Medical decision support system for diagnosis of neuromuscular disorders using DWT and fuzzy support vector machines

A clinical decision support system for diagnosis and severity quantification of lumbosacral radiculopathy using intramuscular electromyography signals

Interpreting intramuscular electromyography (iEMG) signals for diagnosing and quantifying the severity of lumbosacral radiculopathy is challenging due to the subjective evaluation of signals. To address this limitation, a clinical decision support system (CDSS) was developed for the diagnosis and quantification of the severity of lumbosacral radiculopathy based on intramuscular electromyography (iEMG) signals. The CDSS uses the EMG interference pattern method (QEMG IP) to directly extract features from the iEMG signal and provide a quantitative expression of injury severity for each muscle and overall radiculopathy severity. From 126 time and frequency domain features, a set of five features, including the crest factor, mean absolute value, peak frequency, zero crossing count, and intensity, were selected. These features were derived from raw iEMG signals, empirical mode decomposition, and discrete wavelet transform, and the wrapper method was utilized to determine the most significant features. The CDSS was trained and tested on a dataset of 75 patients, achieving an accuracy of 93.3%, sensitivity of 93.3%, and specificity of 96.6%. The system shows promise in assisting physicians in diagnosing lumbosacral radiculopathy with high accuracy and consistency using iEMG data. The CDSS's objective and standardized diagnostic process, along with its potential to reduce the time and effort required by physicians to interpret EMG signals, makes it a potentially valuable tool for clinicians in the diagnosis and management of lumbosacral radiculopathy. Future work should focus on validating the system's performance in diverse clinical settings and patient populations.

Artificial intelligence for automatic classification of needle EMG signals: A scoping review

OBJECTIVE

This scoping review provides an overview of artificial intelligence (AI), including machine and deep learning techniques, in the interpretation of clinical needle electromyography (nEMG) signals.

METHODS

A comprehensive search of Medline, Embase and Web of Science was conducted to find peer-reviewed journal articles. All papers published after 2010 were included. The methodological quality of the included studies was assessed with CLAIM (checklist for artificial intelligence in medical imaging).

RESULTS

51 studies were identified that fulfilled the inclusion criteria. 61% used open-source EMGlab data set to develop models to classify nEMG signal in healthy, amyotrophic lateral sclerosis (ALS) and myopathy (25 subjects). Only two articles developed models to classify signals recorded at rest. Most articles reported high performance accuracies, but many were subject to bias and overtraining.

CONCLUSIONS

Current AI-models of nEMG signals are not sufficient for clinical implementation. Suggestions for future research include emphasizing the need for an optimal training and validation approach using large datasets of clinical nEMG data from a diverse patient population.

SIGNIFICANCE

The outcomes of this study and the suggestions made aim to contribute to developing AI-models that can effectively handle signal quality variability and are suitable for daily clinical practice in interpreting nEMG signals.

The role of artificial intelligence in electrodiagnostic and neuromuscular medicine: Current state and future directions

The rapid advancements in artificial intelligence (AI), including machine learning (ML), and deep learning (DL) have ushered in a new era of technological breakthroughs in healthcare. These technologies are revolutionizing the way we utilize medical data, enabling improved disease classification, more precise diagnoses, better treatment selection, therapeutic monitoring, and highly accurate prognostication. Different ML and DL models have been used to distinguish between electromyography signals in normal individuals and those with amyotrophic lateral sclerosis and myopathy, with accuracy ranging from 67% to 99.5%. DL models have also been successfully applied in neuromuscular ultrasound, with the use of segmentation techniques achieving diagnostic accuracy of at least 90% for nerve entrapment disorders, and 87% for inflammatory myopathies. Other successful AI applications include prediction of treatment response, and prognostication including prediction of intensive care unit admissions for patients with myasthenia gravis. Despite these remarkable strides, significant knowledge, attitude, and practice gaps persist, including within the field of electrodiagnostic and neuromuscular medicine. In this narrative review, we highlight the fundamental principles of AI and draw parallels with the intricacies of human brain networks. Specifically, we explore the immense potential that AI holds for applications in electrodiagnostic studies, neuromuscular ultrasound, and other aspects of neuromuscular medicine. While there are exciting possibilities for the future, it is essential to acknowledge and understand the limitations of AI and take proactive steps to mitigate these challenges. This collective endeavor holds immense potential for the advancement of healthcare through the strategic and responsible integration of AI technologies.

Diagnostic efficacy of metagenomic next generation sequencing in bronchoalveolar lavage fluid for proven invasive pulmonary aspergillosis

Objective

To assess the diagnostic efficacy of metagenomic next generation sequencing (mNGS) for proven invasive pulmonary aspergillosis (IPA).

Methods

A total of 190 patients including 53 patients who had been diagnosed with proven IPA were retrospectively analyzed. Using the pathological results of tissue biopsy specimens as gold standard, we ploted the receiver operating characteristic (ROC) curve to determine the optimal cut-off value of mNGS species-specific read number (SSRN) of Aspergillus in bronchoalveolar lavage fluid (BALF)for IPA. Furthermore, we evaluated optimal cut-off value of mNGS SSRN in different populations.

Results

The optimal cut-off value of Aspergillus mNGS SSRN in BALF for IPA diagnosis was 2.5 for the whole suspected IPA population, and 1 and 4.5 for immunocompromised and diabetic patients, respectively. The accuracy of mNGS was 80.5%, 73.7% and 85.3% for the whole population, immunocompromised and diabetic patients, respectively.

Conclusions

The mNGS in BALF has a high diagnostic efficacy for proven IPA, superioring to Aspergillus culture in sputum and BALF and GM test in blood and BALF. However, the cut-off value of SSRN should be adjusted when in different population.

Distinguishing normal, neuropathic and myopathic EMG with an automated machine learning approach

OBJECTIVE

Distinguishing normal, neuropathic and myopathic electromyography (EMG) traces can be challenging. We aimed to create an automated time series classification algorithm.

METHODS

EMGs of healthy controls (HC, n = 25), patients with amyotrophic lateral sclerosis (ALS, n = 20) and inclusion body myositis (IBM, n = 20), were retrospectively selected based on longitudinal clinical follow-up data (ALS and HC) or muscle biopsy (IBM). A machine learning pipeline was applied based on 5-second EMG fragments of each muscle. Diagnostic yield expressed as area under the curve (AUC) of a receiver-operator characteristics curve, accuracy, sensitivity, and specificity were determined per muscle (muscle-level) and per patient (patient-level).

RESULTS

Diagnostic yield of the classification ALS vs. HC was: AUC 0.834 ± 0.014 at muscle-level and 0.856 ± 0.009 at patient-level. For the classification HC vs. IBM, AUC was 0.744 ± 0.043 at muscle-level and 0.735 ± 0.029 at patient-level. For the classification ALS vs. IBM, AUC was 0.569 ± 0.024 at muscle-level and 0.689 ± 0.035 at patient-level.

CONCLUSIONS

An automated time series classification algorithm can distinguish EMGs from healthy individuals from those of patients with ALS with a high diagnostic yield. Using longer EMG fragments with different levels of muscle activation may improve performance.

SIGNIFICANCE

In the future, machine learning algorithms may help improve the diagnostic accuracy of EMG examinations.

Identifying neuropathies through time series analysis of postural tests

BACKGROUND

In physical therapy, postural tests are frequently used to diagnose neuropathies, particularly in diabetic individuals. This study aims to develop a method based on the analysis of time series that allows discriminating between healthy and diabetic subjects with or without a neuropathic condition.

RESEARCH QUESTION

Do features obtained from time series corresponding to postural tests allow us to reliably discriminate between healthy, diabetic and neuropathic patients?

METHODS

In this study, 32 people participated in the healthy, diabetic, and neuropathic categories (11, 9, and 12, respectively). The data was collected by positioning each participant on a Wii Balanced Board platform, under 8 different conditions. The analyzed time series are sensed by devices that capture variations in the subject's center of pressure when subjected to a test on different conditions over a short period of time. The method proposed considers statistical techniques used for characterizing the time series combined with machine learning techniques to classify the individual's profile into one of the three categories mentioned. The classification is supported by an underlying probabilistic model, based on the characteristics of the time series, generating average curves for each class, which are then used by the classification methods.

RESULTS

The empirical results include classification models for each class, obtaining a performance (F-score) over 98%. In addition, other models considering the particular conditions to which the subject is exposed during the test are developed, revealing that the conditions of eyes open and eyes closed show the highest levels of discrimination to classify participants into one of the three class categories.

SIGNIFICANCE

These results suggest a test protocol simplification and, at the same time, that the proposed method based on the analysis of the time series associated with the test used is highly predictive and may reliably complement or substitute a questionnaire-based diagnosis.

A Machine-Learning Method of Predicting Vital Capacity Plateau Value for Ventilatory Pump Failure Based on Data Mining

Ventilatory pump failure is a common cause of death for patients with neuromuscular diseases. The vital capacity plateau value (VCPLAT) is an important indicator to judge the status of ventilatory pump failure for patients with congenital myopathy, Duchenne muscular dystrophy and spinal muscular atrophy. Due to the complex relationship between VCPLAT and the patient's own condition, it is difficult to predict the VCPLAT for pediatric disease from a medical perspective. We established a VCPLAT prediction model based on data mining and machine learning. We first performed the correlation analysis and recursive feature elimination with cross-validation (RFECV) to provide high-quality feature combinations. Based on this, the Light Gradient Boosting Machine (LightGBM) algorithm was to establish a prediction model with powerful performance. Finally, we verified the validity and superiority of the proposed method via comparison with other prediction models in similar works. After 10-fold cross-validation, the proposed prediction method had the best performance and its explained variance score (EVS), mean absolute error (MAE), mean squared error (MSE), root mean square error (RMSE), median absolute error (MedAE) and R2 were 0.949, 0.028, 0.002, 0.045, 0.015 and 0.948, respectively. It also performed well on test datasets. Therefore, it can accurately and effectively predict the VCPLAT, thereby determining the severity of the condition to provide auxiliary decision-making for doctors in clinical diagnosis and treatment.

Fuzzy support vector machine-based personalizing method to address the inter-subject variance problem of physiological signals in a driver monitoring system

Physiological signals can be utilized to monitor conditions of a driver, but the inter-subject variance of physiological signals can degrade the classification accuracy of the monitoring system. Personalization of the system using the data of a tested subject, called local data, can be a solution, but the acquisition of sufficient local data may not be possible in real situations. Therefore, this paper proposes an effective personalizing method using small-sized local data. The proposed method utilizes a fuzzy support vector machine to allocate higher weight to the local data than to others, and a fuzzy membership is assigned to the training data by analyzing the importance of each datum. Three classification problems for a physiological signal-based driver monitoring system are introduced and utilized to validate the proposed method. The classification accuracy is compared with that of other personalizing methods, and the results show that the proposed method achieves a better accuracy on average, which is 3.46% higher than that of the simple approach using a basic support vector machine, thereby proving its effectiveness. The proposed method can train a personalized classifier with improved accuracy for a tested subject. The advantages of the proposed method can be utilized to develop a practical driver monitoring system.

Transparent Electrophysiological Muscle Classification From EMG Signals Using Fuzzy-Based Multiple Instance Learning

Although a well-established body of literature has examined electrophysiological muscle classification methods and systems, ways to enhance their transparency is still an important challenge and requires further study. In this work, a transparent semi-supervised electrophysiological muscle classification system which uses needle-detected EMG signals to classify muscles as normal, myopathic, or neurogenic is proposed. The electrophysiological muscle classification (EMC) problem is naturally formulated using multiple instance learning (MIL) and needs an adaptation of standard supervised classifiers for the purpose of training and evaluating bags of instances. Here, a novel MIL-based EMC system in which the muscle classifier uses predictions based on motor unit potentials (MUPs) to infer muscle labels is described. This system uses morphological, stability, near fiber and spectral MUP features. Quantitative results obtained from applying the proposed transparent system to four electrophysiologically different groups of muscles, composed of proximal and distal hand and leg muscles, resulted in an average classification accuracy of 95.85%. The findings show the superior and stable performance of the proposed EMC system compared to previous works using other supervised, semi-supervised and unsupervised methods.

Comparison of Bagging and Boosting Ensemble Machine Learning Methods for Automated EMG Signal Classification

The neuromuscular disorders are diagnosed using electromyographic (EMG) signals. Machine learning algorithms are employed as a decision support system to diagnose neuromuscular disorders. This paper compares bagging and boosting ensemble learning methods to classify EMG signals automatically. Even though ensemble classifiers' efficacy in relation to real-life issues has been presented in numerous studies, there are almost no studies which focus on the feasibility of bagging and boosting ensemble classifiers to diagnose the neuromuscular disorders. Therefore, the purpose of this paper is to assess the feasibility of bagging and boosting ensemble classifiers to diagnose neuromuscular disorders through the use of EMG signals. It should be understood that there are three steps to this method, where the step number one is to calculate the wavelet packed coefficients (WPC) for every type of EMG signal. After this, it is necessary to calculate statistical values of WPC so that the distribution of wavelet coefficients could be demonstrated. In the last step, an ensemble classifier used the extracted features as an input of the classifier to diagnose the neuromuscular disorders. Experimental results showed the ensemble classifiers achieved better performance for diagnosis of neuromuscular disorders. Results are promising and showed that the AdaBoost with random forest ensemble method achieved an accuracy of 99.08%, F-measure 0.99, AUC 1, and kappa statistic 0.99.

Assessment of In-Meal Eating Behaviour using Fuzzy SVM

Certain patterns of eating behaviour during meal have been identified as risk factors for long-term abnormal eating development in healthy individuals and, eventually, can affect the body weight. To detect early signs of problematic eating behaviour, this paper proposes a novel method for building behaviour assessment models. The goal of the models is to predict whether the in-meal eating behaviour resembles patterns associated with obesity, eating disorders, or low-risk behaviours. The models are trained using meals recorded with a plate scale from a reference population and labels annotated by a domain expert. In addition, the domain expert assigned scores that characterise the degree of any exhibited abnormal patterns. To improve model effectiveness, we use the domain expert's scores to create training error regularisation weights that alter the importance of each training instance for its class during model training. The behaviour assessment models are based on the SVM algorithm and the fuzzy SVM algorithm for their instance-weighted variation. Experiments conducted on meals recorded from 120 individuals show that: (a) the proposed approach can produce effective models for eating behaviour classification (for individuals), or for ranking (for populations); and (b) the instance-weighted fuzzy SVM models achieve significant performance improvements, compared to the non-weighted, standard SVM models.

Fuzzy decision support systems to diagnose musculoskeletal disorders: A systematic literature review

BACKGROUND AND OBJECTIVE

Musculoskeletal disorders (MSDs) are one of the most important causes of disability with a high prevalence. The accurate and timely diagnosis of these disorders is often difficult. Clinical decision support systems (CDSSs) can help physicians to diagnose diseases quickly and accurately. Given the ambiguous nature of MSDs, fuzzy logic can be helpful in designing the CDSSs knowledge bases. The present study aimed to review the studies on fuzzy CDSSs to diagnose MSDs.

METHODS

A comprehensive search was conducted in Medline, Scopus, Cochrane Library, and ISI Web of Science databases to identify relevant studies published until March 15, 2016. Studies were included in which CDSSs were developed using fuzzy logic to diagnose MSDs, and tested their accuracy using real data from patients.

RESULTS

Of the 3188 papers examined, 23 papers included according to the inclusion criteria. The results showed that among all the designed CDSSs only one (CADIAG-2) was implemented in the clinical environment. In about half of the included studies (52%), CDSSs were designed to diagnose inflammatory/infectious disorder of the bone and joint. In most of the included studies (70%), the knowledge was extracted using a combination of three methods (acquiring from experts, analyzing the data, and reviewing the literature). The median accuracy of fuzzy rule-based CDSSs was 91% and it was 90% for other fuzzy models. The most frequently used membership functions were triangular and trapezoidal functions, and the most used method for inference was the Mamdani.

CONCLUSIONS

In general, fuzzy CDSSs have a high accuracy to diagnose MSDs. Despite the high accuracy, these systems have been used to a limited extent in the clinical environments. To design of knowledge base for CDSSs to diagnose MSDs, rule-based methods are used more than other fuzzy methods.

Electrophysiological Muscle Classification Using Multiple Instance Learning and Unsupervised Time and Spectral Domain Analysis

OBJECTIVE

Electrophysiological muscle classification (EMC) is a crucial step in the diagnosis of neuromuscular disorders. Existing quantitative techniques are not sufficiently robust and accurate to be reliably clinically used. Here, EMC is modeled as a multiple instance learning (MIL) problem and a system to infer unsupervised motor unit potential (MUP) labels and create supervised muscle classifications is presented.

METHODS

The system has five main steps: MUP representation using morphological, stability, and near fiber parameters as well as spectral features extracted from wavelet coefficients; MUP feature selection using unsupervised Laplacian scores; MUP clustering using neighborhood distance entropy consistency to find representations of MUP normality and abnormality; muscle representation by embedding its MUP cluster associations in a feature vector; and muscle classification using support vector machines or random forests.

RESULTS

The evaluation data consist of 63, 83, 93, and 84 sets of MUPs recorded in deltoid, vastus medialis, first dorsal interosseous, and tibialis anterior muscles, respectively. The proposed system discovered representations of normal, myopathic, and neurogenic MUPs for each specific muscle type and resulted in an average classification accuracy of 98%, which is higher than in previous works.

CONCLUSION

Modeling EMC as an instance of the MIL solves the traditional problem of characterizing MUPs without full supervision. Furthermore, finding representations of MUP normality and abnormality using morphological, stability, near fiber, and spectral features improve muscle classification.

SIGNIFICANCE

The proposed method is able to characterize MUPs with respect to disease categories, with no a priori information.

Classification of amyotrophic lateral sclerosis disease based on convolutional neural network and reinforcement sample learning algorithm

Electromyogram (EMG) signals contain useful information of the neuromuscular diseases like amyotrophic lateral sclerosis (ALS). ALS is a well-known brain disease, which can progressively degenerate the motor neurons. In this paper, we propose a deep learning based method for efficient classification of ALS and normal EMG signals. Spectrogram, continuous wavelet transform (CWT), and smoothed pseudo Wigner-Ville distribution (SPWVD) have been employed for time-frequency (T-F) representation of EMG signals. A convolutional neural network is employed to classify these features. In it, Two convolution layers, two pooling layer, a fully connected layer and a lost function layer is considered in CNN architecture. The CNN architecture is trained with the reinforcement sample learning strategy. The efficiency of the proposed implementation is tested on publicly available EMG dataset. The dataset contains 89 ALS and 133 normal EMG signals with 24 kHz sampling frequency. Experimental results show 96.80% accuracy. The obtained results are also compared with other methods, which show the superiority of the proposed method.

A Density-Based Clustering Approach to Motor Unit Potential Characterizations to Support Diagnosis of Neuromuscular Disorders

Electrophysiological muscle classification involves characterization of extracted motor unit potentials (MUPs) followed by the aggregation of these MUP characterizations. Existing techniques consider three classes (i.e., myopathic, neurogenic, and normal) for both MUP characterization and electrophysiological muscle classification. However, diseased-induced MUP changes are continuous in nature, which make it difficult to find distinct boundaries between normal, myopathic, and neurogenic MUPs. Hence, MUP characterization based on more than three classes is better able to represent the various effects of disease. Here, a novel, electrophysio- logical muscle classification system is proposed, which considers a dynamic number of classes for characterizing MUPs. To this end, a clustering algorithm called neighbor- hood distances entropy consistency is proposed to find clusters with arbitrary shapes and densities in an MUP feature space. These clusters represent several concepts of MUP normality and abnormality and are used for MUP characterization instead of the conventional three classes. An examined muscle is then classified by embedding its MUP characterizations in a feature vector fed to an ensemble of support vector machine and nearest neighbor classifiers. For 103 sets of MUPs recorded in tibialis anterior muscles, the proposed system had a 97% electro-physiological muscle classification accuracy, which is significantly higher than in previous works.

Classification and identification of Rhodobryum roseum Limpr. and its adulterants based on fourier-transform infrared spectroscopy (FTIR) and chemometrics

Fourier-transform infrared spectroscopy (FTIR) with the attenuated total reflectance technique was used to identify Rhodobryum roseum from its four adulterants. The FTIR spectra of six samples in the range from 4000 cm-1 to 600 cm-1 were obtained. The second-derivative transformation test was used to identify the small and nearby absorption peaks. A cluster analysis was performed to classify the spectra in a dendrogram based on the spectral similarity. Principal component analysis (PCA) was used to classify the species of six moss samples. A cluster analysis with PCA was used to identify different genera. However, some species of the same genus exhibited highly similar chemical components and FTIR spectra. Fourier self-deconvolution and discrete wavelet transform (DWT) were used to enhance the differences among the species with similar chemical components and FTIR spectra. Three scales were selected as the feature-extracting space in the DWT domain. The results show that FTIR spectroscopy with chemometrics is suitable for identifying Rhodobryum roseum and its adulterants.

An EMG-based feature extraction method using a normalized weight vertical visibility algorithm for myopathy and neuropathy detection

Background

Electromyography (EMG) signals recorded from healthy, myopathic, and amyotrophic lateral sclerosis (ALS) subjects are nonlinear, non-stationary, and similar in the time domain and the frequency domain. Therefore, it is difficult to classify these various statuses.

Methods

This study proposes an EMG-based feature extraction method based on a normalized weight vertical visibility algorithm (NWVVA) for myopathy and ALS detection. In this method, sampling points or nodes based on sampling theory are extracted, and features are derived based on relations among the vertical visibility nodes with their amplitude differences as weights. The features are calculated via selective statistical mechanics and measurements, and the obtained features are assembled into a feature matrix as classifier input. Finally, powerful classifiers, such as k-nearest neighbor, multilayer perceptron neural network, and support vector machine classifiers, are utilized to differentiate signals of healthy, myopathy, and ALS cases.

Results

Performance evaluation experiments are carried out, and the results revealed 98.36% accuracy, which corresponds to approximately a 2% improvement compared with conventional methods.

Conclusions

An EMG-based feature extraction method using a NWVVA is proposed and implemented to detect healthy, ALS, and myopathy statuses.

Medical Decision Support System for Diagnosis of Heart Arrhythmia using DWT and Random Forests Classifier

In this study, Random Forests (RF) classifier is proposed for ECG heartbeat signal classification in diagnosis of heart arrhythmia. Discrete wavelet transform (DWT) is used to decompose ECG signals into different successive frequency bands. A set of different statistical features were extracted from the obtained frequency bands to denote the distribution of wavelet coefficients. This study shows that RF classifier achieves superior performances compared to other decision tree methods using 10-fold cross-validation for the ECG datasets and the obtained results suggest that further significant improvements in terms of classification accuracy can be accomplished by the proposed classification system. Accurate ECG signal classification is the major requirement for detection of all arrhythmia types. Performances of the proposed system have been evaluated on two different databases, namely MIT-BIH database and St. -Petersburg Institute of Cardiological Technics 12-lead Arrhythmia Database. For MIT-BIH database, RF classifier yielded an overall accuracy 99.33 % against 98.44 and 98.67 % for the C4.5 and CART classifiers, respectively. For St. -Petersburg Institute of Cardiological Technics 12-lead Arrhythmia Database, RF classifier yielded an overall accuracy 99.95 % against 99.80 % for both C4.5 and CART classifiers, respectively. The combined model with multiscale principal component analysis (MSPCA) de-noising, discrete wavelet transform (DWT) and RF classifier also achieves better performance with the area under the receiver operating characteristic (ROC) curve (AUC) and F-measure equal to 0.999 and 0.993 for MIT-BIH database and 1 and 0.999 for and St. -Petersburg Institute of Cardiological Technics 12-lead Arrhythmia Database, respectively. Obtained results demonstrate that the proposed system has capacity for reliable classification of ECG signals, and to assist the clinicians for making an accurate diagnosis of cardiovascular disorders (CVDs).

A clinical decision support system for diagnosis of Allergic Rhinitis based on intradermal skin tests

BACKGROUNDS AND OBJECTIVES

Allergic Rhinitis is a universal common disease, especially in populated cities and urban areas. Diagnosis and treatment of Allergic Rhinitis will improve the quality of life of allergic patients. Though skin tests remain the gold standard test for diagnosis of allergic disorders, clinical experts are required for accurate interpretation of test outcomes. This work presents a clinical decision support system (CDSS) to assist junior clinicians in the diagnosis of Allergic Rhinitis.

METHODS

Intradermal Skin tests were performed on patients who had plausible allergic symptoms. Based on patient׳s history, 40 clinically relevant allergens were tested. 872 patients who had allergic symptoms were considered for this study. The rule based classification approach and the clinical test results were used to develop and validate the CDSS. Clinical relevance of the CDSS was compared with the Score for Allergic Rhinitis (SFAR). Tests were conducted for junior clinicians to assess their diagnostic capability in the absence of an expert.

RESULTS

The class based Association rule generation approach provides a concise set of rules that is further validated by clinical experts. The interpretations of the experts are considered as the gold standard. The CDSS diagnoses the presence or absence of rhinitis with an accuracy of 88.31%. The allergy specialist and the junior clinicians prefer the rule based approach for its comprehendible knowledge model.

CONCLUSION

The Clinical Decision Support Systems with rule based classification approach assists junior doctors and clinicians in the diagnosis of Allergic Rhinitis to make reliable decisions based on the reports of intradermal skin tests.

Single-Channel EMG Classification With Ensemble-Empirical-Mode-Decomposition-Based ICA for Diagnosing Neuromuscular Disorders

An accurate and computationally efficient quantitative analysis of electromyography (EMG) signals plays an inevitable role in the diagnosis of neuromuscular disorders, prosthesis, and several related applications. Since it is often the case that the measured signals are the mixtures of electric potentials that emanate from surrounding muscles (sources), many EMG signal processing approaches rely on linear source separation techniques such as the independent component analysis (ICA). Nevertheless, naive implementations of ICA algorithms do not comply with the task of extracting the underlying sources from a single-channel EMG measurement. In this respect, the present work focuses on a classification method for neuromuscular disorders that deals with the data recorded using a single-channel EMG sensor. The ensemble empirical mode decomposition algorithm decomposes the single-channel EMG signal into a set of noise-canceled intrinsic mode functions, which in turn are separated by the FastICA algorithm. A reduced set of five time domain features extracted from the separated components are classified using the linear discriminant analysis, and the classification results are fine-tuned with a majority voting scheme. The performance of the proposed method has been validated with a clinical EMG database, which reports a higher classification accuracy (98%). The outcome of this study encourages possible extension of this approach to real settings to assist the clinicians in making correct diagnosis of neuromuscular disorders.

Distributed object detection with linear SVMs

In vision and learning, low computational complexity and high generalization are two important goals for video object detection. Low computational complexity here means not only fast speed but also less energy consumption. The sliding window object detection method with linear support vector machines (SVMs) is a general object detection framework. The computational cost is herein mainly paid in complex feature extraction and innerproduct-based classification. This paper first develops a distributed object detection framework (DOD) by making the best use of spatial-temporal correlation, where the process of feature extraction and classification is distributed in the current frame and several previous frames. In each framework, only subfeature vectors are extracted and the response of partial linear classifier (i.e., subdecision value) is computed. To reduce the dimension of traditional block-based histograms of oriented gradients (BHOG) feature vector, this paper proposes a cell-based HOG (CHOG) algorithm, where the features in one cell are not shared with overlapping blocks. Using CHOG as feature descriptor, we develop CHOG-DOD as an instance of DOD framework. Experimental results on detection of hand, face, and pedestrian in video show the superiority of the proposed method.

Wavelet domain feature extraction scheme based on dominant motor unit action potential of EMG signal for neuromuscular disease classification

In this paper, two schemes for neuromuscular disease classification from electromyography (EMG) signals are proposed based on discrete wavelet transform (DWT) features. In the first scheme, a few high energy DWT coefficients along with the maximum value are extracted in a frame by frame manner from the given EMG data. Instead of considering only such local information obtained from a single frame, we propose to utilize global statistics which is obtained based on information collected from some consecutive frames. In the second scheme, motor unit action potentials (MUAPs) are first extracted from the EMG data via template matching based decomposition technique. It is well known that not all MUAPs obtained via decomposition are capable of uniquely representing a class. Thus, a novel idea of selecting a dominant MUAP, based on energy criterion, is proposed and instead of all MUAPs, only the dominant MUAP is used for the classification. A feature extraction scheme based on some statistical properties of the DWT coefficients of dominant MUAPs is proposed. For the purpose of classification, the K-nearest neighborhood (KNN) classifier is employed. Extensive analysis is performed on clinical EMG database for the classification of neuromuscular diseases and it is found that the proposed methods provide a very satisfactory performance in terms of specificity, sensitivity, and overall classification accuracy.

Hybrid soft computing systems for electromyographic signals analysis: a review

Electromyographic (EMG) is a bio-signal collected on human skeletal muscle. Analysis of EMG signals has been widely used to detect human movement intent, control various human-machine interfaces, diagnose neuromuscular diseases, and model neuromusculoskeletal system. With the advances of artificial intelligence and soft computing, many sophisticated techniques have been proposed for such purpose. Hybrid soft computing system (HSCS), the integration of these different techniques, aims to further improve the effectiveness, efficiency, and accuracy of EMG analysis. This paper reviews and compares key combinations of neural network, support vector machine, fuzzy logic, evolutionary computing, and swarm intelligence for EMG analysis. Our suggestions on the possible future development of HSCS in EMG analysis are also given in terms of basic soft computing techniques, further combination of these techniques, and their other applications in EMG analysis.