Estimating outcomes in newborn infants using fuzzy logic

Artificial Intelligence to Improve Health Outcomes in the NICU and PICU: A Systematic Review

CONTEXT

Artificial intelligence (AI) technologies are increasingly used in pediatrics and have the potential to help inpatient physicians provide high-quality care for critically ill children.

OBJECTIVE

We aimed to describe the use of AI to improve any health outcome(s) in neonatal and pediatric intensive care.

DATA SOURCE

PubMed, IEEE Xplore, Cochrane, and Web of Science databases.

STUDY SELECTION

We used peer-reviewed studies published between June 1, 2010, and May 31, 2020, in which researchers described (1) AI, (2) pediatrics, and (3) intensive care. Studies were included if researchers assessed AI use to improve at least 1 health outcome (eg, mortality).

DATA EXTRACTION

Data extraction was conducted independently by 2 researchers. Articles were categorized by direct or indirect impact of AI, defined by the European Institute of Innovation and Technology Health joint report.

RESULTS

Of the 287 publications screened, 32 met inclusion criteria. Approximately 22% (n = 7) of studies revealed a direct impact and improvement in health outcomes after AI implementation. Majority were in prototype testing, and few were deployed into an ICU setting. Among the remaining 78% (n = 25) AI models outperformed standard clinical modalities and may have indirectly influenced patient outcomes. Quantitative assessment of health outcomes using statistical measures, such as area under the receiver operating curve (56%; n = 18) and specificity (38%; n = 12), revealed marked heterogeneity in metrics and standardization.

CONCLUSIONS

Few studies have revealed that AI has directly improved health outcomes for pediatric critical care patients. Further prospective, experimental studies are needed to assess AI's impact by using established implementation frameworks, standardized metrics, and validated outcome measures.

Fuzzy Logic Intelligent Systems and Methods in Midwifery and Obstetrics

Background:

Fuzzy logic can be used to model and manipulate imprecise and subjective knowledge imitating the human reasoning.

Objective:

The aim of this systematic review was to analyze research studies pertaining to fuzzy logic and fuzzy intelligent systems applications in midwifery and obstetrics.

Methods:

A thorough literature review was performed in four electronic databases (PubMed, APA PsycINFO, SCOPUS, ScienceDirect). Only the papers that discussed fuzzy logic and fuzzy intelligent systems applications in midwifery and obstetrics were considered in this review. Selected papers were critically evaluated as for their relevance and a contextual synthesis was conducted.

Results:

Twentynine papers were included in this systematic review as they met the inclusion and methodological criteria specified in this study. The results suggest that fuzzy logic and fuzzy intelligent systems have been successfully applied in midwifery and obstetrics topics, such as diagnosis, pregnancy risk assessment, fetal monitoring, bladder tumor, etc.

Conclusion:

This systematic review suggests that fuzzy logic is applicable to midwifery and obstetrics domains providing the means for developing affective intelligent systems that can assist human experts in dealing with complex diagnosis and problem solving. However, its full potential is not yet been examined, thus presenting an opportunity for further research.

FUZZY COMPUTATIONAL MODELS TO EVALUATE THE EFFECTS OF AIR POLLUTION ON CHILDREN

Objective:

To build a fuzzy computational model to estimate the number of hospitalizations of children aged up to 10 years due to respiratory conditions based on pollutants and climatic factors in the city of São José do Rio Preto, Brazil.

Methods:

A computational model was constructed using the fuzzy logic. The model has 4 inputs, each with 2 membership functions generating 16 rules, and the output with 5 pertinence functions, based on the Mamdani’s method, to estimate the association between the pollutants and the number of hospitalizations. Data from hospitalizations, from 2011-2013, were obtained in DATASUS - and the pollutants Particulate Matter (PM₁₀) and Nitrogen Dioxide (NO₂), wind speed and temperature were obtained by the Environmental Company of São Paulo State (Cetesb).

Results:

A total of 1,161 children were hospitalized in the period and the mean of pollutants was 36 and 51 µg/m³ - PM₁₀ and NO₂, respectively. The best values of the Pearson correlation (0.34) and accuracy measured by the Receiver Operating Characteristic (ROC) curve (NO₂ - 96.7% and PM₁₀ - 90.4%) were for hospitalizations on the same day of exposure.

Conclusions:

The model was effective in predicting the number of hospitalizations of children and could be used as a tool in the hospital management of the studied region.