An IoT and Fog Computing-Based Monitoring System for Cardiovascular Patients with Automatic ECG Classification Using Deep Neural Networks

Remote Health Monitoring Systems for Elderly People: A Survey

This paper addresses the growing demand for healthcare systems, particularly among the elderly population. The need for these systems arises from the desire to enable patients and seniors to live independently in their homes without relying heavily on their families or caretakers. To achieve substantial improvements in healthcare, it is essential to ensure the continuous development and availability of information technologies tailored explicitly for patients and elderly individuals. The primary objective of this study is to comprehensively review the latest remote health monitoring systems, with a specific focus on those designed for older adults. To facilitate a comprehensive understanding, we categorize these remote monitoring systems and provide an overview of their general architectures. Additionally, we emphasize the standards utilized in their development and highlight the challenges encountered throughout the developmental processes. Moreover, this paper identifies several potential areas for future research, which promise further advancements in remote health monitoring systems. Addressing these research gaps can drive progress and innovation, ultimately enhancing the quality of healthcare services available to elderly individuals. This, in turn, empowers them to lead more independent and fulfilling lives while enjoying the comforts and familiarity of their own homes. By acknowledging the importance of healthcare systems for the elderly and recognizing the role of information technologies, we can address the evolving needs of this population. Through ongoing research and development, we can continue to enhance remote health monitoring systems, ensuring they remain effective, efficient, and responsive to the unique requirements of elderly individuals.

Deep Learning-Based IoT System for Remote Monitoring and Early Detection of Health Issues in Real-Time

With an aging population and increased chronic diseases, remote health monitoring has become critical to improving patient care and reducing healthcare costs. The Internet of Things (IoT) has recently drawn much interest as a potential remote health monitoring remedy. IoT-based systems can gather and analyze a wide range of physiological data, including blood oxygen levels, heart rates, body temperatures, and ECG signals, and then provide real-time feedback to medical professionals so they may take appropriate action. This paper proposes an IoT-based system for remote monitoring and early detection of health problems in home clinical settings. The system comprises three sensor types: MAX30100 for measuring blood oxygen level and heart rate; AD8232 ECG sensor module for ECG signal data; and MLX90614 non-contact infrared sensor for body temperature. The collected data is transmitted to a server using the MQTT protocol. A pre-trained deep learning model based on a convolutional neural network with an attention layer is used on the server to classify potential diseases. The system can detect five different categories of heartbeats: Normal Beat, Supraventricular premature beat, Premature ventricular contraction, Fusion of ventricular, and Unclassifiable beat from ECG sensor data and fever or non-fever from body temperature. Furthermore, the system provides a report on the patient's heart rate and oxygen level, indicating whether they are within normal ranges or not. The system automatically connects the user to the nearest doctor for further diagnosis if any critical abnormalities are detected.

Smart Wearables for the Detection of Cardiovascular Diseases: A Systematic Literature Review

Background: The advancement of information and communication technologies and the growing power of artificial intelligence are successfully transforming a number of concepts that are important to our daily lives. Many sectors, including education, healthcare, industry, and others, are benefiting greatly from the use of such resources. The healthcare sector, for example, was an early adopter of smart wearables, which primarily serve as diagnostic tools. In this context, smart wearables have demonstrated their effectiveness in detecting and predicting cardiovascular diseases (CVDs), the leading cause of death worldwide. Objective: In this study, a systematic literature review of smart wearable applications for cardiovascular disease detection and prediction is presented. After conducting the required search, the documents that met the criteria were analyzed to extract key criteria such as the publication year, vital signs recorded, diseases studied, hardware used, smart models used, datasets used, and performance metrics. Methods: This study followed the PRISMA guidelines by searching IEEE, PubMed, and Scopus for publications published between 2010 and 2022. Once records were located, they were reviewed to determine which ones should be included in the analysis. Finally, the analysis was completed, and the relevant data were included in the review along with the relevant articles. Results: As a result of the comprehensive search procedures, 87 papers were deemed relevant for further review. In addition, the results are discussed to evaluate the development and use of smart wearable devices for cardiovascular disease management, and the results demonstrate the high efficiency of such wearable devices. Conclusions: The results clearly show that interest in this topic has increased. Although the results show that smart wearables are quite accurate in detecting, predicting, and even treating cardiovascular disease, further research is needed to improve their use.

An artificial intelligence-enabled ECG algorithm for identifying ventricular premature contraction during sinus rhythm

Background

Ventricular premature complex (VPC) is a common arrhythmia in clinical practice. VPC could trigger ventricular tachycardia/fibrillation or VPC-induced cardiomyopathy in susceptible patients. Existing screening methods require prolonged monitoring and are limited by cost and low yield when the frequency of VPC is low. Twelve-lead electrocardiogram (ECG) is low cost and widely used. We aimed to identify patients with VPC during normal sinus rhythm (NSR) using artificial intelligence (AI) and machine learning-based ECG reading.

Methods

We developed AI-enabled ECG algorithm using a convolutional neural network (CNN) to detect the ECG signature of VPC presented during NSR using standard 12-lead ECGs. A total of 2515 ECG records from 398 patients with VPC were collected. Among them, only ECG records of NSR without VPC (1617 ECG records) were parsed.

Results

A total of 753 normal ECG records from 387 patients under NSR were used for comparison. Both image and time-series datasets were parsed for the training process by the CNN models. The computer architectures were optimized to select the best model for the training process. Both the single-input image model (InceptionV3, accuracy: 0.895, 95% confidence interval [CI] 0.683–0.937) and multi-input time-series model (ResNet50V2, accuracy: 0.880, 95% CI 0.646–0.943) yielded satisfactory results for VPC prediction, both of which were better than the single-input time-series model (ResNet50V2, accuracy: 0.840, 95% CI 0.629–0.952).

Conclusions

AI-enabled ECG acquired during NSR permits rapid identification at point of care of individuals with VPC and has the potential to predict VPC episodes automatically rather than traditional long-time monitoring.

Technologies for Interoperable Internet of Medical Things Platforms to Manage Medical Emergencies in Home Care and Prehospital Care: Protocol for a Scoping Review (Preprint)

Background

Population growth and aging have highlighted the need for more effective home and prehospital care. Interconnected medical devices and applications, which comprise an infrastructure referred to as the Internet of Medical Things (IoMT), have enabled remote patient monitoring and can be important tools to cope with these demographic changes. However, developing IoMT platforms requires profound knowledge of clinical needs and challenges related to interoperability and how these can be managed with suitable technologies.

Objective

The purpose of this scoping review is to summarize the best practices and technologies to overcome interoperability concerns in IoMT platform development for medical emergencies in home and prehospital care.

Methods

This scoping review will be conducted in accordance with Arksey and O’Malley’s 5-stage framework and adhere to the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols) guidelines. Only peer-reviewed articles published in English will be considered. The databases/web search engines that will be used are IEEE Xplore, PubMed, Scopus, Google Scholar, National Center for Biotechnology Information, SAGE Journals, and ScienceDirect. The search process for relevant literature will be divided into 4 different steps. This will ensure that a suitable approach is followed in terms of search terms, limitations, and eligibility criteria. Relevant articles that meet the inclusion criteria will be screened in 2 stages: abstract and title screening and full-text screening. To reduce selection bias, the screening process will be performed by 2 reviewers.

Results

The results of the preliminary search indicate that there is sufficient literature to form a good foundation for the scoping review. The search was performed in April 2022, and a total of 4579 articles were found. The main clinical focus is the prevention and management of falls, but other medical emergencies, such as heart disease and stroke, are also considered. Preliminary results show that little attention has been given to real-time IoMT platforms that can be deployed in real-world care settings. The final results are expected to be presented in a scoping review in 2023 and will be disseminated through scientific conference presentations, oral presentations, and publication in a peer-reviewed journal.

Conclusions

This scoping review will provide insights and recommendations regarding how interoperable real-time IoMT platforms can be developed to handle medical emergencies in home and prehospital care. The findings of this research could be used by researchers, clinicians, and implementation teams to facilitate future development and interdisciplinary discussions.

International Registered Report Identifier (IRRID)

DERR1-10.2196/40243

XBeats: A Real-Time Electrocardiogram Monitoring and Analysis System

This work presents XBeats, a novel platform for real-time electrocardiogram monitoring and analysis that uses edge computing and machine learning for early anomaly detection. The platform encompasses a data acquisition ECG patch with 12 leads to collect heart signals, perform on-chip processing, and transmit the data to healthcare providers in real-time for further analysis. The ECG patch provides a dynamically configurable selection of the active ECG leads that could be transmitted to the backend monitoring system. The selection ranges from a single ECG lead to a complete 12-lead ECG testing configuration. XBeats implements a lightweight binary classifier for early anomaly detection to reduce the time to action should abnormal heart conditions occur. This initial detection phase is performed on the edge (i.e., the device paired with the patch) and alerts can be configured to notify designated healthcare providers. Further deep analysis can be performed on the full fidelity 12-lead data sent to the backend. A fully functional prototype of the XBeats has been implemented to demonstrate the feasibly and usability of the proposed system. Performance evaluation shows that XBeats can achieve up to 95.30% detection accuracy for abnormal conditions, while maintaining a high data acquisition rate of up to 441 samples per second. Moreover, the analytical results of the energy consumption profile show that the ECG patch provides up to 37 h of continuous 12-lead ECG streaming.

State-of-the-art Deep Learning Methods on Electrocardiogram Data: A Systematic Review (Preprint)

Background

Electrocardiogram (ECG) is one of the most common noninvasive diagnostic tools that can provide useful information regarding a patient’s health status. Deep learning (DL) is an area of intense exploration that leads the way in most attempts to create powerful diagnostic models based on physiological signals.

Objective

This study aimed to provide a systematic review of DL methods applied to ECG data for various clinical applications.

Methods

The PubMed search engine was systematically searched by combining “deep learning” and keywords such as “ecg,” “ekg,” “electrocardiogram,” “electrocardiography,” and “electrocardiology.” Irrelevant articles were excluded from the study after screening titles and abstracts, and the remaining articles were further reviewed. The reasons for article exclusion were manuscripts written in any language other than English, absence of ECG data or DL methods involved in the study, and absence of a quantitative evaluation of the proposed approaches.

Results

We identified 230 relevant articles published between January 2020 and December 2021 and grouped them into 6 distinct medical applications, namely, blood pressure estimation, cardiovascular disease diagnosis, ECG analysis, biometric recognition, sleep analysis, and other clinical analyses. We provide a complete account of the state-of-the-art DL strategies per the field of application, as well as major ECG data sources. We also present open research problems, such as the lack of attempts to address the issue of blood pressure variability in training data sets, and point out potential gaps in the design and implementation of DL models.

Conclusions

We expect that this review will provide insights into state-of-the-art DL methods applied to ECG data and point to future directions for research on DL to create robust models that can assist medical experts in clinical decision-making.

Research Progress of ECG Monitoring Equipment and Algorithms Based on Polymer Materials

Heart diseases such as myocardial ischemia (MI) are the main causes of human death. The prediction of MI and arrhythmia is an effective method for the early detection, diagnosis, and treatment of heart disease. For the rapid detection of arrhythmia and myocardial ischemia, the electrocardiogram (ECG) is widely used in clinical diagnosis, and its detection equipment and algorithm are constantly optimized. This paper introduces the current progress of portable ECG monitoring equipment, including the use of polymer material sensors and the use of deep learning algorithms. First, it introduces the latest portable ECG monitoring equipment and the polymer material sensor it uses and then focuses on reviewing the progress of detection algorithms. We mainly introduce the basic structure of existing deep learning methods and enumerate the internationally recognized ECG datasets. This paper outlines the deep learning algorithms used for ECG diagnosis, compares the prediction results of different classifiers, and summarizes two existing problems of ECG detection technology: imbalance of categories and high computational overhead. Finally, we put forward the development direction of using generative adversarial networks (GAN) to improve the quality of the ECG database and lightweight ECG diagnosis algorithm to adapt to portable ECG monitoring equipment.

Smart Assistive Architecture for the Integration of IoT Devices, Robotic Systems, and Multimodal Interfaces in Healthcare Environments

This paper presents a new architecture that integrates Internet of Things (IoT) devices, service robots, and users in a smart assistive environment. A new intuitive and multimodal interaction system supporting people with disabilities and bedbound patients is presented. This interaction system allows the user to control service robots and devices inside the room in five different ways: touch control, eye control, gesture control, voice control, and augmented reality control. The interaction system is comprised of an assistive robotic arm holding a tablet PC. The robotic arm can place the tablet PC in front of the user. A demonstration of the developed technology, a prototype of a smart room equipped with home automation devices, and the robotic assistive arm are presented. The results obtained from the use of the various interfaces and technologies are presented in the article. The results include user preference with regard to eye-base control (performing clicks, and using winks or gaze) and the use of mobile phones over augmented reality glasses, among others.

Recent Advances in Collaborative Scheduling of Computing Tasks in an Edge Computing Paradigm

In edge computing, edge devices can offload their overloaded computing tasks to an edge server. This can give full play to an edge server’s advantages in computing and storage, and efficiently execute computing tasks. However, if they together offload all the overloaded computing tasks to an edge server, it can be overloaded, thereby resulting in the high processing delay of many computing tasks and unexpectedly high energy consumption. On the other hand, the resources in idle edge devices may be wasted and resource-rich cloud centers may be underutilized. Therefore, it is essential to explore a computing task collaborative scheduling mechanism with an edge server, a cloud center and edge devices according to task characteristics, optimization objectives and system status. It can help one realize efficient collaborative scheduling and precise execution of all computing tasks. This work analyzes and summarizes the edge computing scenarios in an edge computing paradigm. It then classifies the computing tasks in edge computing scenarios. Next, it formulates the optimization problem of computation offloading for an edge computing system. According to the problem formulation, the collaborative scheduling methods of computing tasks are then reviewed. Finally, future research issues for advanced collaborative scheduling in the context of edge computing are indicated.