an introduction to AI and highlights its applications in the clinical flow of diagnosing and treating valvular heart diseases (VHDs). More specifically, this review first introduces some key concepts and subareas in AI. Secondly, it discusses the application of AI in heart sound auscultation and medical image analysis for assistance in diagnosing VHDs. Thirdly, it introduces using AI algorithms to identify risk factors and predict mortality of cardiac surgery. This review also describes the state-of-the-art autonomous surgical robots and their roles in cardiac surgery and intervention.

Machine Listening for Heart Status Monitoring: Introducing and Benchmarking HSS - the Heart Sounds Shenzhen Corpus

Auscultation of the heart is a widely studied technique, which requires precise hearing from practitioners as a means of distinguishing subtle differences in heart-beat rhythm. This technique is popular due to its non-invasive nature, and can be an early diagnosis aid for a range of cardiac conditions. Machine listening approaches can support this process, monitoring continuously and allowing for a representation of both mild and chronic heart conditions. Despite this potential, relevant databases and benchmark studies are scarce. In this paper, we introduce our publicly accessible database, the Heart Sounds Shenzhen Corpus (HSS), which was first released during the recent INTERSPEECH 2018 ComParE Heart Sound sub-challenge. Additionally, we provide a survey of machine learning work in the area of heart sound recognition, as well as a benchmark for HSS utilising standard acoustic features and machine learning models. At best our support vector machine with Log Mel features achieves 49.7% unweighted average recall on a three category task (normal, mild, moderate/severe).

A database for using machine learning and data mining techniques for coronary artery disease diagnosis

We present the coronary artery disease (CAD) database, a comprehensive resource, comprising 126 papers and 68 datasets relevant to CAD diagnosis, extracted from the scientific literature from 1992 and 2018. These data were collected to help advance research on CAD-related machine learning and data mining algorithms, and hopefully to ultimately advance clinical diagnosis and early treatment. To aid users, we have also built a web application that presents the database through various reports.

Automated diagnosis of heart valve degradation using novelty detection algorithms and machine learning

The blood flow through the major vessels holds great diagnostic potential for the identification of cardiovascular complications and is therefore routinely assessed with current diagnostic modalities. Heart valves are subject to high hydrodynamic loads which render them prone to premature degradation. Failing native aortic valves are routinely replaced with bioprosthetic heart valves. This type of prosthesis is limited by a durability that is often less than the patient's life expectancy. Frequent assessment of valvular function can therefore help to ensure good long-term outcomes and to plan reinterventions. In this article, we describe how unsupervised novelty detection algorithms can be used to automate the interpretation of blood flow data to improve outcomes through early detection of adverse cardiovascular events without requiring repeated check-ups in a clinical environment. The proposed method was tested in an in-vitro flow loop which allowed simulating a failing aortic valve in a laboratory setting. Aortic regurgitation of increasing severity was deliberately introduced with tube-shaped inserts, preventing complete valve closure during diastole. Blood flow recordings from a flow meter at the location of the ascending aorta were analyzed with the algorithms introduced in this article and a diagnostic index was defined that reflects the severity of valvular degradation. The results indicate that the proposed methodology offers a high sensitivity towards pathological changes of valvular function and that it is capable of automatically identifying valvular degradation. Such methods may be a step towards computer-assisted diagnostics and telemedicine that provide the clinician with novel tools to improve patient care.

Machine learning-based coronary artery disease diagnosis: A comprehensive review

Coronary artery disease (CAD) is the most common cardiovascular disease (CVD) and often leads to a heart attack. It annually causes millions of deaths and billions of dollars in financial losses worldwide. Angiography, which is invasive and risky, is the standard procedure for diagnosing CAD. Alternatively, machine learning (ML) techniques have been widely used in the literature as fast, affordable, and noninvasive approaches for CAD detection. The results that have been published on ML-based CAD diagnosis differ substantially in terms of the analyzed datasets, sample sizes, features, location of data collection, performance metrics, and applied ML techniques. Due to these fundamental differences, achievements in the literature cannot be generalized. This paper conducts a comprehensive and multifaceted review of all relevant studies that were published between 1992 and 2019 for ML-based CAD diagnosis. The impacts of various factors, such as dataset characteristics (geographical location, sample size, features, and the stenosis of each coronary artery) and applied ML techniques (feature selection, performance metrics, and method) are investigated in detail. Finally, the important challenges and shortcomings of ML-based CAD diagnosis are discussed.

Classification of Heart Sounds Based on the Wavelet Fractal and Twin Support Vector Machine

Heart is an important organ of human beings. As more and more heart diseases are caused by people’s living pressure or habits, the diagnosis and treatment of heart diseases also require technical improvement. In order to assist the heart diseases diagnosis, the heart sound signal is used to carry a large amount of cardiac state information, so that the heart sound signal processing can achieve the purpose of heart diseases diagnosis and treatment. In order to quickly and accurately judge the heart sound signal, the classification method based on Wavelet Fractal and twin support vector machine (TWSVM) is proposed in this paper. Firstly, the original heart sound signal is decomposed by wavelet transform, and the wavelet decomposition coefficients of the signal are extracted. Then the two-norm eigenvectors of the heart sound signal are obtained by solving the two-norm values of the decomposition coefficients. In order to express the feature information more abundantly, the energy entropy of the decomposed wavelet coefficients is calculated, and then the energy entropy characteristics of the signal are obtained. In addition, based on the fractal dimension, the complexity of the signal is quantitatively described. The box dimension of the heart sound signal is solved by the binary box dimension method. So its fractal dimension characteristics can be obtained. The above eigenvectors are synthesized as the eigenvectors of the heart sound signal. Finally, the twin support vector machine (TWSVM) is applied to classify the heart sound signals. The proposed algorithm is verified on the PhysioNet/CinC Challenge 2016 heart sound database. The experimental results show that this proposed algorithm based on twin support vector machine (TWSVM) is superior to the algorithm based on support vector machine (SVM) in classification accuracy and speed. The proposed algorithm achieves the best results with classification accuracy 90.4%, sensitivity 94.6%, specificity 85.5% and F1 Score 95.2%.

Predicting coronary artery disease: a comparison between two data mining algorithms

Background

Cardiovascular diseases (CADs) are the first leading cause of death across the world. World Health Organization has estimated that morality rate caused by heart diseases will mount to 23 million cases by 2030. Hence, the use of data mining algorithms could be useful in predicting coronary artery diseases. Therefore, the present study aimed to compare the positive predictive value (PPV) of CAD using artificial neural network (ANN) and SVM algorithms and their distinction in terms of predicting CAD in the selected hospitals.

Methods

The present study was conducted by using data mining techniques. The research sample was the medical records of the patients with coronary artery disease who were hospitalized in three hospitals affiliated to AJA University of Medical Sciences between March 2016 and March 2017 (n = 1324). The dataset and the predicting variables used in this study was the same for both data mining techniques. Totally, 25 variables affecting CAD were selected and related data were extracted. After normalizing and cleaning the data, they were entered into SPSS (V23.0) and Excel 2013. Then, R 3.3.2 was used for statistical computing.

Results

The SVM model had lower MAPE (112.03), higher Hosmer-Lemeshow test’s result (16.71), and higher sensitivity (92.23). Moreover, variables affecting CAD (74.42) yielded better goodness of fit in SVM model and provided more accurate result than the ANN model. On the other hand, since the area under the receiver operating characteristic (ROC) curve in the SVM algorithm was more than this area in ANN model, it could be concluded that SVM model had higher accuracy than the ANN model.

Conclusion

According to the results, the SVM algorithm presented higher accuracy and better performance than the ANN model and was characterized with higher power and sensitivity. Overall, it provided a better classification for the prediction of CAD. The use of other data mining algorithms are suggested to improve the positive predictive value of the disease prediction.

Training of feedforward neural networks for data classification using hybrid particle swarm optimization, Mantegna Lévy flight and neighborhood search

Artificial Neural networks (ANNs) are often applied to data classification problems. However, training ANNs remains a challenging task due to the large and high dimensional nature of search space particularly in the process of fine-tuning the best set of control parameters in terms of weight and bias. Evolutionary algorithms are proved to be a reliable optimization method for training the parameters. While a number of conventional training algorithms have been proposed and applied to various applications, most of them share the common disadvantages of local optima stagnation and slow convergence. In this paper, we propose a new evolutionary training algorithm referred to as LPSONS, which combines the velocity operators in Particle Swarm Optimization (PSO) with Mantegna Lévy distribution to produce more diverse solutions by dividing the population and generation between different sections of the algorithm. It further combines Neighborhood Search with Mantegna Lévy distribution to mitigate premature convergence and avoid local minima. The proposed algorithm can find optimal results and at the same time avoid stagnation in local optimum solutions as well as prevent premature convergence in training Feedforward Multi-Layer Perceptron (MLP) ANNs. Experiments with fourteen standard datasets from UCI machine learning repository confirm that the LPSONS algorithm significantly outperforms a gradient-based approach as well as some well-known evolutionary algorithms that are also based on enhancing PSO.

Review of Medical Decision Support and Machine-Learning Methods

Machine-learning methods can assist with the medical decision-making processes at the both the clinical and diagnostic levels. In this article, we first review historical milestones and specific applications of computer-based medical decision support tools in both veterinary and human medicine. Next, we take a mechanistic look at 3 archetypal learning algorithms—naive Bayes, decision trees, and neural network—commonly used to power these medical decision support tools. Last, we focus our discussion on the data sets used to train these algorithms and examine methods for validation, data representation, transformation, and feature selection. From this review, the reader should gain some appreciation for how these decision support tools have and can be used in medicine along with insight on their inner workings.

eDoctor: machine learning and the future of medicine

Machine learning (ML) is a burgeoning field of medicine with huge resources being applied to fuse computer science and statistics to medical problems. Proponents of ML extol its ability to deal with large, complex and disparate data, often found within medicine and feel that ML is the future for biomedical research, personalized medicine, computer-aided diagnosis to significantly advance global health care. However, the concepts of ML are unfamiliar to many medical professionals and there is untapped potential in the use of ML as a research tool. In this article, we provide an overview of the theory behind ML, explore the common ML algorithms used in medicine including their pitfalls and discuss the potential future of ML in medicine.

A Framework for “Just-in-Time Learning” Decision Support in Organizations

This article describes an integrated “Just-in-Time Learning” framework for providing decision support in organizations. The framework emerges from years of work with the national laboratories and facilities that are under the direction of the United States Department of Energy. The article begins by describing expert systems technology and how it has been used to provide decision support in organizations. This is followed by a discussion of the strengths and weaknesses of expert systems technology for this purpose. Next, a “Just-in-Time Learning” framework is introduced where the theoretical foundation for the framework is described. Afterwards, the other aspects of the framework including the types of knowledge, learners it serves, and how the framework can be utilized for decision support are detailed. Finally, a discussion section summarizes how a Just-in-Time Learning Framework can achieve some of the strengths -- while overcoming some of the weaknesses -- of expert system technology for providing decision support in organizations.

Heart sound classification using Gaussian mixture model

Background:

This article represents a new method of classifying the heart sound status using the loudness features from the heart sound.

Materials and methods:

The method includes the following 3 main steps. First, the heart sound, which is usually found noisy, is heavily filtered by a 6th-order Chebyshev-I filter. The heart sound is then segmented using the event synchronous method to separate the sounds into the first heart sound, the systole and the second heart sound, the diastole. In the second step, the heart sound features namely maximum loudness index and minimum loudness index are obtained from the spectrogram of the sound by taking the row means. As a third step, the heart sound is classified using the Gaussian mixture model approach to categorize the sounds.

Results:

This method has been tested on a very large database of heart sounds consisting of over 3000 heart sounds recordings with a success rate of 97.77%.

Conclusion:

Only 2 features are used in this method namely, minimum loudness index and maximum loudness index. Classification of sounds using these 2 features yields high accuracy even under noisy conditions and is comparable to any state-of-the-art technique.

PCG Classification Using Multidomain Features and SVM Classifier

This paper proposes a method using multidomain features and support vector machine (SVM) for classifying normal and abnormal heart sound recordings. The database was provided by the PhysioNet/CinC Challenge 2016. A total of 515 features are extracted from nine feature domains, i.e., time interval, frequency spectrum of states, state amplitude, energy, frequency spectrum of records, cepstrum, cyclostationarity, high-order statistics, and entropy. Correlation analysis is conducted to quantify the feature discrimination abilities, and the results show that "frequency spectrum of state", "energy", and "entropy" are top domains to contribute effective features. A SVM with radial basis kernel function was trained for signal quality estimation and classification. The SVM classifier is independently trained and tested by many groups of top features. It shows the average of sensitivity, specificity, and overall score are high up to 0.88, 0.87, and 0.88, respectively, when top 400 features are used. This score is competitive to the best previous scores. The classifier has very good performance with even small number of top features for training and it has stable output regardless of randomly selected features for training. These simulations demonstrate that the proposed features and SVM classifier are jointly powerful for classifying heart sound recordings.

Learning Front-end Filter-bank Parameters using Convolutional Neural Networks for Abnormal Heart Sound Detection

Automatic heart sound abnormality detection can play a vital role in the early diagnosis of heart diseases, particularly in low-resource settings. The state-of-the-art algorithms for this task utilize a set of Finite Impulse Response (FIR) band-pass filters as a front-end followed by a Convolutional Neural Network (CNN) model. In this work, we propound a novel CNN architecture that integrates the front-end band-pass filters within the network using time-convolution (tConv) layers, which enables the FIR filter-bank parameters to become learnable. Different initialization strategies for the learnable filters, including random parameters and a set of predefined FIR filter-bank coefficients, are examined. Using the proposed tConv layers, we add constraints to the learnable FIR filters to ensure linear and zero phase responses. Experimental evaluations are performed on a balanced 4-fold cross-validation task prepared using the PhysioNet/CinC 2016 dataset. Results demonstrate that the proposed models yield superior performance compared to the state-of-the-art system, while the linear phase FIR filter-bank method provides an absolute improvement of 9.54% over the baseline in terms of an overall accuracy metric.

Detection of pathological heart sounds

Heart sound analysis has been a major topic of research over the past few decades. However, the necessity for a large and reliable database has been a major concern in these studies.

OBJECTIVE

Noting that the current heart sound classification methods do not work properly for noisy signals, the PhysioNet/CinC Challenge 2016 aims to develop the heart sound classification algorithms by providing a global open database for challengers. This paper addresses the problem of heart sound classification methods within noisy real-world phonocardiogram recordings by implementing an innovative approach.

SIGNIFICANCE

After locating the fundamental heart sounds and the systolic and diastolic components, a novel method named cycle quality assessment is applied to each recording. The presented method detects those cycles which are less affected by noise and better segmented by the use of two criteria here proposed in this paper. The selected cycles are the inputs of a further feature extraction process.

APPROACH

Due to the variability of the heart sound signal induced by various cardiac arrhythmias, four sets of features from the time, time-frequency and perceptual domains are extracted. Before starting the main classification process, the obtained 90-dimensional feature vector is mapped to a new feature space to pre-detect normal recordings by applying a Fisher's discriminant analysis. The main classification procedure is then done based on three feed-forward neural networks and a voting system among classifiers.

MAIN RESULTS

The presented method is evaluated using the training and hidden test sets of the PhysioNet/CinC Challenge 2016. Also, the results are compared with the top five ranked submissions. The results indicate that the proposed method is effective in classifying heart sounds as normal versus abnormal recordings.

An open access database for the evaluation of heart sound algorithms

In the past few decades, analysis of heart sound signals (i.e. the phonocardiogram or PCG), especially for automated heart sound segmentation and classification, has been widely studied and has been reported to have the potential value to detect pathology accurately in clinical applications. However, comparative analyses of algorithms in the literature have been hindered by the lack of high-quality, rigorously validated, and standardized open databases of heart sound recordings. This paper describes a public heart sound database, assembled for an international competition, the PhysioNet/Computing in Cardiology (CinC) Challenge 2016. The archive comprises nine different heart sound databases sourced from multiple research groups around the world. It includes 2435 heart sound recordings in total collected from 1297 healthy subjects and patients with a variety of conditions, including heart valve disease and coronary artery disease. The recordings were collected from a variety of clinical or nonclinical (such as in-home visits) environments and equipment. The length of recording varied from several seconds to several minutes. This article reports detailed information about the subjects/patients including demographics (number, age, gender), recordings (number, location, state and time length), associated synchronously recorded signals, sampling frequency and sensor type used. We also provide a brief summary of the commonly used heart sound segmentation and classification methods, including open source code provided concurrently for the Challenge. A description of the PhysioNet/CinC Challenge 2016, including the main aims, the training and test sets, the hand corrected annotations for different heart sound states, the scoring mechanism, and associated open source code are provided. In addition, several potential benefits from the public heart sound database are discussed.

Optimizing the Learning Process of Feedforward Neural Networks Using Lightning Search Algorithm

Evolutionary Neural Networks are proven to be beneficial in solving challenging datasets mainly due to the high local optima avoidance. Stochastic operators in such techniques reduce the probability of stagnation in local solutions and assist them to supersede conventional training algorithms such as Back Propagation (BP) and Levenberg-Marquardt (LM). According to the No-Free-Lunch (NFL), however, there is no optimization technique for solving all optimization problems. This means that a Neural Network trained by a new algorithm has the potential to solve a new set of problems or outperform the current techniques in solving existing problems. This motivates our attempts to investigate the efficiency of the recently proposed Evolutionary Algorithm called Lightning Search Algorithm (LSA) in training Neural Network for the first time in the literature. The LSA-based trainer is benchmarked on 16 popular medical diagnosis problems and compared to BP, LM, and 6 other evolutionary trainers. The quantitative and qualitative results show that the LSA algorithm is able to show not only better local solutions avoidance but also faster convergence speed compared to the other algorithms employed. In addition, the statistical test conducted proves that the LSA-based trainer is significantly superior in comparison with the current algorithms on the majority of datasets.

Artificial neural networks approach to early lung cancer detection

Lung cancer is rated with the highest incidence and mortality every year compared with other forms of cancer, therefore early detection and diagnosis is essential. Artificial Neural Networks (ANNs) are “artificial intelligence” software which have been used to assess a few prognostic situations. In this study, a database containing 193 patients from Diagnostic and Monitoring of Tuberculosis and Illness of Lungs Ward in Kuyavia and Pomerania Centre of the Pulmonology (Bydgoszcz, Poland) was analysed using ANNs. Each patient was described using 48 factors (i.e. age, sex, data of patient history, results from medical examinations etc.) and, as an output value, the expected presence of lung cancer was established. All 48 features were retrospectively collected and the database was divided into a training set (n=97), testing set (n=48) and a validating set (n=48). The best prediction score of the ANN model (MLP 48-9-2) was above 0.99 of the area under a receiver operator characteristic (ROC) curve. The ANNs were able to correctly classify 47 out of 48 test cases. These data suggest that Artificial Neural Networks can be used in prognosis of lung cancer and could help the physician in diagnosis of patients with the suspicion of lung cancer.

Empirical mode decomposition and neural network for the classification of electroretinographic data

The processing of biosignals is increasingly being utilized in ambulatory situations in order to extract significant signals' features that can help in clinical diagnosis. However, this task is hampered by the fact that biomedical signals exhibit a complex behavior characterized by strong nonlinear and non-stationary properties that cannot always be perceived by simple visual examination. New processing methods need be considered. In this context, we propose a signal processing method, based on empirical mode decomposition and artificial neural networks, to analyze electroretinograms, i.e., the retinal response to a light flash, with the aim to detect and classify retinal diseases. The present application focuses on two retinal pathologies: achromatopsia, which is a cone disease, and congenital stationary night blindness, which affects the photoreceptoral signal transmission. The results indicate that, under suitable conditions, the method proposed here has the potential to provide a powerful tool for routine clinical examinations, since it is able to recognize with high level of confidence the eventual presence of one of the two pathologies.