A Deep Feature Learning Model for Pneumonia Detection Applying a Combination of mRMR Feature Selection and Machine Learning Models

Data-driven classification and explainable-AI in the field of lung imaging

Detecting lung diseases in medical images can be quite challenging for radiologists. In some cases, even experienced experts may struggle with accurately diagnosing chest diseases, leading to potential inaccuracies due to complex or unseen biomarkers. This review paper delves into various datasets and machine learning techniques employed in recent research for lung disease classification, focusing on pneumonia analysis using chest X-ray images. We explore conventional machine learning methods, pretrained deep learning models, customized convolutional neural networks (CNNs), and ensemble methods. A comprehensive comparison of different classification approaches is presented, encompassing data acquisition, preprocessing, feature extraction, and classification using machine vision, machine and deep learning, and explainable-AI (XAI). Our analysis highlights the superior performance of transfer learning-based methods using CNNs and ensemble models/features for lung disease classification. In addition, our comprehensive review offers insights for researchers in other medical domains too who utilize radiological images. By providing a thorough overview of various techniques, our work enables the establishment of effective strategies and identification of suitable methods for a wide range of challenges. Currently, beyond traditional evaluation metrics, researchers emphasize the importance of XAI techniques in machine and deep learning models and their applications in classification tasks. This incorporation helps in gaining a deeper understanding of their decision-making processes, leading to improved trust, transparency, and overall clinical decision-making. Our comprehensive review serves as a valuable resource for researchers and practitioners seeking not only to advance the field of lung disease detection using machine learning and XAI but also from other diverse domains.

Face detection based on K-medoids clustering and associated with convolutional neural networks

Over the last several years, the COVID-19 epidemic has spread over the globe. People have become used to the novel standard, which involves working from home, chatting online, and keeping oneself clean, to stop the spread of COVID-19. Due to this, many public spaces make an effort to make sure that their visitors wear proper face masks and maintain a safe distance from one another. It is impossible for monitoring workers to ensure that everyone is wearing a face mask; automated solutions are a far better option for face mask identification and monitoring to assist control public conduct and reduce the COVID-19 epidemic. The motivation for developing this technology was the need to identify those individuals who uncover their faces. Most of the previously published research publications focused on various methodologies. This study built new methods namely K-medoids, K-means, and Fuzzy K-Means(FKM) to use image pre-processing to get the better quality of the face and reduce the noise data. In addition, this study investigates various machine learning models Convolutional neural networks (CNN) with pre-trained (DenseNet201, VGG-16, and VGG-19) models, and Support Vector Machine (SVM) for the detection of face masks. The experimental results of the proposed method K-medoids with pre-trained model DenseNet201 achieved the 97.7 % accuracy best results for face mask identification. Our research results indicate that the segmentation of images may improve the identification of accuracy. More importantly, the face mask identification tool is more beneficial when it can identify the face mask in a side-on approach.

An augmentation aided concise CNN based architecture for COVID-19 diagnosis in real time

Over 6.5 million people around the world have lost their lives due to the highly contagious COVID 19 virus. The virus increases the danger of fatal health effects by damaging the lungs severely. The only method to reduce mortality and contain the spread of this disease is by promptly detecting it. Recently, deep learning has become one of the most prominent approaches to CAD, helping surgeons make more informed decisions. But deep learning models are computation hungry and devices with TPUs and GPUs are needed to run these models. The current focus of machine learning research is on developing models that can be deployed on mobile and edge devices. To this end, this research aims to develop a concise convolutional neural network-based computer-aided diagnostic system for detecting the COVID 19 virus in X-ray images, which may be deployed on devices with limited processing resources, such as mobile phones and tablets. The proposed architecture aspires to use the image enhancement in first phase and data augmentation in the second phase for image pre-processing, additionally hyperparameters are also optimized to obtain the optimal parameter settings in the third phase that provide the best results. The experimental analysis has provided empirical evidence of the impact of image enhancement, data augmentation, and hyperparameter tuning on the proposed convolutional neural network model, which increased accuracy from 94 to 98%. Results from the evaluation show that the suggested method gives an accuracy of 98%, which is better than popular transfer learning models like Xception, Resnet50, and Inception.

Convolutional Neural Networks (CNNs) for Pneumonia Classification on Pediatric Chest Radiographs

BACKGROUND

 Pneumonia is an infectious disease that is especially harmful to those with weak immune systems, such as children under the age of 5. While radiologists' diagnosis of pediatric pneumonia on chest radiographs (CXRs) is often accurate, subtle findings can be missed due to the subjective nature of the diagnosis process. Artificial intelligence (AI) techniques, such as convolutional neural networks (CNNs), can help make the process more objective and precise. However, off-the-shelf CNNs may perform poorly if they are not tuned to their appropriate hyperparameters. Our study aimed to identify the CNNs and their hyperparameter combinations (dropout, batch size, and optimizer) that optimize model performance.

METHODOLOGY

 Sixty models based on five CNNs (VGG 16, VGG 19, DenseNet 121, DenseNet 169, and InceptionResNet V2) and 12 hyperparameter combinations were tested. Adam, Root Mean Squared Propagation (RmsProp), and Mini-Batch Stochastic Gradient Descent (SGD) optimizers were used. Two batch sizes, 32 and 64, were utilized. A dropout rate of either 0.5 or 0.7 was used in all dropout layers. We used a deidentified CXR dataset of 4200 pneumonia (Figure 1a) and 1600 normal images (Figure 1b). Seventy percent of the CXRs in the dataset were used for training the model, 20% were used for validating the model, and 10% were used for testing the model. All CNNs were trained first on the ImageNet dataset. They were then trained, with frozen weights, on the CXR-containing dataset.  Results: Among the 60 models, VGG-19 (dropout of 0.5, batch size of 32, and Adam optimizer) was the most accurate. This model achieved an accuracy of 87.9%. A dropout of 0.5 consistently gave higher accuracy, area under the receiver operating characteristics curve (AUROC), and area under the precision-recall curve (AUPRC) compared to a dropout of 0.7. The CNNs InceptionResNet V2, DenseNet 169, VGG 16, and VGG 19 significantly outperformed the DenseNet121 CNN in accuracy and AUROC. The Adam and RmsProp optimizer had improved AUROC and AUPRC compared to the SGD optimizer. The batch size had no statistically significant effect on model performance.

CONCLUSION

 We recommend using low dropout rates (0.5) and RmsProp or Adam optimizer for pneumonia-detecting CNNs. Additionally, we discourage using the DenseNet121 CNN when other CNNs are available. Finally, the batch size may be set to any value, dependent on computational resources.

Computer-aided diagnosis using embedded ensemble deep learning for multiclass drug-resistant tuberculosis classification

Introduction

This study aims to develop a web application, TB-DRD-CXR, for the categorization of tuberculosis (TB) patients into subgroups based on their level of drug resistance. The application utilizes an ensemble deep learning model that classifies TB strains into five subtypes: drug sensitive tuberculosis (DS-TB), drug resistant TB (DR-TB), multidrug-resistant TB (MDR-TB), pre-extensively drug-resistant TB (pre-XDR-TB), and extensively drug-resistant TB (XDR-TB).

Methods

The ensemble deep learning model employed in the TB-DRD-CXR web application incorporates novel fusion techniques, image segmentation, data augmentation, and various learning rate strategies. The performance of the proposed model is compared with state-of-the-art techniques and standard homogeneous CNN architectures documented in the literature.

Results

Computational results indicate that the suggested method outperforms existing methods reported in the literature, providing a 4.0%-33.9% increase in accuracy. Moreover, the proposed model demonstrates superior performance compared to standard CNN models, including DenseNet201, NASNetMobile, EfficientNetB7, EfficientNetV2B3, EfficientNetV2M, and ConvNeXtSmall, with accuracy improvements of 28.8%, 93.4%, 2.99%, 48.0%, 4.4%, and 7.6% respectively.

Conclusion

The TB-DRD-CXR web application was developed and tested with 33 medical staff. The computational results showed a high accuracy rate of 96.7%, time-based efficiency (ET) of 4.16 goals/minutes, and an overall relative efficiency (ORE) of 100%. The system usability scale (SUS) score of the proposed application is 96.7%, indicating user satisfaction and a likelihood of recommending the TB-DRD-CXR application to others based on previous literature.

Review on chest pathogies detection systems using deep learning techniques

Chest radiography is the standard and most affordable way to diagnose, analyze, and examine different thoracic and chest diseases. Typically, the radiograph is examined by an expert radiologist or physician to decide about a particular anomaly, if exists. Moreover, computer-aided methods are used to assist radiologists and make the analysis process accurate, fast, and more automated. A tremendous improvement in automatic chest pathologies detection and analysis can be observed with the emergence of deep learning. The survey aims to review, technically evaluate, and synthesize the different computer-aided chest pathologies detection systems. The state-of-the-art of single and multi-pathologies detection systems, which are published in the last five years, are thoroughly discussed. The taxonomy of image acquisition, dataset preprocessing, feature extraction, and deep learning models are presented. The mathematical concepts related to feature extraction model architectures are discussed. Moreover, the different articles are compared based on their contributions, datasets, methods used, and the results achieved. The article ends with the main findings, current trends, challenges, and future recommendations.

Dual deterministic model based on deep neural network for the classification of pneumonia

Pneumonia is a disease caused by the virus (flu, respiratory Syncytial Virus) or bacteria. It can be fatal if not diagnosed and treated at an early stage. Chest X-rays have been widely utilized to diagnose such abnormalities with high exactitude and are primarily responsible for the augment real-world diagnosis process. Poor availability of authentic data and yardstick-based approaches and studies complicates the comparison process and identifying the safest recognition method. In this paper, a Dual Deterministic Model (DD-M) is proposed based on a Deep Neural network that would identify Pneumonia from chest X-ray and distinguish the cause in case of either viral or bacterial infection at an efficiency equivalent of an active radiologist. To accomplish the automated task of the proposed algorithm, an automatic computer-aided system is necessary. The proposed algorithm incorporates deep learning techniques to understand radiographic imaging better. The results were evaluated after implementing the proposed algorithm where; it reveals various aspects of the chest infected with Pneumonia compared to the healthy individual with approximately 97.45% accuracy and distinguishes between the viral and bacterial infection with the efficiency of 88.41%. The proposed algorithm with an improved image dataset will help the doctors diagnose.

A systematic review: Chest radiography images (X-ray images) analysis and COVID-19 categorization diagnosis using artificial intelligence techniques

COVID-19 pandemic created a turmoil across nations due to Severe Acute Respiratory Syndrome Corona virus-1(SARS - Co-V-2). The severity of COVID-19 symptoms is starting from cold, breathing problems, issues in respiratory system which may also lead to life threatening situations. This disease is widely contaminating and transmitted from man-to-man. The contamination is spreading when the human organs like eyes, nose, and mouth get in contact with contaminated fluids. This virus can be screened through performing a nasopharyngeal swab test which is time consuming. So the physicians are preferring the fast detection methods like chest radiography images and CT scans. At times some confusion in finding out the accurate disorder from chest radiography images can happen. To overcome this issue this study reviews several deep learning and machine learning procedures to be implemented in X-ray images of chest. This also helps the professionals to find out the other types of malfunctions happening in the chest other than COVID-19 also. This review can act as a guidance to the doctors and radiologists in identifying the COVID-19 and other types of viruses causing illness in the human anatomy and can provide aid soon.

Chest X-ray in Emergency Radiology: What Artificial Intelligence Applications Are Available?

Due to its widespread availability, low cost, feasibility at the patient's bedside and accessibility even in low-resource settings, chest X-ray is one of the most requested examinations in radiology departments. Whilst it provides essential information on thoracic pathology, it can be difficult to interpret and is prone to diagnostic errors, particularly in the emergency setting. The increasing availability of large chest X-ray datasets has allowed the development of reliable Artificial Intelligence (AI) tools to help radiologists in everyday clinical practice. AI integration into the diagnostic workflow would benefit patients, radiologists, and healthcare systems in terms of improved and standardized reporting accuracy, quicker diagnosis, more efficient management, and appropriateness of the therapy. This review article aims to provide an overview of the applications of AI for chest X-rays in the emergency setting, emphasizing the detection and evaluation of pneumothorax, pneumonia, heart failure, and pleural effusion.

Drug-Resistant Tuberculosis Treatment Recommendation, and Multi-Class Tuberculosis Detection and Classification Using Ensemble Deep Learning-Based System

This research develops the TB/non-TB detection and drug-resistant categorization diagnosis decision support system (TB-DRC-DSS). The model is capable of detecting both TB-negative and TB-positive samples, as well as classifying drug-resistant strains and also providing treatment recommendations. The model is developed using a deep learning ensemble model with the various CNN architectures. These architectures include EfficientNetB7, mobileNetV2, and Dense-Net121. The models are heterogeneously assembled to create an effective model for TB-DRC-DSS, utilizing effective image segmentation, augmentation, and decision fusion techniques to improve the classification efficacy of the current model. The web program serves as the platform for determining if a patient is positive or negative for tuberculosis and classifying several types of drug resistance. The constructed model is evaluated and compared to current methods described in the literature. The proposed model was assessed using two datasets of chest X-ray (CXR) images collected from the references. This collection of datasets includes the Portal dataset, the Montgomery County dataset, the Shenzhen dataset, and the Kaggle dataset. Seven thousand and eight images exist across all datasets. The dataset was divided into two subsets: the training dataset (80%) and the test dataset (20%). The computational result revealed that the classification accuracy of DS-TB against DR-TB has improved by an average of 43.3% compared to other methods. The categorization between DS-TB and MDR-TB, DS-TB and XDR-TB, and MDR-TB and XDR-TB was more accurate than with other methods by an average of 28.1%, 6.2%, and 9.4%, respectively. The accuracy of the embedded multiclass model in the web application is 92.6% when evaluated with the test dataset, but 92.8% when evaluated with a random subset selected from the aggregate dataset. In conclusion, 31 medical staff members have evaluated and utilized the online application, and the final user preference score for the web application is 9.52 out of a possible 10.

A Deep Learning Approach for Detecting Stroke from Brain CT Images Using OzNet

A brain stroke is a life-threatening medical disorder caused by the inadequate blood supply to the brain. After the stroke, the damaged area of the brain will not operate normally. As a result, early detection is crucial for more effective therapy. Computed tomography (CT) images supply a rapid diagnosis of brain stroke. However, while doctors are analyzing each brain CT image, time is running fast. This circumstance may lead to result in a delay in treatment and making errors. Therefore, we targeted the utilization of an efficient artificial intelligence algorithm in stroke detection. In this paper, we designed hybrid algorithms that include a new convolution neural networks (CNN) architecture called OzNet and various machine learning algorithms for binary classification of real brain stroke CT images. When we classified the dataset with OzNet, we acquired successful performance. However, for this target, we combined it with a minimum Redundancy Maximum Relevance (mRMR) method and Decision Tree (DT), k-Nearest Neighbors (kNN), Linear Discriminant Analysis (LDA), Naïve Bayes (NB), and Support Vector Machines (SVM). In addition, 4096 significant features were obtained from the fully connected layer of OzNet, and we reduced the dimension of features from 4096 to 250 using the mRMR method. Finally, we utilized these machine learning algorithms to classify important features. As a result, OzNet-mRMR-NB was an excellent hybrid algorithm and achieved an accuracy of 98.42% and AUC of 0.99 to detect stroke from brain CT images.

Stacked ensemble learning based on deep convolutional neural networks for pediatric pneumonia diagnosis using chest X-ray images

Pneumonia is an acute respiratory infection caused by bacteria, viruses, or fungi and has become very common in children ranging from 1 to 5 years of age. Common symptoms of pneumonia include difficulty breathing due to inflamed or pus and fluid-filled alveoli. The United Nations Children's Fund reports nearly 800,000 deaths in children due to pneumonia. Delayed diagnosis and overpriced tests are the prime reason for the high mortality rate, especially in underdeveloped countries. A time and cost-efficient diagnosis tool: Chest X-rays, was thus accepted as the standard diagnostic test for pediatric pneumonia. However, the lower radiation levels for diagnosis in children make the task much more onerous and time-consuming. The mentioned challenges initiate the need for a computer-aided detection model that is instantaneous and accurate. Our work proposes a stacked ensemble learning of deep learning-based features for pediatric pneumonia classification. The extracted features from the global average pooling layer of the fine-tuned Xception model pretrained on ImageNet weights are sent to the Kernel Principal Component Analysis for dimensionality reduction. The dimensionally reduced features are further trained and validated on the stacking classifier. The stacking classifier consists of two stages; the first stage uses the Random-Forest classifier, K-Nearest Neighbors, Logistic Regression, XGB classifier, Support Vector Classifier (SVC), Nu-SVC, and MLP classifier. The second stage operates on Logistic Regression using the first stage predictions for the final classification with Stratified K-fold cross-validation to prevent overfitting. The model was tested on the publicly available pediatric pneumonia dataset, achieving an accuracy of 98.3%, precision of 99.29%, recall of 98.36%, F1-score of 98.83%, and an AUC score of 98.24%. The performance shows its reliability for real-time deployment in assisting radiologists and physicians.

A Review on Detection of Pneumonia in Chest X-ray Images Using Neural Networks

The health organisation has suffered from the lack of diagnosis support systems and physicians in India. Further, the physicians are struggling to treat many patients, and the hospitals also have the lack of a radiologist especially in rural areas; thus, almost all cases are handled by a single physician, leading to many misdiagnoses. Computer aided diagnostic systems are being developed to address this problem. The current study aimed to review the different methods to detect pneumonia using neural networks and compare their approach and results. For the best comparisons, only papers with the same data set Chest X-ray14 are studied.

Embedded AMIS-Deep Learning with Dialog-Based Object Query System for Multi-Class Tuberculosis Drug Response Classification

A person infected with drug-resistant tuberculosis (DR-TB) is the one who does not respond to typical TB treatment. DR-TB necessitates a longer treatment period and a more difficult treatment protocol. In addition, it can spread and infect individuals in the same manner as regular TB, despite the fact that early detection of DR-TB could reduce the cost and length of TB treatment. This study provided a fast and effective classification scheme for the four subtypes of TB: Drug-sensitive tuberculosis (DS-TB), drug-resistant tuberculosis (DR-TB), multidrug-resistant tuberculosis (MDR-TB), and extensively drug-resistant tuberculosis (XDR-TB). The drug response classification system (DRCS) has been developed as a classification tool for DR-TB subtypes. As a classification method, ensemble deep learning (EDL) with two types of image preprocessing methods, four convolutional neural network (CNN) architectures, and three decision fusion methods have been created. Later, the model developed by EDL will be included in the dialog-based object query system (DBOQS), in order to enable the use of DRCS as the classification tool for DR-TB in assisting medical professionals with diagnosing DR-TB. EDL yields an improvement of 1.17-43.43% over the existing methods for classifying DR-TB, while compared with classic deep learning, it generates 31.25% more accuracy. DRCS was able to increase accuracy to 95.8% and user trust to 95.1%, and after the trial period, 99.70% of users were interested in continuing the utilization of the system as a supportive diagnostic tool.

Pediatric pneumonia diagnosis using stacked ensemble learning on multi-model deep CNN architectures

Pediatric pneumonia has drawn immense awareness due to the high mortality rates over recent years. The acute respiratory infection caused by bacteria, viruses, or fungi infects the lung region and hinders oxygen transport, making breathing difficult due to inflamed or pus and fluid-filled alveoli. Being non-invasive and painless, chest X-rays are the most common modality for pediatric pneumonia diagnosis. However, the low radiation levels for diagnosis in children make accurate detection challenging. This challenge initiates the need for an unerring computer-aided diagnosis model. Our work proposes Contrast Limited Adaptive Histogram Equalization for image enhancement and a stacking classifier based on the fusion of deep learning-based features for pediatric pneumonia diagnosis. The extracted features from the global average pooling layers of the fine-tuned MobileNet, DenseNet121, DenseNet169, and DenseNet201 are concatenated for the final classification using a stacked ensemble classifier. The stacking classifier uses Support Vector Classifier, Nu-SVC, Logistic Regression, K-Nearest Neighbor, Random Forest Classifier, Gaussian Naïve Bayes, AdaBoost classifier, Bagging Classifier, and Extra-trees Classifier for the first stage, and Nu-SVC as the meta-classifier. The stacking classifier validated using Stratified K-Fold cross-validation achieves an accuracy of 98.62%, precision of 98.99%, recall of 99.53%, F1 score of 99.26%, and an AUC score of 93.17% on the publicly available pediatric pneumonia dataset. We expect this model to greatly help the real-time diagnosis of pediatric pneumonia.

Deep Learning Based Feature Selection Algorithm for Small Targets Based on mRMR

Small target features are difficult to distinguish and identify in an environment with complex backgrounds. The identification and extraction of multi-dimensional features have been realized due to the rapid development of deep learning, but there are still redundant relationships between features, reducing feature recognition accuracy. The YOLOv5 neural network is used in this paper to achieve preliminary feature extraction, and the minimum redundancy maximum relevance algorithm is used for the 512 candidate features extracted in the fully connected layer to perform de-redundancy processing on the features with high correlation, reducing the dimension of the feature set and making small target feature recognition a reality. Simultaneously, by pre-processing the image, the feature recognition of the pre-processed image can be improved. Simultaneously, by pre-processing the image, the feature recognition of the pre-processed image can significantly improve the recognition accuracy. The experimental results demonstrate that using the minimum redundancy maximum relevance algorithm can effectively reduce the feature dimension and identify small target features.

A new improved maximal relevance and minimal redundancy method based on feature subset

Feature selection plays a very significant role for the success of pattern recognition and data mining. Based on the maximal relevance and minimal redundancy (mRMR) method, combined with feature subset, this paper proposes an improved maximal relevance and minimal redundancy (ImRMR) feature selection method based on feature subset. In ImRMR, the Pearson correlation coefficient and mutual information are first used to measure the relevance of a single feature to the sample category, and a factor is introduced to adjust the weights of the two measurement criteria. And an equal grouping method is exploited to generate candidate feature subsets according to the ranking features. Then, the relevance and redundancy of candidate feature subsets are calculated and the ordered sequence of these feature subsets is gained by incremental search method. Finally, the final optimal feature subset is obtained from these feature subsets by combining the sequence forward search method and the classification learning algorithm. Experiments are conducted on seven datasets. The results show that ImRMR can effectively remove irrelevant and redundant features, which can not only reduce the dimension of sample features and time of model training and prediction, but also improve the classification performance.

Supervised Learning Models for the Preliminary Detection of COVID-19 in Patients Using Demographic and Epidemiological Parameters

The World Health Organization labelled the new COVID-19 breakout a public health crisis of worldwide concern on 30 January 2020, and it was named the new global pandemic in March 2020. It has had catastrophic consequences on the world economy and well-being of people and has put a tremendous strain on already-scarce healthcare systems globally, particularly in underdeveloped countries. Over 11 billion vaccine doses have already been administered worldwide, and the benefits of these vaccinations will take some time to appear. Today, the only practical approach to diagnosing COVID-19 is through the RT-PCR and RAT tests, which have sometimes been known to give unreliable results. Timely diagnosis and implementation of precautionary measures will likely improve the survival outcome and decrease the fatality rates. In this study, we propose an innovative way to predict COVID-19 with the help of alternative non-clinical methods such as supervised machine learning models to identify the patients at risk based on their characteristic parameters and underlying comorbidities. Medical records of patients from Mexico admitted between 23 January 2020 and 26 March 2022, were chosen for this purpose. Among several supervised machine learning approaches tested, the XGBoost model achieved the best results with an accuracy of 92%. It is an easy, non-invasive, inexpensive, instant and accurate way of forecasting those at risk of contracting the virus. However, it is pretty early to deduce that this method can be used as an alternative in the clinical diagnosis of coronavirus cases.

Pneumonia Detection on Chest X-ray Images Using Ensemble of Deep Convolutional Neural Networks

Pneumonia is a life-threatening lung infection resulting from several different viral infections. Identifying and treating pneumonia on chest X-ray images can be difficult due to its similarity to other pulmonary diseases. Thus, the existing methods for predicting pneumonia cannot attain substantial levels of accuracy. This paper presents a computer-aided classification of pneumonia, coined Ensemble Learning (EL), to simplify the diagnosis process on chest X-ray images. Our proposal is based on Convolutional Neural Network (CNN) models , which are pretrained CNN models that have been recently employed to enhance the performance of many medical tasks instead of training CNN models from scratch. We propose to use three well-known CNNs (DenseNet169, MobileNetV2, and Vision Transformer) pretrained using the ImageNet database.

Early Diagnosis of Brain Tumour MRI Images Using Hybrid Techniques between Deep and Machine Learning

Cancer is considered one of the most aggressive and destructive diseases that shortens the average lives of patients. Misdiagnosed brain tumours lead to false medical intervention, which reduces patients' chance of survival. Accurate early medical diagnoses of brain tumour are an essential point for starting treatment plans that improve the survival of patients with brain tumours. Computer-aided diagnostic systems have provided consecutive successes for helping medical doctors make accurate diagnoses and have conducted positive strides in the field of deep and machine learning. Deep convolutional layers extract strong distinguishing features from the regions of interest compared with those extracted using traditional methods. In this study, different experiments are performed for brain tumour diagnosis by combining deep learning and traditional machine learning techniques. AlexNet and ResNet-18 are used with the support vector machine (SVM) algorithm for brain tumour classification and diagnosis. Brain tumour magnetic resonance imaging (MRI) images are enhanced using the average filter technique. Then, deep learning techniques are applied to extract robust and important deep features via deep convolutional layers. The process of combining deep and machine learning techniques starts, where features are extracted using deep learning techniques, namely, AlexNet and ResNet-18. These features are then classified using SoftMax and SVM. The MRI dataset contains 3,060 images divided into four classes, which are three tumours and one normal. All systems have achieved superior results. Specifically, the AlexNet+SVM hybrid technique exhibits the best performance, with 95.10% accuracy, 95.25% sensitivity, and 98.50% specificity.

Lung Disease Classification in CXR Images Using Hybrid Inception-ResNet-v2 Model and Edge Computing

Chest X-ray (CXR) imaging is one of the most widely used and economical tests to diagnose a wide range of diseases. However, even for expert radiologists, it is a challenge to accurately diagnose diseases from CXR samples. Furthermore, there remains an acute shortage of trained radiologists worldwide. In the present study, a range of machine learning (ML), deep learning (DL), and transfer learning (TL) approaches have been evaluated to classify diseases in an openly available CXR image dataset. A combination of the synthetic minority over-sampling technique (SMOTE) and weighted class balancing is used to alleviate the effects of class imbalance. A hybrid Inception-ResNet-v2 transfer learning model coupled with data augmentation and image enhancement gives the best accuracy. The model is deployed in an edge environment using Amazon IoT Core to automate the task of disease detection in CXR images with three categories, namely pneumonia, COVID-19, and normal. Comparative analysis has been given in various metrics such as precision, recall, accuracy, AUC-ROC score, etc. The proposed technique gives an average accuracy of 98.66%. The accuracies of other TL models, namely SqueezeNet, VGG19, ResNet50, and MobileNetV2 are 97.33%, 91.66%, 90.33%, and 76.00%, respectively. Further, a DL model, trained from scratch, gives an accuracy of 92.43%. Two feature-based ML classification techniques, namely support vector machine with local binary pattern (SVM + LBP) and decision tree with histogram of oriented gradients (DT + HOG) yield an accuracy of 87.98% and 86.87%, respectively.

A Novel MRI Diagnosis Method for Brain Tumor Classification Based on CNN and Bayesian Optimization

Brain tumor is one of the most aggressive diseases nowadays, resulting in a very short life span if it is diagnosed at an advanced stage. The treatment planning phase is thus essential for enhancing the quality of life for patients. The use of Magnetic Resonance Imaging (MRI) in the diagnosis of brain tumors is extremely widespread, but the manual interpretation of large amounts of images requires considerable effort and is prone to human errors. Hence, an automated method is necessary to identify the most common brain tumors. Convolutional Neural Network (CNN) architectures are successful in image classification due to their high layer count, which enables them to conceive the features effectively on their own. The tuning of CNN hyperparameters is critical in every dataset since it has a significant impact on the efficiency of the training model. Given the high dimensionality and complexity of the data, manual hyperparameter tuning would take an inordinate amount of time, with the possibility of failing to identify the optimal hyperparameters. In this paper, we proposed a Bayesian Optimization-based efficient hyperparameter optimization technique for CNN. This method was evaluated by classifying 3064 T-1-weighted CE-MRI images into three types of brain tumors (Glioma, Meningioma, and Pituitary). Based on Transfer Learning, the performance of five well-recognized deep pre-trained models is compared with that of the optimized CNN. After using Bayesian Optimization, our CNN was able to attain 98.70% validation accuracy at best without data augmentation or cropping lesion techniques, while VGG16, VGG19, ResNet50, InceptionV3, and DenseNet201 achieved 97.08%, 96.43%, 89.29%, 92.86%, and 94.81% validation accuracy, respectively. Moreover, the proposed model outperforms state-of-the-art methods on the CE-MRI dataset, demonstrating the feasibility of automating hyperparameter optimization.

Review on COVID-19 diagnosis models based on machine learning and deep learning approaches

COVID-19 is the disease evoked by a new breed of coronavirus called the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Recently, COVID-19 has become a pandemic by infecting more than 152 million people in over 216 countries and territories. The exponential increase in the number of infections has rendered traditional diagnosis techniques inefficient. Therefore, many researchers have developed several intelligent techniques, such as deep learning (DL) and machine learning (ML), which can assist the healthcare sector in providing quick and precise COVID-19 diagnosis. Therefore, this paper provides a comprehensive review of the most recent DL and ML techniques for COVID-19 diagnosis. The studies are published from December 2019 until April 2021. In general, this paper includes more than 200 studies that have been carefully selected from several publishers, such as IEEE, Springer and Elsevier. We classify the research tracks into two categories: DL and ML and present COVID-19 public datasets established and extracted from different countries. The measures used to evaluate diagnosis methods are comparatively analysed and proper discussion is provided. In conclusion, for COVID-19 diagnosing and outbreak prediction, SVM is the most widely used machine learning mechanism, and CNN is the most widely used deep learning mechanism. Accuracy, sensitivity, and specificity are the most widely used measurements in previous studies. Finally, this review paper will guide the research community on the upcoming development of machine learning for COVID-19 and inspire their works for future development. This review paper will guide the research community on the upcoming development of ML and DL for COVID-19 and inspire their works for future development.

Deep learning based fusion model for COVID-19 diagnosis and classification using computed tomography images

Recently, the COVID-19 pandemic becomes increased in a drastic way, with the availability of a limited quantity of rapid testing kits. Therefore, automated COVID-19 diagnosis models are essential to identify the existence of disease from radiological images. Earlier studies have focused on the development of Artificial Intelligence (AI) techniques using X-ray images on COVID-19 diagnosis. This paper aims to develop a Deep Learning Based MultiModal Fusion technique called DLMMF for COVID-19 diagnosis and classification from Computed Tomography (CT) images. The proposed DLMMF model operates on three main processes namely Weiner Filtering (WF) based pre-processing, feature extraction and classification. The proposed model incorporates the fusion of deep features using VGG16 and Inception v4 models. Finally, Gaussian Naïve Bayes (GNB) based classifier is applied for identifying and classifying the test CT images into distinct class labels. The experimental validation of the DLMMF model takes place using open-source COVID-CT dataset, which comprises a total of 760 CT images. The experimental outcome defined the superior performance with the maximum sensitivity of 96.53%, specificity of 95.81%, accuracy of 96.81% and F-score of 96.73%.

CoviLearn: A Machine Learning Integrated Smart X-Ray Device in Healthcare Cyber-Physical System for Automatic Initial Screening of COVID-19

The pandemic of novel Coronavirus Disease 2019 (COVID-19) is widespread all over the world causing serious health problems as well as serious impact on the global economy. Reliable and fast testing of the COVID-19 has been a challenge for researchers and healthcare practitioners. In this work, we present a novel machine learning (ML) integrated X-ray device in Healthcare Cyber-Physical System (H-CPS) or smart healthcare framework (called "CoviLearn") to allow healthcare practitioners to perform automatic initial screening of COVID-19 patients. We propose convolutional neural network (CNN) models of X-ray images integrated into an X-ray device for automatic COVID-19 detection. The proposed CoviLearn device will be useful in detecting if a person is COVID-19 positive or negative by considering the chest X-ray image of individuals. CoviLearn will be useful tool doctors to detect potential COVID-19 infections instantaneously without taking more intrusive healthcare data samples, such as saliva and blood. COVID-19 attacks the endothelium tissues that support respiratory tract, and X-rays images can be used to analyze the health of a patient's lungs. As all healthcare centers have X-ray machines, it could be possible to use proposed CoviLearn X-rays to test for COVID-19 without the especial test kits. Our proposed automated analysis system CoviLearn which has 98.98% accuracy will be able to save valuable time of medical professionals as the X-ray machines come with a drawback as it needed a radiology expert.

VGGCOV19-NET: automatic detection of COVID-19 cases from X-ray images using modified VGG19 CNN architecture and YOLO algorithm

X-ray images are an easily accessible, fast, and inexpensive method of diagnosing COVID-19, widely used in health centers around the world. In places where there is a shortage of specialist doctors and radiologists, there is need for a system that can direct patients to advanced health centers by pre-diagnosing COVID-19 from X-ray images. Also, smart computer-aided systems that automatically detect COVID-19 positive cases will support daily clinical applications. The study aimed to classify COVID-19 via X-ray images in high precision ratios with pre-trained VGG19 deep CNN architecture and the YOLOv3 detection algorithm. For this purpose, VGG19, VGGCOV19-NET models, and the original Cascade models were created by feeding these models with the YOLOv3 algorithm. Cascade models are the original models fed with the lung zone X-ray images detected with the YOLOv3 algorithm. Model performances were evaluated using fivefold cross-validation according to recall, specificity, precision, f1-score, confusion matrix, and ROC analysis performance metrics. While the accuracy of the Cascade VGGCOV19-NET model was 99.84% for the binary class (COVID vs. no-findings) data set, it was 97.16% for the three-class (COVID vs. no-findings vs. pneumonia) data set. The Cascade VGGCOV19-NET model has a higher classification performance than VGG19, Cascade VGG19, VGGCOV19-NET and previous studies. Feeding the CNN models with the YOLOv3 detection algorithm decreases the training test time while increasing the classification performance. The results indicate that the proposed Cascade VGGCOV19-NET architecture was highly successful in detecting COVID-19. Therefore, this study contributes to the literature in terms of both YOLO-aided deep architecture and classification success.

Coronavirus herd immunity optimizer with greedy crossover for feature selection in medical diagnosis

The importance of medical data and the crucial nature of the decisions that are based on such data, as well as the large increase in its volume, has encouraged researchers to develop feature selection (FS)-based approaches to identify the most relevant data for specific medical problems In this paper, two intelligent wrapper FS approaches based on a new metaheuristic algorithm named the coronavirus herd immunity optimizer (CHIO) were applied with and without the incorporation of a greedy crossover (GC) operator strategy to enhance exploration of the search space by CHIO. The two proposed approaches, CHIO and CHIO-GC, were evaluated using 23 medical benchmark datasets and a real-world COVID-19 dataset. The experimental results indicated that CHIO-GC outperformed CHIO in terms of search capability, as reflected in classification accuracy, selection size, F-measure, standard deviation and convergence speed. The GC operator was able to enhance the balance between exploration and exploitation of the CHIO in the search and correct suboptimal solutions for faster convergence. The proposed CHIO-GC was also compared with two previous wrapper FS approaches, namely, binary moth flame optimization with Lévy flight (LBMFO_V3) and the hyper learning binary dragonfly algorithm (HLBDA), as well as four filter methods namely, Chi-square, Relief, correlation-based feature selection and information gain. CHIO-GC surpassed LBMFO_V3 and the four filter methods with an accuracy rate of 0.79 on 23 medical benchmark datasets. CHIO-GC also surpassed HLBDA with an accuracy rate of 0.93 when applied to the COVID-19 dataset. These encouraging results were obtained by striking a sufficient balance between the two search phases of CHIO-GC during the hunt for correct solutions, which also increased the convergence rate. This was accomplished by integrating a greedy crossover technique into the CHIO algorithm to remedy the inferior solutions found during premature convergence and while locked into a local optimum search space.

A lightweight deep learning architecture for the automatic detection of pneumonia using chest X-ray images

Pneumonia is a life-threatening respiratory lung disease. Children are more prone to be affected by the disease and accurate manual detection is not easy. Generally, chest radiographs are used for the manual detection of pneumonia and expert radiologists are required for the assessment of the X-ray images. An automatic system would be beneficial for the diagnosis of pneumonia based on chest radiographs as manual detection is time-consuming and tedious. Therefore, a method is proposed in this paper for the fast and automatic detection of pneumonia. A deep learning-based architecture 'MobileNet' is proposed for the automatic detection of pneumonia based on the chest X-ray images. A benchmark dataset of 5856 chest X-ray images was taken for the training, testing, and evaluation of the proposed deep learning network. The proposed model was trained within 3 Hrs. and achieved a training accuracy of 97.34%, a validation accuracy of 87.5%, and a testing accuracy of 94.23% for automatic detection of pneumonia. However, the combined accuracy was achieved as 97.09% with 0.96 specificity, 0.97 precision, 0.98 recall, and 0.97 F-Score. The proposed method was found faster and computationally lesser expensive as compared to other methods in the literature and achieved a promising accuracy.

A computer-aided diagnosis system for the classification of COVID-19 and non-COVID-19 pneumonia on chest X-ray images by integrating CNN with sparse autoencoder and feed forward neural network

Several infectious diseases have affected the lives of many people and have caused great dilemmas all over the world. COVID-19 was declared a pandemic caused by a newly discovered virus named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) by the World Health Organisation in 2019. RT-PCR is considered the golden standard for COVID-19 detection. Due to the limited RT-PCR resources, early diagnosis of the disease has become a challenge. Radiographic images such as Ultrasound, CT scans, X-rays can be used for the detection of the deathly disease. Developing deep learning models using radiographic images for detecting COVID-19 can assist in countering the outbreak of the virus. This paper presents a computer-aided detection model utilizing chest X-ray images for combating the pandemic. Several pre-trained networks and their combinations have been used for developing the model. The method uses features extracted from pre-trained networks along with Sparse autoencoder for dimensionality reduction and a Feed Forward Neural Network (FFNN) for the detection of COVID-19. Two publicly available chest X-ray image datasets, consisting of 504 COVID-19 images and 542 non-COVID-19 images, have been combined to train the model. The method was able to achieve an accuracy of 0.9578 and an AUC of 0.9821, using the combination of InceptionResnetV2 and Xception. Experiments have proved that the accuracy of the model improves with the usage of sparse autoencoder as the dimensionality reduction technique.

Detecting COVID-19 in chest images based on deep transfer learning and machine learning algorithms

Background

This study aimed to propose an automatic prediction of COVID-19 disease using chest CT images based on deep transfer learning models and machine learning (ML) algorithms.

Results

The dataset consisted of 5480 samples in two classes, including 2740 CT chest images of patients with confirmed COVID-19 and 2740 images of suspected cases was assessed. The DenseNet201 model has obtained the highest training with an accuracy of 100%. In combining pre-trained models with ML algorithms, the DenseNet201 model and KNN algorithm have received the best performance with an accuracy of 100%. Created map by t-SNE in the DenseNet201 model showed not any points clustered with the wrong class.

Conclusions

The mentioned models can be used in remote places, in low- and middle-income countries, and laboratory equipment with limited resources to overcome a shortage of radiologists.

Competitive Deep Learning Methods for COVID-19 Detection using X-ray Images

After the World War II, every country throughout the world is experiencing the biggest crisis induced by the devastating Coronavirus disease (COVID-19), which initially arose in the city of Wuhan in December 2019. This global pandemic has severely affected not only the health of billions of people but also the economy of countries all over the world. It has been evident that novel virus has infected a total of 20,674,903 lives as on 12 August 2020. The dissemination of the virus can be regulated by detecting the positive COVID cases as soon as possible. The reverse-transcriptase polymerase chain reaction (RT-PCR) is the basic approach used in the identification of the COVID-19. As RT-PCR is less sensitive to determine the novel virus at the beginning stage, it is worthwhile to develop more robust and other diagnosis approaches for the detection of the novel coronavirus. Due to the accessibility of medical datasets comprising of radiography images publicly, more robust diagnosis approaches are contributed by the researchers and technocrats for the identification of COVID-19 images using the techniques of deep leaning. In this paper, we proposed VGG16 and MobileNet-V2, which makes use of ADAM and RMSprop optimizers for the automatic identification of the COVID-19 images from other pneumonia chest X-ray images. Then, the efficiency of the proposed methodology has been enhanced by the application of data augmentation and transfer learning approach which is used to overcome the overfitting problem. From the experimental outcomes, it can be deduced that the proposed MobileNet-V2 model using ADAM and RMSprop optimizer achieves better accomplishment in terms of accuracy, sensitivity and specificity when contrasted with the VGG 16 using ADAM and RMSprop optimizers.

PneumoniaNet: Automated Detection and Classification of Pediatric Pneumonia Using Chest X-ray Images and CNN Approach

Pneumonia is an inflammation of the lung parenchyma that is caused by a variety of infectious microorganisms and non-infective agents. All age groups can be affected; however, in most cases, fragile groups are more susceptible than others. Radiological images such as Chest X-ray (CXR) images provide early detection and prompt action, where typical CXR for such a disease is characterized by radiopaque appearance or seemingly solid segment at the affected parts of the lung due to inflammatory exudate formation replacing the air in the alveoli. The early and accurate detection of pneumonia is crucial to avoid fatal ramifications, particularly in children and seniors. In this paper, we propose a novel 50 layers Convolutional Neural Network (CNN)-based architecture that outperforms the state-of-the-art models. The suggested framework is trained using 5852 CXR images and statistically tested using five-fold cross-validation. The model can distinguish between three classes: viz viral, bacterial, and normal; with 99.7% ± 0.2 accuracy, 99.74% ± 0.1 sensitivity, and 0.9812 Area Under the Curve (AUC). The results are promising, and the new architecture can be used to recognize pneumonia early with cost-effectiveness and high accuracy, especially in remote areas that lack proper access to expert radiologists, and therefore, reduces pneumonia-caused mortality rates.

Diagnosis of Pediatric Pneumonia with Ensemble of Deep Convolutional Neural Networks in Chest X-Ray Images

Pneumonia is a fatal disease that appears in the lungs and is caused by viral or bacterial infection. Diagnosis of pneumonia in chest X-ray images can be difficult and error-prone because of its similarity with other infections in the lungs. The aim of this study is to develop a computer-aided pneumonia detection system to facilitate the diagnosis decision process. Therefore, a convolutional neural network (CNN) ensemble method was proposed for the automatic diagnosis of pneumonia which is seen in children. In this context, seven well-known CNN models (VGG-16, VGG-19, ResNet-50, Inception-V3, Xception, MobileNet, and SqueezeNet) pre-trained on the ImageNet dataset were trained with the appropriate transfer learning and fine-tuning strategies on the chest X-ray dataset. Among the seven different models, the three most successful ones were selected for the ensemble method. The final results were obtained by combining the predictions of CNN models with the ensemble method during the test. In addition, a CNN model was trained from scratch, and the results of this model were compared with the proposed ensemble method. The proposed ensemble method achieved remarkable results with an AUC of 95.21 and a sensitivity of 97.76 on the test data. Also, the proposed ensemble method achieved classification accuracy of 90.71 in chest X-ray images as normal, viral pneumonia, and bacterial pneumonia.

Bayesian convolutional neural network estimation for pediatric pneumonia detection and diagnosis

BACKGROUND AND OBJECTIVES

Pneumonia is a disease that affects the lungs, making breathing difficult. Nowadays, pneumonia is the disease that kills the most children under the age of five in the world, and if no action is taken, pneumonia is estimated to kill 11 million children by the year 2030. Knowing that rapid and accurate diagnosis of pneumonia is a significant factor in reducing mortality, acceleration, or automation of the diagnostic process is highly desirable. The use of computational methods can decrease specialists' workload and even offer a second opinion, increasing the number of accurate diagnostics.

METHODS

This work proposes a method for constructing a specific convolutional neural network architecture to detect pneumonia and classify viral and bacterial types using Bayesian optimization from pre-trained networks.

RESULTS

The results obtained are promising, in the order of 0.964 accuracy for pneumonia detection and 0.957 accuracy for pneumonia type classification.

CONCLUSION

This research demonstrated the efficiency of CNN architecture estimation for detecting and diagnosing pneumonia using Bayesian optimization. The proposed network proved to have promising results, despite not using common preprocessing techniques such as histogram equalization and lung segmentation. This fact shows that the proposed method provides efficient and high-performance neural networks since image preprocessing is unnecessary.

Identification and classification of pneumonia disease using a deep learning-based intelligent computational framework

Pneumonia is one of the hazardous diseases that lead to life insecurity. It needs to be diagnosed at the initial stages to prevent a person from more damage and help them save their lives. Various techniques are used to identify pneumonia, including chest X-ray, blood culture, sputum culture, fluid sample, bronchoscopy, and pulse oximetry. Chest X-ray is the most widely used method to diagnose pneumonia and is considered one of the most reliable approaches. To analyse chest X-ray images accurately, an expert radiologist needs expertise and experience in the desired domain. However, human-assisted approaches have some drawbacks: expert availability, treatment cost, availability of diagnostic tools, etc. Hence, the need for an intelligent and automated system comes into place that operates on chest X-ray images and diagnoses pneumonia. The primary purpose of technology is to develop algorithms and tools that assist humans and make their lives easier. This study proposes a scalable and interpretable deep convolutional neural network (DCNN) to identify pneumonia using chest X-ray images. The proposed modified DCNN model first extracts useful features from the images and then classifies them into normal and pneumonia classes. The proposed system has been trained and tested on chest X-ray images dataset. Various performance metrics have been utilized to inspect the stability and efficacy of the proposed model. The experimental result shows that the proposed model's performance is greater compared to the other state-of-the-art methodologies used to identify pneumonia.

Home Textile Pattern Emotion Labeling Using Deep Multi-View Feature Learning

Different home textile patterns have different emotional expressions. Emotion evaluation of home textile patterns can effectively improve the retrieval performance of home textile patterns based on semantics. It can not only help designers make full use of existing designs and stimulate creative inspiration but also help users select designs and products that are more in line with their needs. In this study, we develop a three-stage framework for home textile pattern emotion labeling based on artificial intelligence. To be specific, first of all, three kinds of aesthetic features, i.e., shape, texture, and salient region, are extracted from the original home textile patterns. Then, a CNN (convolutional neural network)-based deep feature extractor is constructed to extract deep features from the aesthetic features acquired in the previous stage. Finally, a novel multi-view classifier is designed to label home textile patterns that can automatically learn the weight of each view. The three-stage framework is evaluated by our data and the experimental results show its promising performance in home textile patterns labeling.

COVID-19 Detection Empowered with Machine Learning and Deep Learning Techniques: A Systematic Review

COVID-19 has infected 223 countries and caused 2.8 million deaths worldwide (at the time of writing this article), and the death rate is increasing continuously. Early diagnosis of COVID patients is a critical challenge for medical practitioners, governments, organizations, and countries to overcome the rapid spread of the deadly virus in any geographical area. In this situation, the previous epidemic evidence on Machine Learning (ML) and Deep Learning (DL) techniques encouraged the researchers to play a significant role in detecting COVID-19. Similarly, the rising scope of ML/DL methodologies in the medical domain also advocates its significant role in COVID-19 detection. This systematic review presents ML and DL techniques practiced in this era to predict, diagnose, classify, and detect the coronavirus. In this study, the data was retrieved from three prevalent full-text archives, i.e., Science Direct, Web of Science, and PubMed, using the search code strategy on 16 March 2021. Using professional assessment, among 961 articles retrieved by an initial query, only 40 articles focusing on ML/DL-based COVID-19 detection schemes were selected. Findings have been presented as a country-wise distribution of publications, article frequency, various data collection, analyzed datasets, sample sizes, and applied ML/DL techniques. Precisely, this study reveals that ML/DL technique accuracy lay between 80% to 100% when detecting COVID-19. The RT-PCR-based model with Support Vector Machine (SVM) exhibited the lowest accuracy (80%), whereas the X-ray-based model achieved the highest accuracy (99.7%) using a deep convolutional neural network. However, current studies have shown that an anal swab test is super accurate to detect the virus. Moreover, this review addresses the limitations of COVID-19 detection along with the detailed discussion of the prevailing challenges and future research directions, which eventually highlight outstanding issues.

Study protocol and design for the assessment of paediatric pneumonia from X-ray images using deep learning

Introduction

In low-income and middle-income countries, pneumonia remains the leading cause of illness and death in children<5 years. The recommended tool for diagnosing paediatric pneumonia is the interpretation of chest X-ray images, which is difficult to standardise and requires trained clinicians/radiologists. Current automated computational tools have primarily focused on assessing adult pneumonia and were trained on images evaluated by a single specialist. We aim to provide a computational tool using a deep-learning approach to diagnose paediatric pneumonia using X-ray images assessed by multiple specialists trained by the WHO expert X-ray image reading panel.

Methods and analysis

Approximately 10 000 paediatric chest X-ray images are currently being collected from an ongoing WHO-supported surveillance study in Bangladesh. Each image will be read by two trained clinicians/radiologists for the presence or absence of primary endpoint pneumonia (PEP) in each lung, as defined by the WHO. Images whose PEP labels are discordant in either lung will be reviewed by a third specialist and the final assignment will be made using a majority vote. Convolutional neural networks will be used for lung segmentation to align and scale the images to a reference, and for interpretation of the images for the presence of PEP. The model will be evaluated against an independently collected and labelled set of images from the WHO. The study outcome will be an automated method for the interpretation of chest radiographs for diagnosing paediatric pneumonia.

Ethics and dissemination

All study protocols were approved by the Ethical Review Committees of the Bangladesh Institute of Child Health, Bangladesh. The study sponsor deemed it unnecessary to attain ethical approval from the Academic and Clinical Central Office for Research and Development of University of Edinburgh, UK. The study uses existing X-ray images from an ongoing WHO-coordinated surveillance. All findings will be published in an open-access journal. All X-ray labels and statistical code will be made openly available. The model and images will be made available on request.