One of the major issues in time-critical medical applications using wireless technology is the size of the payload packet, which is generally designed to be very small to improve the transmission process. Using small packets to transmit continuous ECG data is still costly. Thus, data compression is commonly used to reduce the huge amount of ECG data transmitted through telecardiology devices. In this paper, a new ECG compression scheme is introduced to ensure that the compressed ECG segments fit into the available limited payload packets, while maintaining a fixed CR to preserve the diagnostic information. The scheme automatically divides the ECG block into segments, while maintaining other compression parameters fixed. This scheme adopts discrete wavelet transform (DWT) method to decompose the ECG data, bit-field preserving (BFP) method to preserve the quality of the DWT coefficients, and a modified running-length encoding (RLE) scheme to encode the coefficients. The proposed dynamic compression scheme showed promising results with a percentage packet reduction (PR) of about 85.39% at low percentage root-mean square difference (PRD) values, less than 1%. ECG records from MIT-BIH Arrhythmia Database were used to test the proposed method. The simulation results showed promising performance that satisfies the needs of portable telecardiology systems, like the limited payload size and low power consumption.
This paper presents the results obtained for medical image compression using autoencoder neural networks. Since mammograms (medical images) are usually of big sizes, training of autoencoders becomes extremely tedious and difficult if the whole image is used for training. We show in this paper that the autoencoders can be trained successfully by using image patches instead of the whole image. The compression performances of different types of autoencoders are compared based on two parameters, namely mean square error and structural similarity index. It is found from the experimental results that the autoencoder which does not use Restricted Boltzmann Machine pre-training yields better results than those which use this pre-training method.
The aim of this study was to explore the importance of service need along with perceived technology attributes in potentially influence the acceptance of teleconsultation. The study was conducted based on the concurrent triangulation design involving qualitative and quantitative study methods. These entailed interviews with key informants and questionnaires survey of health care providers who practiced in the participating hospitals in Malaysia. Thematic analysis involving iterative coding was conducted on qualitative data. Scale reliability test and hypothesis testing procedures were performed on quantitative data. Subsequently, both data were merged, compared and interpreted. In particular, this study utilized a qualitative priority such that a superior emphasis was placed on the qualitative method to demonstrate an overall understanding. Based on the responses of 20 key informants, there was a significant need for teleconsultation as a tool to extend health services to patients under constrained resources and critical conditions. Apparently, the latest attributes of teleconsultation technology have generally met users' expectation but rather perceived as supportive facets in encouraging the usage. Concurrently, based on the survey engaging 72 health care providers, teleconsultation acceptance was statistically proven to be strongly associated with service need and not originated exclusively from the technological attributes. Additionally, the results of this study can be used to promote teleconsultation as an effective means in delivering better health services. Thus, the categories emerged from this study may be further revised and examined for explaining the acceptance of teleconsultation technology in other relevant contexts.
Tumor budding is defined as the presence of single tumor cells or small tumor clusters (less than five cells) that 'bud' from the invasive front of the main tumor. Tumor budding (TB) has recently emerged as an important adverse prognostic factor for many different cancer types. In colorectal carcinoma (CRC), tumor budding has been independently associated with lymph node metastasis and poor outcome. Pathologic assessment of tumor budding by light microscopy requires close evaluation of tumor invasive front on intermediate to high power magnification, entailing locating the 'hotspot' of tumor budding, counting all TB in one high power field, and generating a tumor budding score. By automating these time-consuming tasks, computer-assisted image analysis tools can be helpful for daily pathology practice, since tumor budding reporting is now recommended on select cases. In this paper, we report our work on the development of a tumor budding detection system in CRC from whole-slide Cytokeratin AE1/3 images, based on de novo computer algorithm that automates morphometric analysis of tumor budding.
Recently, Wireless Body Area Network (WBAN) has witnessed significant attentions in research and product development due to the growing number of sensor-based applications in healthcare domain. Design of efficient and effective Medium Access Control (MAC) protocol is one of the fundamental research themes in WBAN. Static on-demand slot allocation to patient data is the main approach adopted in the design of MAC protocol in literature, without considering the type of patient data specifically the level of severity on patient data. This leads to the degradation of the performance of MAC protocols considering effectiveness and traffic adjustability in realistic medical environments. In this context, this paper proposes a Traffic Priority-Aware MAC (TraPy-MAC) protocol for WBAN. It classifies patient data into emergency and non-emergency categories based on the severity of patient data. The threshold value aided classification considers a number of parameters including type of sensor, body placement location, and data transmission time for allocating dedicated slots patient data. Emergency data are not required to carry out contention and slots are allocated by giving the due importance to threshold value of vital sign data. The contention for slots is made efficient in case of non-emergency data considering threshold value in slot allocation. Moreover, the slot allocation to emergency and non-emergency data are performed parallel resulting in performance gain in channel assignment. Two algorithms namely, Detection of Severity on Vital Sign data (DSVS), and ETS Slots allocation based on the Severity on Vital Sign (ETS-SVS) are developed for calculating threshold value and resolving the conflicts of channel assignment, respectively. Simulations are performed in ns2 and results are compared with the state-of-the-art MAC techniques. Analysis of results attests the benefit of TraPy-MAC in comparison with the state-of-the-art MAC in channel assignment in realistic medical environments.
This paper proposes a robotic Transesophageal Echocardiography (TOE) system concept for Catheterization Laboratories. Cardiovascular disease causes one third of all global mortality. TOE is utilized to assess cardiovascular structures and monitor cardiac function during diagnostic procedures and catheter-based structural interventions. However, the operation of TOE underlies various conditions that may cause a negative impact on performance, the health of the cardiac sonographer and patient safety. These factors have been conflated and evince the potential of robot-assisted TOE. Hence, a careful integration of clinical experience and Systems Engineering methods was used to develop a concept and physical model for TOE manipulation. The motion of different actuators of the fabricated motorized system has been tested. It is concluded that the developed medical system, counteracting conflated disadvantages, represents a progressive approach for cardiac healthcare.
The security effectiveness based on users' behaviors is becoming a top priority of Health Information System (HIS). In the first step of this study, through the review of previous studies 'Self-efficacy in Information Security' (SEIS) and 'Security Competency' (SCMP) were identified as the important factors to transforming HIS users to the first line of defense in the security. Subsequently, a conceptual model was proposed taking into mentioned factors for HIS security effectiveness. Then, this quantitative study used the structural equation modeling to examine the proposed model based on survey data collected from a sample of 263 HIS users from eight hospitals in Iran. The result shows that SEIS is one of the important factors to cultivate of good end users' behaviors toward HIS security effectiveness. However SCMP appears a feasible alternative to providing SEIS. This study also confirms the mediation effects of SEIS on the relationship between SCMP and HIS security effectiveness. The results of this research paper can be used by HIS and IT managers to implement their information security process more effectively.
This study aims to systematically review prior research on the evaluation and benchmarking of automated acute leukaemia classification tasks. The review depends on three reliable search engines: ScienceDirect, Web of Science and IEEE Xplore. A research taxonomy developed for the review considers a wide perspective for automated detection and classification of acute leukaemia research and reflects the usage trends in the evaluation criteria in this field. The developed taxonomy consists of three main research directions in this domain. The taxonomy involves two phases. The first phase includes all three research directions. The second one demonstrates all the criteria used for evaluating acute leukaemia classification. The final set of studies includes 83 investigations, most of which focused on enhancing the accuracy and performance of detection and classification through proposed methods or systems. Few efforts were made to undertake the evaluation issues. According to the final set of articles, three groups of articles represented the main research directions in this domain: 56 articles highlighted the proposed methods, 22 articles involved proposals for system development and 5 papers centred on evaluation and comparison. The other taxonomy side included 16 main and sub-evaluation and benchmarking criteria. This review highlights three serious issues in the evaluation and benchmarking of multiclass classification of acute leukaemia, namely, conflicting criteria, evaluation criteria and criteria importance. It also determines the weakness of benchmarking tools. To solve these issues, multicriteria decision-making (MCDM) analysis techniques were proposed as effective recommended solutions in the methodological aspect. This methodological aspect involves a proposed decision support system based on MCDM for evaluation and benchmarking to select suitable multiclass classification models for acute leukaemia. The said support system is examined and has three sequential phases. Phase One presents the identification procedure and process for establishing a decision matrix based on a crossover of evaluation criteria and acute leukaemia multiclass classification models. Phase Two describes the decision matrix development for the selection of acute leukaemia classification models based on the integrated Best and worst method (BWM) and VIKOR. Phase Three entails the validation of the proposed system.
The new and ground-breaking real-time remote monitoring in triage and priority-based sensor technology used in telemedicine have significantly bounded and dispersed communication components. To examine these technologies and provide researchers with a clear vision of this area, we must first be aware of the utilised approaches and existing limitations in this line of research. To this end, an extensive search was conducted to find articles dealing with (a) telemedicine, (b) triage, (c) priority and (d) sensor; (e) comprehensively review related applications and establish the coherent taxonomy of these articles. ScienceDirect, IEEE Xplore and Web of Science databases were checked for articles on triage and priority-based sensor technology in telemedicine. The retrieved articles were filtered according to the type of telemedicine technology explored. A total of 150 articles were selected and classified into two categories. The first category includes reviews and surveys of triage and priority-based sensor technology in telemedicine. The second category includes articles on the three-tiered architecture of telemedicine. Tier 1 represents the users. Sensors acquire the vital signs of the users and send them to Tier 2, which is the personal gateway that uses local area network protocols or wireless body area network. Medical data are sent from Tier 2 to Tier 3, which is the healthcare provider in medical institutes. Then, the motivation for using triage and priority-based sensor technology in telemedicine, the issues related to the obstruction of its application and the development and utilisation of telemedicine are examined on the basis of the findings presented in the literature.
The main obstacles in mass adoption of cloud computing for database operations in healthcare organization are the data security and privacy issues. In this paper, it is shown that IT services particularly in hardware performance evaluation in virtual machine can be accomplished effectively without IT personnel gaining access to actual data for diagnostic and remediation purposes. The proposed mechanisms utilized the hypothetical data from TPC-H benchmark, to achieve 2 objectives. First, the underlying hardware performance and consistency is monitored via a control system, which is constructed using TPC-H queries. Second, the mechanism to construct stress-testing scenario is envisaged in the host, using a single or combination of TPC-H queries, so that the resource threshold point can be verified, if the virtual machine is still capable of serving critical transactions at this constraining juncture. This threshold point uses server run queue size as input parameter, and it serves 2 purposes: It provides the boundary threshold to the control system, so that periodic learning of the synthetic data sets for performance evaluation does not reach the host's constraint level. Secondly, when the host undergoes hardware change, stress-testing scenarios are simulated in the host by loading up to this resource threshold level, for subsequent response time verification from real and critical transactions.
The Internet of Things (IoT) has been identified in various applications across different domains, such as in the healthcare sector. IoT has also been recognised for its revolution in reshaping modern healthcare with aspiring wide range prospects, including economical, technological and social. This study aims to establish IoT-based smart home security solutions for real-time health monitoring technologies in telemedicine architecture. A multilayer taxonomy is driven and conducted in this study. In the first layer, a comprehensive analysis on telemedicine, which focuses on the client and server sides, shows that other studies associated with IoT-based smart home applications have several limitations that remain unaddressed. Particularly, remote patient monitoring in healthcare applications presents various facilities and benefits by adopting IoT-based smart home technologies without compromising the security requirements and potentially large number of risks. An extensive search is conducted to identify articles that handle these issues, related applications are comprehensively reviewed and a coherent taxonomy for these articles is established. A total number of (n = 3064) are gathered between 2007 and 2017 for most reliable databases, such as ScienceDirect, Web of Science and Institute of Electrical and Electronic Engineer Xplore databases. Then, the articles based on IoT studies that are associated with telemedicine applications are filtered. Nine articles are selected and classified into two categories. The first category, which accounts for 22.22% (n = 2/9), includes surveys on telemedicine articles and their applications. The second category, which accounts for 77.78% (n = 7/9), includes articles on the client and server sides of telemedicine architecture. The collected studies reveal the essential requirement in constructing another taxonomy layer and review IoT-based smart home security studies. Therefore, IoT-based smart home security features are introduced and analysed in the second layer. The security of smart home design based on IoT applications is an aspect that represents a crucial matter for general occupants of smart homes, in which studies are required to provide a better solution with patient security, privacy protection and security of users' entities from being stolen or compromised. Innovative technologies have dispersed limitations related to this matter. The existing gaps and trends in this area should be investigated to provide valuable visions for technical environments and researchers. Thus, 67 articles are obtained in the second layer of our taxonomy and are classified into six categories. In the first category, 25.37% (n = 17/67) of the articles focus on architecture design. In the second category, 17.91% (n = 12/67) includes security analysis articles that investigate the research status in the security area of IoT-based smart home applications. In the third category, 10.44% (n = 7/67) includes articles about security schemes. In the fourth category, 17.91% (n = 12/67) comprises security examination. In the fifth category, 13.43% (n = 9/67) analyses security protocols. In the final category, 14.92% (n = 10/67) analyses the security framework. Then, the identified basic characteristics of this emerging field are presented and provided in the following aspects. Open challenges experienced on the development of IoT-based smart home security are addressed to be adopted fully in telemedicine applications. Then, the requirements are provided to increase researcher's interest in this study area. On this basis, a number of recommendations for different parties are described to provide insights on the next steps that should be considered to enhance the security of smart homes based on IoT. A map matching for both taxonomies is developed in this study to determine the novel risks and benefits of IoT-based smart home security for real-time remote health monitoring within client and server sides in telemedicine applications.
A novel technique to quantify the signal-to-noise ratio (SNR) of magnetic resonance images is developed. The image SNR is quantified by estimating the amplitude of the signal spectrum using the autocorrelation function of just one single magnetic resonance image. To test the performance of the quantification, SNR measurement data are fitted to theoretically expected curves. It is shown that the technique can be implemented in a highly efficient way for the magnetic resonance imaging system.
The new and groundbreaking real-time remote healthcare monitoring system on sensor-based mobile health (mHealth) authentication in telemedicine has considerably bounded and dispersed communication components. mHealth, an attractive part in telemedicine architecture, plays an imperative role in patient security and privacy and adapts different sensing technologies through many built-in sensors. This study aims to improve sensor-based defence and attack mechanisms to ensure patient privacy in client side when using mHealth. Thus, a multilayer taxonomy was conducted to attain the goal of this study. Within the first layer, real-time remote monitoring studies based on sensor technology for telemedicine application were reviewed and analysed to examine these technologies and provide researchers with a clear vision of security- and privacy-based sensors in the telemedicine area. An extensive search was conducted to find articles about security and privacy issues, review related applications comprehensively and establish the coherent taxonomy of these articles. ScienceDirect, IEEE Xplore and Web of Science databases were investigated for articles on mHealth in telemedicine-based sensor. A total of 3064 papers were collected from 2007 to 2017. The retrieved articles were filtered according to the security and privacy of sensor-based telemedicine applications. A total of 19 articles were selected and classified into two categories. The first category, 57.89% (n = 11/19), included survey on telemedicine articles and their applications. The second category, 42.1% (n = 8/19), included articles contributed to the three-tiered architecture of telemedicine. The collected studies improved the essential need to add another taxonomy layer and review the sensor-based smartphone authentication studies. This map matching for both taxonomies was developed for this study to investigate sensor field comprehensively and gain access to novel risks and benefits of the mHealth security in telemedicine application. The literature on sensor-based smartphones in the second layer of our taxonomy was analysed and reviewed. A total of 599 papers were collected from 2007 to 2017. In this layer, we obtained a final set of 81 articles classified into three categories. The first category of the articles [86.41% (n = 70/81)], where sensor-based smartphones were examined by utilising orientation sensors for user authentication, was used. The second category [7.40% (n = 6/81)] included attack articles, which were not intensively included in our literature analysis. The third category [8.64% (n = 7/81)] included 'other' articles. Factors were considered to understand fully the various contextual aspects of the field in published studies. The characteristics included the motivation and challenges related to sensor-based authentication of smartphones encountered by researchers and the recommendations to strengthen this critical area of research. Finally, many studies on the sensor-based smartphone in the second layer have focused on enhancing accurate authentication because sensor-based smartphones require sensors that could authentically secure mHealth.
Many authentication schemes have been proposed for telecare medicine information systems (TMIS) to ensure the privacy, integrity, and availability of patient records. These schemes are crucial for TMIS systems because otherwise patients' medical records become susceptible to tampering thus hampering diagnosis or private medical conditions of patients could be disclosed to parties who do not have a right to access such information. Very recently, Hao et al. proposed a chaotic map-based authentication scheme for telecare medicine information systems in a recent issue of Journal of Medical Systems. They claimed that the authentication scheme can withstand various attacks and it is secure to be used in TMIS. In this paper, we show that this authentication scheme is vulnerable to key-compromise impersonation attacks, off-line password guessing attacks upon compromising of a smart card, and parallel session attacks. We also exploit weaknesses in the password change phase of the scheme to mount a denial-of-service attack. Our results show that this scheme cannot be used to provide security in a telecare medicine information system.
The increasing demand for Android mobile devices and blockchain has motivated malware creators to develop mobile malware to compromise the blockchain. Although the blockchain is secure, attackers have managed to gain access into the blockchain as legal users, thereby comprising important and crucial information. Examples of mobile malware include root exploit, botnets, and Trojans and root exploit is one of the most dangerous malware. It compromises the operating system kernel in order to gain root privileges which are then used by attackers to bypass the security mechanisms, to gain complete control of the operating system, to install other possible types of malware to the devices, and finally, to steal victims' private keys linked to the blockchain. For the purpose of maximizing the security of the blockchain-based medical data management (BMDM), it is crucial to investigate the novel features and approaches contained in root exploit malware. This study proposes to use the bio-inspired method of practical swarm optimization (PSO) which automatically select the exclusive features that contain the novel android debug bridge (ADB). This study also adopts boosting (adaboost, realadaboost, logitboost, and multiboost) to enhance the machine learning prediction that detects unknown root exploit, and scrutinized three categories of features including (1) system command, (2) directory path and (3) code-based. The evaluation gathered from this study suggests a marked accuracy value of 93% with Logitboost in the simulation. Logitboost also helped to predicted all the root exploit samples in our developed system, the root exploit detection system (RODS).
Coronaviruses (CoVs) are a large family of viruses that are common in many animal species, including camels, cattle, cats and bats. Animal CoVs, such as Middle East respiratory syndrome-CoV, severe acute respiratory syndrome (SARS)-CoV, and the new virus named SARS-CoV-2, rarely infect and spread among humans. On January 30, 2020, the International Health Regulations Emergency Committee of the World Health Organisation declared the outbreak of the resulting disease from this new CoV called 'COVID-19', as a 'public health emergency of international concern'. This global pandemic has affected almost the whole planet and caused the death of more than 315,131 patients as of the date of this article. In this context, publishers, journals and researchers are urged to research different domains and stop the spread of this deadly virus. The increasing interest in developing artificial intelligence (AI) applications has addressed several medical problems. However, such applications remain insufficient given the high potential threat posed by this virus to global public health. This systematic review addresses automated AI applications based on data mining and machine learning (ML) algorithms for detecting and diagnosing COVID-19. We aimed to obtain an overview of this critical virus, address the limitations of utilising data mining and ML algorithms, and provide the health sector with the benefits of this technique. We used five databases, namely, IEEE Xplore, Web of Science, PubMed, ScienceDirect and Scopus and performed three sequences of search queries between 2010 and 2020. Accurate exclusion criteria and selection strategy were applied to screen the obtained 1305 articles. Only eight articles were fully evaluated and included in this review, and this number only emphasised the insufficiency of research in this important area. After analysing all included studies, the results were distributed following the year of publication and the commonly used data mining and ML algorithms. The results found in all papers were discussed to find the gaps in all reviewed papers. Characteristics, such as motivations, challenges, limitations, recommendations, case studies, and features and classes used, were analysed in detail. This study reviewed the state-of-the-art techniques for CoV prediction algorithms based on data mining and ML assessment. The reliability and acceptability of extracted information and datasets from implemented technologies in the literature were considered. Findings showed that researchers must proceed with insights they gain, focus on identifying solutions for CoV problems, and introduce new improvements. The growing emphasis on data mining and ML techniques in medical fields can provide the right environment for change and improvement.
Remotely monitoring a patient's condition is a serious issue and must be addressed. Remote health monitoring systems (RHMS) in telemedicine refers to resources, strategies, methods and installations that enable doctors or other medical professionals to work remotely to consult, diagnose and treat patients. The goal of RHMS is to provide timely medical services at remote areas through telecommunication technologies. Through major advancements in technology, particularly in wireless networking, cloud computing and data storage, RHMS is becoming a feasible aspect of modern medicine. RHMS for the prioritisation of patients with multiple chronic diseases (MCDs) plays an important role in sustainably providing high-quality healthcare services. Further investigations are required to highlight the limitations of the prioritisation of patients with MCDs over a telemedicine environment. This study introduces a comprehensive and inclusive review on the prioritisation of patients with MCDs in telemedicine applications. Furthermore, it presents the challenges and open issues regarding patient prioritisation in telemedicine. The findings of this study are as follows: (1) The limitations and problems of existing patients' prioritisation with MCDs are presented and emphasised. (2) Based on the analysis of the academic literature, an accurate solution for remote prioritisation in a large scale of patients with MCDs was not presented. (3) There is an essential need to produce a new multiple-criteria decision-making theory to address the current problems in the prioritisation of patients with MCDs.
Promoting patient care is a priority for all healthcare providers with the overall purpose of realising a high degree of patient satisfaction. A medical centre server is a remote computer that enables hospitals and physicians to analyse data in real time and offer appropriate services to patients. The server can also manage, organise and support professionals in telemedicine. Therefore, a remote medical centre server plays a crucial role in sustainably delivering quality healthcare services in telemedicine. This article presents a comprehensive review of the provision of healthcare services in telemedicine applications, especially in the medical centre server. Moreover, it highlights the open issues and challenges related to providing healthcare services in the medical centre server within telemedicine. Methodological aspects to control and manage the process of healthcare service provision and three distinct and successive phases are presented. The first phase presents the identification process to propose a decision matrix (DM) on the basis of a crossover of 'multi-healthcare services' and 'hospital list' within intelligent data and service management centre (Tier 4). The second phase discusses the development of a DM for hospital selection on the basis of integrated VIKOR-Analytic Hierarchy Process (AHP) methods. Finally, the last phase examines the validation process for the proposed framework.
The development of wireless body area sensor networks is imperative for modern telemedicine. However, attackers and cybercriminals are gradually becoming aware in attacking telemedicine systems, and the black market value of protected health information has the highest price nowadays. Security remains a formidable challenge to be resolved. Intelligent home environments make up one of the major application areas of pervasive computing. Security and privacy are the two most important issues in the remote monitoring and control of intelligent home environments for clients and servers in telemedicine architecture. The personal authentication approach that uses the finger vein pattern is a newly investigated biometric technique. This type of biometric has many advantages over other types (explained in detail later on) and is suitable for different human categories and ages. This study aims to establish a secure verification method for real-time monitoring systems to be used for the authentication of patients and other members who are working in telemedicine systems. The process begins with the sensor based on Tiers 1 and 2 (client side) in the telemedicine architecture and ends with patient verification in Tier 3 (server side) via finger vein biometric technology to ensure patient security on both sides. Multilayer taxonomy is conducted in this research to attain the study's goal. In the first layer, real-time remote monitoring studies based on the sensor technology used in telemedicine applications are reviewed and analysed to provide researchers a clear vision of security and privacy based on sensors in telemedicine. An extensive search is conducted to identify articles that deal with security and privacy issues, related applications are reviewed comprehensively and a coherent taxonomy of these articles is established. ScienceDirect, IEEE Xplore and Web of Science databases are checked for articles on mHealth in telemedicine based on sensors. A total of 3064 papers are collected from 2007 to 2017. The retrieved articles are filtered according to the security and privacy of telemedicine applications based on sensors. Nineteen articles are selected and classified into two categories. The first category, which accounts for 57.89% (n = 11/19), includes surveys on telemedicine articles and their applications. The second category, accounting for 42.1% (n = 8/19), includes articles on the three-tiered architecture of telemedicine. The collected studies reveal the essential need to construct another taxonomy layer and review studies on finger vein biometric verification systems. This map-matching for both taxonomies is developed for this study to go deeply into the sensor field and determine novel risks and benefits for patient security and privacy on client and server sides in telemedicine applications. In the second layer of our taxonomy, the literature on finger vein biometric verification systems is analysed and reviewed. In this layer, we obtain a final set of 65 articles classified into four categories. In the first category, 80% (n = 52/65) of the articles focus on development and design. In the second category, 12.30% (n = 8/65) includes evaluation and comparative articles. These articles are not intensively included in our literature analysis. In the third category, 4.61% (n = 3/65) includes articles about analytical studies. In the fourth category, 3.07% (n = 2/65) comprises reviews and surveys. This study aims to provide researchers with an up-to-date overview of studies that have been conducted on (user/patient) authentication to enhance the security level in telemedicine or any information system. In the current study, taxonomy is presented by explaining previous studies. Moreover, this review highlights the motivations, challenges and recommendations related to finger vein biometric verification systems and determines the gaps in this research direction (protection of finger vein templates in real time), which represent a new research direction in this area.
In real-time medical systems, the role of biometric technology is significant in authentication systems because it is used in verifying the identity of people through their biometric features. The biometric technology provides crucial properties for biometric features that can support the process of personal identification. The storage of biometric template within a central database makes it vulnerable to attack which can also occur during data transmission. Therefore, an alternative mechanism of protection becomes important to develop. On this basis, this study focuses on providing a detailed analysis of the extant literature (2013-2018) to identify the taxonomy and research distribution. Furthermore, this study also seeks to ascertain the challenges and motivations associated with biometric steganography in real-time medical systems to provide recommendations that can enhance the efficient use of real-time medical systems in biometric steganography and its applications. A review of articles on human biometric steganography in real-time medical systems obtained from three main databases (IEEE Xplore, ScienceDirect and Web of Science) is conducted according to an appropriate review protocol. Then, 41 related articles are selected by using exclusion and inclusion criteria. Majority of the studies reviewed had been conducted in the field of data-hiding (particularly steganography) technologies. In this review, various steganographic methods that have been applied in different human biometrics are investigated. Thereafter, these methods are categorised according to taxonomy, and the results are presented on the basis of human steganography biometric real-time medical systems, testing and evaluation methods, significance of use and applications and techniques. Finally, recommendations on how the challenges associated with data hiding can be addressed are provided to enhance the efficiency of using biometric information processed in any authentication real-time medical system. These recommendations are expected to be immensely helpful to developers, company users and researchers.