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Bazoukis G, Bollepalli SC, Chung CT, Li X, Tse G, Bartley BL, Batool-Anwar S, Quan SF, Armoundas AA. Application of artificial intelligence in the diagnosis of sleep apnea. J Clin Sleep Med 2023; 19:1337-1363. [PMID: 36856067 PMCID: PMC10315608 DOI: 10.5664/jcsm.10532] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 03/02/2023]
Abstract
STUDY OBJECTIVES Machine learning (ML) models have been employed in the setting of sleep disorders. This review aims to summarize the existing data about the role of ML techniques in the diagnosis, classification, and treatment of sleep-related breathing disorders. METHODS A systematic search in Medline, EMBASE, and Cochrane databases through January 2022 was performed. RESULTS Our search strategy revealed 132 studies that were included in the systematic review. Existing data show that ML models have been successfully used for diagnostic purposes. Specifically, ML models showed good performance in diagnosing sleep apnea using easily obtained features from the electrocardiogram, pulse oximetry, and sound signals. Similarly, ML showed good performance for the classification of sleep apnea into obstructive and central categories, as well as predicting apnea severity. Existing data show promising results for the ML-based guided treatment of sleep apnea. Specifically, the prediction of outcomes following surgical treatment and optimization of continuous positive airway pressure therapy can be guided by ML models. CONCLUSIONS The adoption and implementation of ML in the field of sleep-related breathing disorders is promising. Advancements in wearable sensor technology and ML models can help clinicians predict, diagnose, and classify sleep apnea more accurately and efficiently. CITATION Bazoukis G, Bollepalli SC, Chung CT, et al. Application of artificial intelligence in the diagnosis of sleep apnea. J Clin Sleep Med. 2023;19(7):1337-1363.
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Affiliation(s)
- George Bazoukis
- Department of Cardiology, Larnaca General Hospital, Larnaca, Cyprus
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus
| | | | - Cheuk To Chung
- Cardiac Electrophysiology Unit, Cardiovascular Analytics Group, China-UK Collaboration, Hong Kong
| | - Xinmu Li
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin, China
| | - Gary Tse
- Cardiac Electrophysiology Unit, Cardiovascular Analytics Group, China-UK Collaboration, Hong Kong
- Kent and Medway Medical School, Canterbury, Kent, United Kingdom
| | - Bethany L. Bartley
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Salma Batool-Anwar
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Stuart F. Quan
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts
- Asthma and Airway Disease Research Center, University of Arizona College of Medicine, Tucson, Arizona
| | - Antonis A. Armoundas
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts
- Broad Institute, Massachusetts Institute of Technology, Cambridge, Massachusetts
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Li X, Ono C, Warita N, Shoji T, Nakagawa T, Usukura H, Yu Z, Takahashi Y, Ichiji K, Sugita N, Kobayashi N, Kikuchi S, Kimura R, Hamaie Y, Hino M, Kunii Y, Murakami K, Ishikuro M, Obara T, Nakamura T, Nagami F, Takai T, Ogishima S, Sugawara J, Hoshiai T, Saito M, Tamiya G, Fuse N, Fujii S, Nakayama M, Kuriyama S, Yamamoto M, Yaegashi N, Homma N, Tomita H. Comprehensive evaluation of machine learning algorithms for predicting sleep-wake conditions and differentiating between the wake conditions before and after sleep during pregnancy based on heart rate variability. Front Psychiatry 2023; 14:1104222. [PMID: 37415686 PMCID: PMC10322181 DOI: 10.3389/fpsyt.2023.1104222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 05/19/2023] [Indexed: 07/08/2023] Open
Abstract
Introduction Perinatal women tend to have difficulties with sleep along with autonomic characteristics. This study aimed to identify a machine learning algorithm capable of achieving high accuracy in predicting sleep-wake conditions and differentiating between the wake conditions before and after sleep during pregnancy based on heart rate variability (HRV). Methods Nine HRV indicators (features) and sleep-wake conditions of 154 pregnant women were measured for 1 week, from the 23rd to the 32nd weeks of pregnancy. Ten machine learning and three deep learning methods were applied to predict three types of sleep-wake conditions (wake, shallow sleep, and deep sleep). In addition, the prediction of four conditions, in which the wake conditions before and after sleep were differentiated-shallow sleep, deep sleep, and the two types of wake conditions-was also tested. Results and Discussion In the test for predicting three types of sleep-wake conditions, most of the algorithms, except for Naïve Bayes, showed higher areas under the curve (AUCs; 0.82-0.88) and accuracy (0.78-0.81). The test using four types of sleep-wake conditions with differentiation between the wake conditions before and after sleep also resulted in successful prediction by the gated recurrent unit with the highest AUC (0.86) and accuracy (0.79). Among the nine features, seven made major contributions to predicting sleep-wake conditions. Among the seven features, "the number of interval differences of successive RR intervals greater than 50 ms (NN50)" and "the proportion dividing NN50 by the total number of RR intervals (pNN50)" were useful to predict sleep-wake conditions unique to pregnancy. These findings suggest alterations in the vagal tone system specific to pregnancy.
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Affiliation(s)
- Xue Li
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Chiaki Ono
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Noriko Warita
- Department of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan
| | - Tomoka Shoji
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan
| | - Takashi Nakagawa
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Hitomi Usukura
- Department of Disaster Psychiatry, International Research Institute of Disaster Sciences, Tohoku University, Sendai, Japan
| | - Zhiqian Yu
- Department of Disaster Psychiatry, International Research Institute of Disaster Sciences, Tohoku University, Sendai, Japan
| | - Yuta Takahashi
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Kei Ichiji
- Department of Radiological Imaging and Informatics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Norihiro Sugita
- Department of Management Science and Technology, Graduate School of Engineering, Tohoku University, Sendai, Japan
| | | | - Saya Kikuchi
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Ryoko Kimura
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yumiko Hamaie
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
- Department of Disaster Psychiatry, International Research Institute of Disaster Sciences, Tohoku University, Sendai, Japan
| | - Mizuki Hino
- Department of Disaster Psychiatry, International Research Institute of Disaster Sciences, Tohoku University, Sendai, Japan
| | - Yasuto Kunii
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
- Department of Disaster Psychiatry, International Research Institute of Disaster Sciences, Tohoku University, Sendai, Japan
| | - Keiko Murakami
- Department of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan
| | - Mami Ishikuro
- Department of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan
| | - Taku Obara
- Department of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan
| | - Tomohiro Nakamura
- Department of Health Record Informatics, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan
| | - Fuji Nagami
- Department of Public Relations and Planning, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan
| | - Takako Takai
- Department of Health Record Informatics, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan
| | - Soichi Ogishima
- Department of Health Record Informatics, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan
| | - Junichi Sugawara
- Department of Community Medical Supports, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan
| | - Tetsuro Hoshiai
- Department of Obstetrics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masatoshi Saito
- Department of Obstetrics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Gen Tamiya
- Department of Integrative Genomics, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan
| | - Nobuo Fuse
- Department of Integrative Genomics, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan
| | - Susumu Fujii
- Department of Disaster Medical Informatics, International Research Institute of Disaster Sciences, Tohoku University, Sendai, Japan
| | - Masaharu Nakayama
- Department of Disaster Medical Informatics, International Research Institute of Disaster Sciences, Tohoku University, Sendai, Japan
| | - Shinichi Kuriyama
- Department of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan
- Department of Disaster Public Health, International Research Institute of Disaster Sciences, Tohoku University, Sendai, Japan
| | - Masayuki Yamamoto
- Department of Management Science and Technology, Graduate School of Engineering, Tohoku University, Sendai, Japan
- Department of Integrative Genomics, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan
| | - Nobuo Yaegashi
- Department of Public Relations and Planning, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan
- Department of Obstetrics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriyasu Homma
- Department of Radiological Imaging and Informatics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Tomita
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
- Department of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan
- Department of Disaster Psychiatry, International Research Institute of Disaster Sciences, Tohoku University, Sendai, Japan
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Wei K, Zou L, Liu G, Wang C. MS-Net: Sleep apnea detection in PPG using multi-scale block and shadow module one-dimensional convolutional neural network. Comput Biol Med 2023; 155:106469. [PMID: 36842220 DOI: 10.1016/j.compbiomed.2022.106469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/11/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023]
Abstract
Sleep Apnea (SA) is a respiratory disorder that affects sleep. However, the SA detection method based on polysomnography is complex and not suitable for home use. The detection approach using Photoplethysmography is low cost and convenient, which can be used to widely detect SA. This study proposed a method combining a multi-scale one-dimensional convolutional neural network and a shadow one-dimensional convolutional neural network based on dual-channel input. The time-series feature information of different segments were extracted from multi-scale temporal structure. Moreover, shadow module was adopted to make full use of the redundant information generated after multi-scale convolution operation, which improved the accuracy and ensured the portability of the model. At the same time, we introduced balanced bootstrapping and class weight, which effectively alleviated the problem of unbalanced classes. Our method achieved the result of 82.0% average accuracy, 74.4% average sensitivity and 85.1% average specificity for per-segment SA detection, and reached 93.6% average accuracy for per-recording SA detection after 5-fold cross validation. Experimental results show that this method has good robustness. It can be regarded as an effective aid in SA detection in household use.
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Affiliation(s)
- Keming Wei
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, Guangdong, China; Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, Guangzhou, Guangdong, China.
| | - Lang Zou
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, Guangdong, China; Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, Guangzhou, Guangdong, China.
| | - Guanzheng Liu
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, China; Laboratory of Wearable Technology and Artificial Intelligence for Healthcare of Guangdong Province, Shenzhen, Guangdong, China.
| | - Changhong Wang
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, Guangdong, China; Laboratory of Wearable Technology and Artificial Intelligence for Healthcare of Guangdong Province, Shenzhen, Guangdong, China.
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Özen Kavas P, Recep Bozkurt M, Kocayiğit İ, Bilgin C. Machine learning-based medical decision support system for diagnosing HFpEF and HFrEF using PPG. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Abstract
Sleep Apnoea (SA) is a common chronic illness that affects nearly 1 billion people around the world, and the number of patients is rising. SA causes a wide range of psychological and physiological ailments that have detrimental effects on a patient’s wellbeing. The high prevalence and negative health effects make SA a public health problem. Whilst the current gold standard diagnostic procedure, polysomnography (PSG), is reliable, it is resource-expensive and can have a negative impact on sleep quality, as well as the environment. With this study, we focus on the environmental impact that arises from resource utilisation during SA detection, and we propose remote monitoring (RM) as a potential solution that can improve the resource efficiency and reduce travel. By reusing infrastructure technology, such as mobile communication, cloud computing, and artificial intelligence (AI), RM establishes SA detection and diagnosis support services in the home environment. However, there are considerable barriers to a widespread adoption of this technology. To gain a better understanding of the available technology and its associated strength, as well as weaknesses, we reviewed scientific papers that used various strategies for RM-based SA detection. Our review focused on 113 studies that were conducted between 2018 and 2022 and that were listed in Google Scholar. We found that just over 50% of the proposed RM systems incorporated real time signal processing and around 20% of the studies did not report on this important aspect. From an environmental perspective, this is a significant shortcoming, because 30% of the studies were based on measurement devices that must travel whenever the internal buffer is full. The environmental impact of that travel might constitute an additional need for changing from offline to online SA detection in the home environment.
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Li CH, Ly FS, Woodhouse K, Chen J, Cheng Z, Santander T, Ashar N, Turki E, Yang HT, Miller M, Petzold L, Hansma PK. Dynamic Phase Extraction: Applications in Pulse Rate Variability. Appl Psychophysiol Biofeedback 2022; 47:213-222. [PMID: 35704121 DOI: 10.1007/s10484-022-09549-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2022] [Indexed: 11/02/2022]
Abstract
Pulse rate variability is a physiological parameter that has been extensively studied and correlated with many physical ailments. However, the phase relationship between inter-beat interval, IBI, and breathing has very rarely been studied. Develop a technique by which the phase relationship between IBI and breathing can be accurately and efficiently extracted from photoplethysmography (PPG) data. A program based on Lock-in Amplifier technology was written in Python to implement a novel technique, Dynamic Phase Extraction. It was tested using a breath pacer and a PPG sensor on 6 subjects who followed a breath pacer at varied breathing rates. The data were then analyzed using both traditional methods and the novel technique (Dynamic Phase Extraction) utilizing a breath pacer. Pulse data was extracted using a PPG sensor. Dynamic Phase Extraction (DPE) gave the magnitudes of the variation in IBI associated with breathing [Formula: see text] measured with photoplethysmography during paced breathing (with premature ventricular contractions, abnormal arrhythmias, and other artifacts edited out). [Formula: see text] correlated well with two standard measures of pulse rate variability: the Standard Deviation of the inter-beat interval (SDNN) (ρ = 0.911) and with the integrated value of the Power Spectral Density between 0.04 and 0.15 Hz (Low Frequency Power or LF Power) (ρ = 0.885). These correlations were comparable to the correlation between the SDNN and the LF Power (ρ = 0.877). In addition to the magnitude [Formula: see text], Dynamic Phase Extraction also gave the phase between the breath pacer and the changes in the inter-beat interval (IBI) due to respiratory sinus arrythmia (RSA), and correlated well with the phase extracted using a Fourier transform (ρ = 0.857). Dynamic Phase Extraction can extract both the phase between the breath pacer and the changes in IBI due to the respiratory sinus arrhythmia component of pulse rate variability ([Formula: see text], but is limited by needing a breath pacer.
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Affiliation(s)
- Christopher H Li
- Department of Physics, University of California, Santa Barbara, Santa Barbara, USA.
| | - Franklin S Ly
- Department of Mechanical Engineering, University of California, Santa Barbara, Santa Barbara, USA
| | - Kegan Woodhouse
- Department of Mechanical Engineering, University of California, Santa Barbara, Santa Barbara, USA
| | - John Chen
- Department of Mechanical Engineering, University of California, Santa Barbara, Santa Barbara, USA
| | - Zhuowei Cheng
- Department of Computer Science, University of California, Santa Barbara, Santa Barbara, USA
| | - Tyler Santander
- Department of Psychological & Brain Sciences, University of California, Santa Barbara, Santa Barbara, USA
| | - Nirmit Ashar
- Department of Computer Science, University of California, Santa Barbara, Santa Barbara, USA
| | - Elyes Turki
- Department of Physics, University of California, Santa Barbara, Santa Barbara, USA
| | - Henry T Yang
- Department of Mechanical Engineering, University of California, Santa Barbara, Santa Barbara, USA
| | - Michael Miller
- Department of Psychological & Brain Sciences, University of California, Santa Barbara, Santa Barbara, USA
| | - Linda Petzold
- Department of Mechanical Engineering, University of California, Santa Barbara, Santa Barbara, USA.,Department of Computer Science, University of California, Santa Barbara, Santa Barbara, USA
| | - Paul K Hansma
- Department of Physics, University of California, Santa Barbara, Santa Barbara, USA.,Neuroscience Research Institute, University of California, Santa Barbara, Santa Barbara, USA
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Faust O, Hong W, Loh HW, Xu S, Tan RS, Chakraborty S, Barua PD, Molinari F, Acharya UR. Heart rate variability for medical decision support systems: A review. Comput Biol Med 2022; 145:105407. [DOI: 10.1016/j.compbiomed.2022.105407] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/09/2022] [Accepted: 03/12/2022] [Indexed: 12/22/2022]
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Loh HW, Xu S, Faust O, Ooi CP, Barua PD, Chakraborty S, Tan RS, Molinari F, Acharya UR. Application of photoplethysmography signals for healthcare systems: An in-depth review. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 216:106677. [PMID: 35139459 DOI: 10.1016/j.cmpb.2022.106677] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/30/2022] [Accepted: 01/30/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVES Photoplethysmography (PPG) is a device that measures the amount of light absorbed by the blood vessel, blood, and tissues, which can, in turn, translate into various measurements such as the variation in blood flow volume, heart rate variability, blood pressure, etc. Hence, PPG signals can produce a wide variety of biological information that can be useful for the detection and diagnosis of various health problems. In this review, we are interested in the possible health disorders that can be detected using PPG signals. METHODS We applied PRISMA guidelines to systematically search various journal databases and identified 43 PPG studies that fit the criteria of this review. RESULTS Twenty-five health issues were identified from these studies that were classified into six categories: cardiac, blood pressure, sleep health, mental health, diabetes, and miscellaneous. Various routes were employed in these PPG studies to perform the diagnosis: machine learning, deep learning, and statistical routes. The studies were reviewed and summarized. CONCLUSIONS We identified limitations such as poor standardization of sampling frequencies and lack of publicly available PPG databases. We urge that future work should consider creating more publicly available databases so that a wide spectrum of health problems can be covered. We also want to promote the use of PPG signals as a potential precision medicine tool in both ambulatory and hospital settings.
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Affiliation(s)
- Hui Wen Loh
- School of Science and Technology, Singapore University of Social Sciences, Singapore
| | - Shuting Xu
- Cogninet Australia, Sydney, New South Wales 2010, Australia; Faculty of Engineering and Information Technology, University of Technology Sydney, Australia
| | - Oliver Faust
- Department of Engineering and Mathematics, Sheffield Hallam University, Sheffield S1 1WB, United Kingdom
| | - Chui Ping Ooi
- School of Science and Technology, Singapore University of Social Sciences, Singapore
| | - Prabal Datta Barua
- Faculty of Engineering and Information Technology, University of Technology Sydney, Australia; School of Business (Information Systems), Faculty of Business, Education, Law and Arts, University of Southern Queensland, Australia
| | - Subrata Chakraborty
- School of Science and Technology, Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW 2351, Australia; Centre for Advanced Modelling and Geospatial lnformation Systems (CAMGIS), Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Ru-San Tan
- Department of Cardiology, National Heart Centre Singapore, 169609, Singapore; Duke-NUS Medical School, 169857, Singapore
| | - Filippo Molinari
- Department of Electronics and Telecommunications, Politecnico di Torino, Italy
| | - U Rajendra Acharya
- School of Science and Technology, Singapore University of Social Sciences, Singapore; School of Business (Information Systems), Faculty of Business, Education, Law and Arts, University of Southern Queensland, Australia; School of Engineering, Ngee Ann Polytechnic, 535 Clementi Road, 599489, Singapore; Department of Bioinformatics and Medical Engineering, Asia University, Taiwan; Research Organization for Advanced Science and Technology (IROAST), Kumamoto University, Kumamoto, Japan.
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Lee S, Chu Y, Ryu J, Park YJ, Yang S, Koh SB. Artificial Intelligence for Detection of Cardiovascular-Related Diseases from Wearable Devices: A Systematic Review and Meta-Analysis. Yonsei Med J 2022; 63:S93-S107. [PMID: 35040610 PMCID: PMC8790582 DOI: 10.3349/ymj.2022.63.s93] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 10/27/2021] [Accepted: 10/31/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Several artificial intelligence (AI) models for the detection and prediction of cardiovascular-related diseases, including arrhythmias, diabetes, and sleep apnea, have been reported. This systematic review and meta-analysis aimed to identify AI models developed for or applicable to wearable and mobile devices for diverse cardiovascular-related diseases. MATERIALS AND METHODS The searched databases included Medline, Embase, and Cochrane Library. For AI models for atrial fibrillation (AF) detection, a meta-analysis of diagnostic accuracy was performed to summarize sensitivity and specificity. RESULTS A total of 102 studies were included in the qualitative review. There were AI models for the detection of arrythmia (n=62), followed by sleep apnea (n=11), peripheral vascular diseases (n=6), diabetes mellitus (n=5), hyper/hypotension (n=5), valvular heart disease (n=4), heart failure (n=3), myocardial infarction and cardiac arrest (n=2), and others (n=4). For quantitative analysis of 26 studies reporting AI models for AF detection, meta-analyzed sensitivity was 94.80% and specificity was 96.96%. Deep neural networks showed superior performance [meta-analyzed area under receiver operating characteristics curve (AUROC) of 0.981] compared to conventional machine learning algorithms (meta-analyzed AUROC of 0.961). However, AI models tested with proprietary dataset (meta-analyzed AUROC of 0.972) or data acquired from wearable devices (meta-analyzed AUROC of 0.977) showed inferior performance than those with public dataset (meta-analyzed AUROC of 0.986) or data from in-hospital devices (meta-analyzed AUROC of 0.983). CONCLUSION This review found that AI models for diverse cardiovascular-related diseases are being developed, and that they are gradually developing into a form that is suitable for wearable and mobile devices.
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Affiliation(s)
- Solam Lee
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Yuseong Chu
- Department of Biomedical Engineering, Yonsei University, Wonju, Korea
| | - Jiseung Ryu
- Department of Biomedical Engineering, Yonsei University, Wonju, Korea
| | - Young Jun Park
- Division of Cardiology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sejung Yang
- Department of Biomedical Engineering, Yonsei University, Wonju, Korea.
| | - Sang Baek Koh
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
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10
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Li W, Chen Z. Breathing rate estimation based on multiple linear regression. Comput Methods Biomech Biomed Engin 2021; 25:772-782. [PMID: 34514914 DOI: 10.1080/10255842.2021.1977801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The breathing rate is a key clinical parameter that can now be estimated using photoplethysmographic methods. Here, we present an indirect method of breathing rate estimation that does not require bulky and uncomfortable sensors. Breathing modulates a pulsed wave; we extracted the maximum and minimum values, and first-order derivatives thereof, to measure breathing amplitude, frequency, and baseline drift. Demodulation was used to obtain multiple breathing waveforms, from which peak values are extracted to obtain breathing rates. Multiple linear regression was used to combine the breathing rates of different feature points. We used a breathing dataset for 53 subjects, and divided the data into training and test sets when calculating the regression coefficients. We also assessed the generalizability of our linear model. We found that breathing rate estimation was more accurate when using a multivariate signal method with multiple versus a single feature point. The mean absolute error, mean error, and standard deviation of the error were 1.28, -0.07, and 1.60 breaths per minute, respectively.
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Affiliation(s)
- Wenbo Li
- Research Institute of Electronic Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Ziyang Chen
- Research Institute of Electronic Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
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11
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Mandal S, Roy AH, Mondal P. Automated detection of fibrillations and flutters based on fused feature set and ANFIS classifier. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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12
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Ucak S, Dissanayake HU, Sutherland K, de Chazal P, Cistulli PA. Heart rate variability and obstructive sleep apnea: Current perspectives and novel technologies. J Sleep Res 2021; 30:e13274. [PMID: 33462936 DOI: 10.1111/jsr.13274] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 12/20/2022]
Abstract
Obstructive sleep apnea (OSA) is a highly prevalent condition, resulting in recurrent hypoxic events, sleep arousal, and daytime sleepiness. Patients with OSA are at an increased risk of cardiovascular morbidity and mortality. The mechanisms underlying the development of cardiovascular disease in OSA are multifactorial and cause a cascade of events. The primary contributing factor is sympathetic overactivity. Heart rate variability (HRV) can be used to evaluate shifts in the autonomic nervous system, during sleep and in response to treatment in patients with OSA. Newer technologies are aimed at improving HRV analysis to accelerate processing time, improve the diagnosis of OSA, and detection of cardiovascular risk. The present review will present contemporary understandings and uses for HRV, specifically in the realms of physiology, technology, and clinical management.
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Affiliation(s)
- Seren Ucak
- Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Hasthi U Dissanayake
- Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Kate Sutherland
- Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.,Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Philip de Chazal
- Faculty of Engineering, School of Biomedical Engineering, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Peter A Cistulli
- Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.,Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, NSW, Australia
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Mejía-Mejía E, May JM, Torres R, Kyriacou PA. Pulse rate variability in cardiovascular health: a review on its applications and relationship with heart rate variability. Physiol Meas 2020; 41:07TR01. [DOI: 10.1088/1361-6579/ab998c] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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