A case-based reasoning framework for early detection and diagnosis of novel coronavirus

Towards Improved XAI-Based Epidemiological Research into the Next Potential Pandemic

By applying AI techniques to a variety of pandemic-relevant data, artificial intelligence (AI) has substantially supported the control of the spread of the SARS-CoV-2 virus. Along with this, epidemiological machine learning studies of SARS-CoV-2 have been frequently published. While these models can be perceived as precise and policy-relevant to guide governments towards optimal containment policies, their black box nature can hamper building trust and relying confidently on the prescriptions proposed. This paper focuses on interpretable AI-based epidemiological models in the context of the recent SARS-CoV-2 pandemic. We systematically review existing studies, which jointly incorporate AI, SARS-CoV-2 epidemiology, and explainable AI approaches (XAI). First, we propose a conceptual framework by synthesizing the main methodological features of the existing AI pipelines of SARS-CoV-2. Upon the proposed conceptual framework and by analyzing the selected epidemiological studies, we reflect on current research gaps in epidemiological AI toolboxes and how to fill these gaps to generate enhanced policy support in the next potential pandemic.

Multimodal deep learning for COVID-19 prognosis prediction in the emergency department: a bi-centric study

Predicting clinical deterioration in COVID-19 patients remains a challenging task in the Emergency Department (ED). To address this aim, we developed an artificial neural network using textual (e.g. patient history) and tabular (e.g. laboratory values) data from ED electronic medical reports. The predicted outcomes were 30-day mortality and ICU admission. We included consecutive patients from Humanitas Research Hospital and San Raffaele Hospital in the Milan area between February 20 and May 5, 2020. We included 1296 COVID-19 patients. Textual predictors consisted of patient history, physical exam, and radiological reports. Tabular predictors included age, creatinine, C-reactive protein, hemoglobin, and platelet count. TensorFlow tabular-textual model performance indices were compared to those of models implementing only tabular data. For 30-day mortality, the combined model yielded slightly better performances than the tabular fastai and XGBoost models, with AUC 0.87 ± 0.02, F1 score 0.62 ± 0.10 and an MCC 0.52 ± 0.04 (p < 0.32). As for ICU admission, the combined model MCC was superior (p < 0.024) to the tabular models. Our results suggest that a combined textual and tabular model can effectively predict COVID-19 prognosis which may assist ED physicians in their decision-making process.

Deep learning techniques for detection and prediction of pandemic diseases: a systematic literature review

Deep learning (DL) is becoming a fast-growing field in the medical domain and it helps in the timely detection of any infectious disease (IDs) and is essential to the management of diseases and the prediction of future occurrences. Many scientists and scholars have implemented DL techniques for the detection and prediction of pandemics, IDs and other healthcare-related purposes, these outcomes are with various limitations and research gaps. For the purpose of achieving an accurate, efficient and less complicated DL-based system for the detection and prediction of pandemics, therefore, this study carried out a systematic literature review (SLR) on the detection and prediction of pandemics using DL techniques. The survey is anchored by four objectives and a state-of-the-art review of forty-five papers out of seven hundred and ninety papers retrieved from different scholarly databases was carried out in this study to analyze and evaluate the trend of DL techniques application areas in the detection and prediction of pandemics. This study used various tables and graphs to analyze the extracted related articles from various online scholarly repositories and the analysis showed that DL techniques have a good tool in pandemic detection and prediction. Scopus and Web of Science repositories are given attention in this current because they contain suitable scientific findings in the subject area. Finally, the state-of-the-art review presents forty-four (44) studies of various DL technique performances. The challenges identified from the literature include the low performance of the model due to computational complexities, improper labeling and the absence of a high-quality dataset among others. This survey suggests possible solutions such as the development of improved DL-based techniques or the reduction of the output layer of DL-based architecture for the detection and prediction of pandemic-prone diseases as future considerations.

Neural network models for situation similarity assessment in hybrid-CBR

The case-based reasoning method has a high potential for solving tasks of intelligence decision-support. To implement it, it is necessary to solve the problem of comparing situations and selecting the one that is most similar to the current situation in the knowledge base. The problem arises in the case of heterogeneous objects and situations with many different types of parameters and their possible uncertainty. In this paper, an approach based on machine (deep) learning is investigated for this task. It is proposed to carry out the process of selecting situations and solutions from the knowledge base in two stages: recognition of the states of the elements of a complex object and the relationships between them, then the formation of a representation of the situation in the state space and its use for comparing situations using neural networks. An ensemble neural network model based on a multi-layer network is proposed. It successfully simulates the cognitive functions of a human (expert), correctly selects similar situations and ranks them according to the similarity parameter. Proposed neural network models provide the implementation of a hybrid-CBR approach for decision-making on complex objects.

Using Decision Trees as an Expert System for Clinical Decision Support for COVID-19

COVID-19 has impacted billions of people and health care systems globally. However, there is currently no publicly available chatbot for patients and care providers to determine the potential severity of a COVID-19 infection or the possible biological system responses and comorbidities that can contribute to the development of severe cases of COVID-19. This preliminary investigation assesses this lack of a COVID-19 case-by-case chatbot into consideration when building a decision tree with binary classification that was stratified by age and body system, viral infection, comorbidities, and any manifestations. After reviewing the relevant literature, a decision tree was constructed using a suite of tools to build a stratified framework for a chatbot application and interaction with users. A total of 212 nodes were established that were stratified from lung to heart conditions along body systems, medical conditions, comorbidities, and relevant manifestations described in the literature. This resulted in a possible 63,360 scenarios, offering a method toward understanding the data needed to validate the decision tree and highlighting the complicated nature of severe cases of COVID-19. The decision tree confirms that stratification of the viral infection with the body system while incorporating comorbidities and manifestations strengthens the framework. Despite limitations of a viable clinical decision tree for COVID-19 cases, this prototype application provides insight into the type of data required for effective decision support.

Fusing clinical and image data for detecting the severity level of hospitalized symptomatic COVID-19 patients using hierarchical model

Purpose

Based on medical reports, it is hard to find levels of different hospitalized symptomatic COVID-19 patients according to their features in a short time. Besides, there are common and special features for COVID-19 patients at different levels based on physicians’ knowledge that make diagnosis difficult. For this purpose, a hierarchical model is proposed in this paper based on experts’ knowledge, fuzzy C-mean (FCM) clustering, and adaptive neuro-fuzzy inference system (ANFIS) classifier.

Methods

Experts considered a special set of features for different groups of COVID-19 patients to find their treatment plans. Accordingly, the structure of the proposed hierarchical model is designed based on experts’ knowledge. In the proposed model, we applied clustering methods to patients’ data to determine some clusters. Then, we learn classifiers for each cluster in a hierarchical model. Regarding different common and special features of patients, FCM is considered for the clustering method. Besides, ANFIS had better performances than other classification methods. Therefore, FCM and ANFIS were considered to design the proposed hierarchical model. FCM finds the membership degree of each patient’s data based on common and special features of different clusters to reinforce the ANFIS classifier. Next, ANFIS identifies the need of hospitalized symptomatic COVID-19 patients to ICU and to find whether or not they are in the end-stage (mortality target class). Two real datasets about COVID-19 patients are analyzed in this paper using the proposed model. One of these datasets had only clinical features and another dataset had both clinical and image features. Therefore, some appropriate features are extracted using some image processing and deep learning methods.

Results

According to the results and statistical test, the proposed model has the best performance among other utilized classifiers. Its accuracies based on clinical features of the first and second datasets are 92% and 90% to find the ICU target class. Extracted features of image data increase the accuracy by 94%.

Conclusion

The accuracy of this model is even better for detecting the mortality target class among different classifiers in this paper and the literature review. Besides, this model is compatible with utilized datasets about COVID-19 patients based on clinical data and both clinical and image data, as well.

Highlights

• A new hierarchical model is proposed using ANFIS classifiers and FCM clustering method in this paper. Its structure is designed based on experts’ knowledge and real medical process. FCM reinforces the ANFIS classification learning phase based on the features of COVID-19 patients.

• Two real datasets about COVID-19 patients are studied in this paper. One of these datasets has both clinical and image data. Therefore, appropriate features are extracted based on its image data and considered with available meaningful clinical data. Different levels of hospitalized symptomatic COVID-19 patients are considered in this paper including the need of patients to ICU and whether or not they are in end-stage.

• Well-known classification methods including case-based reasoning (CBR), decision tree, convolutional neural networks (CNN), K-nearest neighbors (KNN), learning vector quantization (LVQ), multi-layer perceptron (MLP), Naive Bayes (NB), radial basis function network (RBF), support vector machine (SVM), recurrent neural networks (RNN), fuzzy type-I inference system (FIS), and adaptive neuro-fuzzy inference system (ANFIS) are designed for these datasets and their results are analyzed for different random groups of the train and test data;

• According to unbalanced utilized datasets, different performances of classifiers including accuracy, sensitivity, specificity, precision, F-score, and G-mean are compared to find the best classifier. ANFIS classifiers have the best results for both datasets.

• To reduce the computational time, the effects of the Principal Component Analysis (PCA) feature reduction method are studied on the performances of the proposed model and classifiers. According to the results and statistical test, the proposed hierarchical model has the best performances among other utilized classifiers.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1007/s42600-023-00268-w.

Research Progress and Improvement Ideas of Anti-Epidemic Resilience in China's Urban Communities

In the post-epidemic era, China's urban communities are at the forefront of implementing the whole chain of accurate epidemic prevention and control. However, the uncertainty of COVID-19, the loopholes in community management and people's overly optimistic judgment of the epidemic have led to the frequent rebound of the epidemic and serious consequences. Existing studies have not yet formed a panoramic framework of community anti-epidemic work under the concept of resilience. Therefore, this article first summarizes the current research progress of resilient communities from three perspectives, including ideas and perspectives, theories and frameworks and methods and means, and summarizes the gap of the current research. Then, an innovative idea on the epidemic resilience of urban communities in China is put forward: (1) the evolution mechanism of community anti-epidemic resilience is described through the change law of dynamic networks; (2) the anti-epidemic resilience of urban communities is evaluated or predicted through the measurement criteria; (3) a simulation platform based on Multi-Agent and dynamic Bayesian networks simulates the interactive relationship between "epidemic disturbance-cost constraint--epidemic resilience"; (4) the anti-epidemic strategies are output intelligently to provide community managers with decision-making opinions on community epidemic prevention and control.

Immunity-based Ebola optimization search algorithm for minimization of feature extraction with reduction in digital mammography using CNN models

Feature classification in digital medical images like mammography presents an optimization problem which researchers often neglect. The use of a convolutional neural network (CNN) in feature extraction and classification has been widely reported in the literature to have achieved outstanding performance and acceptance in the disease detection procedure. However, little emphasis is placed on ensuring that only discriminant features extracted by the convolutional operations are passed on to the classifier, to avoid bottlenecking the classification operation. Unfortunately, since this has been left unaddressed, a subtle performance impairment has resulted from this omission. Therefore, this study is devoted to addressing these drawbacks using a metaheuristic algorithm to optimize the number of features extracted by the CNN, so that suggestive features are applied for the classification process. To achieve this, a new variant of the Ebola-based optimization algorithm is proposed, based on the population immunity concept and the use of a chaos mapping initialization strategy. The resulting algorithm, called the immunity-based Ebola optimization search algorithm (IEOSA), is applied to the optimization problem addressed in the study. The optimized features represent the output from the IEOSA, which receives the noisy and unfiltered detected features from the convolutional process as input. An exhaustive evaluation of the IEOSA was carried out using classical and IEEE CEC benchmarked functions. A comparative analysis of the performance of IEOSA is presented, with some recent optimization algorithms. The experimental result showed that IEOSA performed well on all the tested benchmark functions. Furthermore, IEOSA was then applied to solve the feature enhancement and selection problem in CNN for better prediction of breast cancer in digital mammography. The classification accuracy returned by the IEOSA method showed that the new approach improved the classification process on detected features when using CNN models.

A Hybrid Model with Spherical Fuzzy-AHP, PLS-SEM and ANN to Predict Vaccination Intention against COVID-19

This study aims to identify the key factors affecting individuals’ behavioral vaccination intention against COVID-19 in Vietnam through an online questionnaire survey. Differing from previous studies, a novel three-staged approach combining Spherical Fuzzy Analytic Hierarchy Process (SF-AHP), Partial Least Squares-Structural Equation Model (PLS-SEM), and Artificial Neural Network (ANN) is proposed. Five factors associated with individuals’ behavioral vaccination intention (INT) based on 15 experts’ opinions are considered in SF-AHP analysis, including Perceived Severity of COVID-19 (PSC), Perceived COVID-19 vaccines (PVC), Trust in government intervention strategies (TRS), Social Influence (SOI), and Social media (SOM). First, the results of SF-AHP indicated that all proposed factors correlate with INT. Second, the data of 474 valid respondents were collected and analyzed using PLS-SEM. The PLS-SEM results reported that INT was directly influenced by PVC and TRS. In contrast, SOI had no direct effect on INT. Further, PSC and SOM moderated the relationship between PVC, TRS and INT, respectively. The ANN was deployed to validate the previous stages and found that the best predictors of COVID-19 vaccination intention were PVC, TRS, and SOM. These results were consistent with the SF-AHP and PLS-SEM models. This research provides an innovative new approach employing quantitative and qualitative techniques to understand individuals’ vaccination intention during the global pandemic. Furthermore, the proposed method can be used and expanded to assess the perceived efficacy of COVID-19 measures in other nations currently battling the COVID-19 outbreak.

Enhancing reasoning through reduction of vagueness using fuzzy OWL-2 for representation of breast cancer ontologies

The need to address the challenge of vagueness across several domains of applicability of ontology is gaining research attention. The presence of vagueness in knowledge represented with description logic impairs automating reasoning and inference making. The importance of reducing this vagueness in the formalization of medical knowledge representation is rising, considering the vulnerability of this domain to the expression of vague concepts or terms. This vagueness may be addressed from the perspective of ontology modeling language application such as ontology web language (OWL). Although several attempts have been made to tackle this problem in other disease prognoses such as diabetes and cardiovascular diseases, a similar effort is missing for breast cancer. Minimizing vagueness in breast cancer ontology is necessary to enhance automated reasoning and handle knowledge representation problems. This study proposes a framework for reducing vagueness in breast cancer ontology. The approach obtained breast cancer crisp ontology and applied fuzzy ontology elements based on the Fuzzy OWL2 model to formulate breast cancer fuzzy ontology. This was achieved by extending the elements of OWL2 (a more expressive version of OWL) with annotation properties to fuzzify the breast cancer crisp ontology. Results obtained showed a significant reduction of vagueness in the domain, yielding 0.38 for vagueness spread and 1.0 for vagueness explicitness. In addition, ontology metrics such as completeness, consistency, correctness and accuracy were also evaluated, and we obtained impressive performance. The implication of this result is the reduction of vagueness in breast cancer ontology, which provides increased computational reasoning support to applications using the ontology.

Fuzzy case-based reasoning approach for finding COVID-19 patients priority in hospitals at source shortage period

In this research article, we introduced an algorithm to evaluate COVID-19 patients admission in hospitals at source shortage period. Many researchers have expressed their conclusions from different perspectives on various factors such as spatial changes, climate risks, preparedness, blood type, age and comorbidities that may be contributing to COVID-19 mortality rate. However, as the number of people coming to the hospital for COVID-19 treatment increases, the mortality rate is likely to increase due to the lack of medical facilities. In order to provide medical assistance in this situation, we need to consider not only the extent of the disease impact, but also other important factors. No method has yet been proposed to calculate the priority of patients taking into account all the factors. We have provided a solution to this in this research article. Based on eight key factors, we provide a way to determine priorities. In order to achieve the effectiveness and practicability of the proposed method, we studied individuals with different results on all factors. The sigmoid function helps to easily construct factors at different levels. In addition, the cobweb solution model allows us to see the potential of our proposed algorithm very clearly. Using the method we introduced, it is easier to sort high-risk individuals to low-risk individuals. This will make it easier to deal with problems that arise when the number of patients in hospitals continues to increase. It can reduce the mortality of COVID-19 patients. Medical professionals can be very helpful in making the best decisions.

Application of machine learning in CT images and X-rays of COVID-19 pneumonia

ABSTRACT

Coronavirus disease (COVID-19) has spread worldwide. X-ray and computed tomography (CT) are 2 technologies widely used in image acquisition, segmentation, diagnosis, and evaluation. Artificial intelligence can accurately segment infected parts in X-ray and CT images, assist doctors in improving diagnosis efficiency, and facilitate the subsequent assessment of the severity of the patient infection. The medical assistant platform based on machine learning can help radiologists make clinical decisions and helper in screening, diagnosis, and treatment. By providing scientific methods for image recognition, segmentation, and evaluation, we summarized the latest developments in the application of artificial intelligence in COVID-19 lung imaging, and provided guidance and inspiration to researchers and doctors who are fighting the COVID-19 virus.

Case-based reasoning adaptation based on fuzzy gravitational search algorithm for disaster emergency plan

Disasters can result in substantial destructive damages to the world. Emergency plan is vital to deal with these disasters. It is still difficult for the traditional CBR to generate emergency plans to meet requirements of rapid responses. An integrated system including Case-based reasoning (CBR) and gravitational search algorithm (GSA) is proposed to generate the disaster emergency plan. Fuzzy GSA (FGSA) is developed to enhance the convergence ability and accomplish the case adaptation in CBR. The proposed algorithm dynamically updates the main parameters of GSA by introducing a fuzzy system. The FGSA-CBR system is proposed, in which fitness function is defined based on the effectiveness of disaster emergency management. The comparison results have revealed that the proposed algorithm has good performances compared with the original GSA and other algorithms. A gas leakage accident is taken as an empirical study. The results have demonstrated that the FGSA-CBR has good performances when generating the disaster emergency plan. The combination of CBR and FGSA can realize the case adaptation, which provides a useful approach to the real applications.

CovFrameNet: An Enhanced Deep Learning Framework for COVID-19 Detection

The novel coronavirus, also known as COVID-19, is a pandemic that has weighed heavily on the socio-economic affairs of the world. Research into the production of relevant vaccines is progressively being advanced with the development of the Pfizer and BioNTech, AstraZeneca, Moderna, Sputnik V, Janssen, Sinopharm, Valneva, Novavax and Sanofi Pasteur vaccines. There is, however, a need for a computational intelligence solution approach to mediate the process of facilitating quick detection of the disease. Different computational intelligence methods, which comprise natural language processing, knowledge engineering, and deep learning, have been proposed in the literature to tackle the spread of coronavirus disease. More so, the application of deep learning models have demonstrated an impressive performance compared to other methods. This paper aims to advance the application of deep learning and image pre-processing techniques to characterise and detect novel coronavirus infection. Furthermore, the study proposes a framework named CovFrameNet., which consist of a pipelined image pre-processing method and a deep learning model for feature extraction, classification, and performance measurement. The novelty of this study lies in the design of a CNN architecture that incorporates an enhanced image pre-processing mechanism. The National Institutes of Health (NIH) Chest X-Ray dataset and COVID-19 Radiography database were used to evaluate and validate the effectiveness of the proposed deep learning model. Results obtained revealed that the proposed model achieved an accuracy of 0.1, recall/precision of 0.85, F-measure of 0.9, and specificity of 1.0. Thus, the study's outcome showed that a CNN-based method with image pre-processing capability could be adopted for the pre-screening of suspected COVID-19 cases, and the confirmation of RT-PCR-based detected cases of COVID-19.

An overview of molecular biology and nanotechnology based analytical methods for the detection of SARS-CoV-2: promising biotools for the rapid diagnosis of COVID-19

Currently, the 2019 novel coronavirus (2019-nCoV) is drastically affecting 214 countries, causing severe pneumonia in patients, which has resulted in lockdown being implemented in several countries to stop its local transmission. Considering this, the rapid screening and accurate detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; 2019-nCoV) play an essential role in the diagnosis of COVID-19, which can minimize local transmission and prevent an epidemic. Due to this public health emergency, the development of ultra-fast reliable diagnostic kits is essential for the diagnosis of COVID-19. Recently, molecular biology and nanotechnology based analytical methods have proven to be promising diagnostic tools for the rapid screening of 2019-nCoV with high accuracy and precision. The main aim of this review is to provide a retrospective overview on the molecular biology tools (reverse transcription polymerase chain reaction (RT-PCR) and reverse transcription loop-mediated isothermal amplification (RT-LAMP)) and nanotechnology based analytical tools (enzyme-linked immunosorbent assay (ELISA), RT-PCR, and lateral flow assay) for the rapid diagnosis of COVID-19. This review also presents recent reports on other analytical techniques including paper spray mass spectrometry for the diagnosis of COVID-19 in clinical samples. Finally, we provide a quick reference on molecular biology and nanotechnology based analytical tools for COVID-19 diagnosis in clinical samples.