This paper presents a new approach to detect exudates and optic disc from color fundus images based on inverse surface thresholding. The strategy involves the applications of fuzzy c-means clustering, edge detection, otsu thresholding and inverse surface thresholding. The main advantage of the proposed approach is that it does not depend on manually selected parameters that are normally chosen to suit the tested databases. When applied to two sets of databases the proposed method outperforms a method based on watershed segmentation.
In the recent past, Internet of Things (IoT) plays a significant role in different applications such as health care, industrial sector, defense and research etc.… It provides effective framework in maintaining the security, privacy and reliability of the information in internet environment. Among various applications as mentioned health care place a major role, because security, privacy and reliability of the medical information is maintained in an effective way. Even though, IoT provides the effective protocols for maintaining the information, several intermediate attacks and intruders trying to access the health information which in turn reduce the privacy, security and reliability of the entire health care system in internet environment. As a result and to solve the issues, in this research Learning based Deep-Q-Networks has been introduced for reducing the malware attacks while managing the health information. This method examines the medical information in different layers according to the Q-learning concept which helps to minimize the intermediate attacks with less complexity. The efficiency of the system has been evaluated with the help of experimental results and discussions.
In a computerized image analysis environment, the irregularity of a lesion border has been used to differentiate between malignant melanoma and other pigmented skin lesions. The accuracy of the automated lesion border detection is a significant step towards accurate classification at a later stage. In this paper, we propose the use of a combined Spline and B-spline in order to enhance the quality of dermoscopic images before segmentation. In this paper, morphological operations and median filter were used first to remove noise from the original image during pre-processing. Then we proceeded to adjust image RGB values to the optimal color channel (green channel). The combined Spline and B-spline method was subsequently adopted to enhance the image before segmentation. The lesion segmentation was completed based on threshold value empirically obtained using the optimal color channel. Finally, morphological operations were utilized to merge the smaller regions with the main lesion region. Improvement on the average segmentation accuracy was observed in the experimental results conducted on 70 dermoscopic images. The average accuracy of segmentation achieved in this paper was 97.21 % (where, the average sensitivity and specificity were 94 % and 98.05 % respectively).
The massive number of medical images produced by fluoroscopic and other conventional diagnostic imaging devices demand a considerable amount of space for data storage. This paper proposes an effective method for lossless compression of fluoroscopic images. The main contribution in this paper is the extraction of the regions of interest (ROI) in fluoroscopic images using appropriate shapes. The extracted ROI is then effectively compressed using customized correlation and the combination of Run Length and Huffman coding, to increase compression ratio. The experimental results achieved show that the proposed method is able to improve the compression ratio by 400 % as compared to that of traditional methods.
This paper aims at identifying the factors that would help to diagnose acute myocardial infarction (AMI) using data from an electronic medical record system (EMR) and then generating structure decisions in the form of linguistic fuzzy rules to help predict and understand the outcome of the diagnosis. Since there is a tradeoff in the fuzzy system between the accuracy which measures the capability of the system to predict the diagnosis of AMI and transparency which reflects its ability to describe the symptoms-diagnosis relation in an understandable way, the proposed fuzzy rules are designed in a such a way to find an appropriate balance between these two conflicting modeling objectives using multi-objective genetic algorithms. The main advantage of the generated linguistic fuzzy rules is their ability to describe the relation between the symptoms and the outcome of the diagnosis in an understandable way, close to human thinking and this feature may help doctors to understand the decision process of the fuzzy rules.
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.
Wart disease (WD) is a skin illness on the human body which is caused by the human papillomavirus (HPV). This study mainly concentrates on common and plantar warts. There are various treatment methods for this disease, including the popular immunotherapy and cryotherapy methods. Manual evaluation of the WD treatment response is challenging. Furthermore, traditional machine learning methods are not robust enough in WD classification as they cannot deal effectively with small number of attributes. This study proposes a new evolutionary-based computer-aided diagnosis (CAD) system using machine learning to classify the WD treatment response. The main architecture of our CAD system is based on the combination of improved adaptive particle swarm optimization (IAPSO) algorithm and artificial immune recognition system (AIRS). The cross-validation protocol was applied to test our machine learning-based classification system, including five different partition protocols (K2, K3, K4, K5 and K10). Our database consisted of 180 records taken from immunotherapy and cryotherapy databases. The best results were obtained using the K10 protocol that provided the precision, recall, F-measure and accuracy values of 0.8908, 0.8943, 0.8916 and 90%, respectively. Our IAPSO system showed the reliability of 98.68%. It was implemented in Java, while integrated development environment (IDE) was implemented using NetBeans. Our encouraging results suggest that the proposed IAPSO-AIRS system can be employed for the WD management in clinical environment.
Content-based image retrieval techniques have been extensively studied for the past few years. With the growth of digital medical image databases, the demand for content-based analysis and retrieval tools has been increasing remarkably. Blood cell image is a key diagnostic tool for hematologists. An automated system that can retrieved relevant blood cell images correctly and efficiently would save the effort and time of hematologists. The purpose of this work is to develop such a content-based image retrieval system. Global color histogram and wavelet-based methods are used in the prototype. The system allows users to search by providing a query image and select one of four implemented methods. The obtained results demonstrate the proposed extended query refinement has the potential to capture a user's high level query and perception subjectivity by dynamically giving better query combinations. Color-based methods performed better than wavelet-based methods with regard to precision, recall rate and retrieval time. Shape and density of blood cells are suggested as measurements for future improvement. The system developed is useful for undergraduate education.
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.
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.
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 medical systems for patient's authentication, keeping biometric data secure is a general problem. Many studies have presented various ways of protecting biometric data especially finger vein biometric data. Thus, It is needs to find better ways of securing this data by applying the three principles of information security aforementioned, and creating a robust verification system with high levels of reliability, privacy and security. Moreover, it is very difficult to replace biometric information and any leakage of biometrics information leads to earnest risks for example replay attacks using the robbed biometric data. In this paper presented criticism and analysis to all attempts as revealed in the literature review and discussion the proposes a novel verification secure framework based confidentiality, integrity and availability (CIA) standard in triplex blockchain-particle swarm optimization (PSO)-advanced encryption standard (AES) techniques for medical systems patient's authentication. Three stages are performed on discussion. Firstly, proposes a new hybrid model pattern in order to increase the randomization based on radio frequency identification (RFID) and finger vein biometrics. To achieve this, proposed a new merge algorithm to combine the RFID features and finger vein features in one hybrid and random pattern. Secondly, how the propose verification secure framework are followed the CIA standard for telemedicine authentication by combination of AES encryption technique, blockchain and PSO in steganography technique based on proposed pattern model. Finally, discussed the validation and evaluation of the proposed verification secure framework.
This paper aims to assist the administration departments of medical organisations in making the right decision on selecting a suitable multiclass classification model for acute leukaemia. In this paper, we proposed a framework that will aid these departments in evaluating, benchmarking and ranking available multiclass classification models for the selection of the best one. Medical organisations have continuously faced evaluation and benchmarking challenges in such endeavour, especially when no single model is superior. Moreover, the improper selection of multiclass classification for acute leukaemia model may be costly for medical organisations. For example, when a patient dies, one such organisation will be legally or financially sued for incidents in which the model fails to fulfil its desired outcome. With regard to evaluation and benchmarking, multiclass classification models are challenging processes due to multiple evaluation and conflicting criteria. This study structured a decision matrix (DM) based on the crossover of 2 groups of multi-evaluation criteria and 22 multiclass classification models. The matrix was then evaluated with datasets comprising 72 samples of acute leukaemia, which include 5327 gens. Subsequently, multi-criteria decision-making (MCDM) techniques are used in the benchmarking and ranking of multiclass classification models. The MCDM used techniques that include the integrated BWM and VIKOR. BWM has been applied for the weight calculations of evaluation criteria, whereas VIKOR has been used to benchmark and rank classification models. VIKOR has also been employed in two decision-making contexts: individual and group decision making and internal and external group aggregation. Results showed the following: (1) the integration of BWM and VIKOR is effective at solving the benchmarking/selection problems of multiclass classification models. (2) The ranks of classification models obtained from internal and external VIKOR group decision making were almost the same, and the best multiclass classification model based on the two was 'Bayes. Naive Byes Updateable' and the worst one was 'Trees.LMT'. (3) Among the scores of groups in the objective validation, significant differences were identified, which indicated that the ranking results of internal and external VIKOR group decision making were valid.
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 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.
Voice disorders are associated with irregular vibrations of vocal folds. Based on the source filter theory of speech production, these irregular vibrations can be detected in a non-invasive way by analyzing the speech signal. In this paper we present a multiband approach for the detection of voice disorders given that the voice source generally interacts with the vocal tract in a non-linear way. In normal phonation, and assuming sustained phonation of a vowel, the lower frequencies of speech are heavily source dependent due to the low frequency glottal formant, while the higher frequencies are less dependent on the source signal. During abnormal phonation, this is still a valid, but turbulent noise of source, because of the irregular vibration, affects also higher frequencies. Motivated by such a model, we suggest a multiband approach based on a three-level discrete wavelet transformation (DWT) and in each band the fractal dimension (FD) of the estimated power spectrum is estimated. The experiments suggest that frequency band 1-1562 Hz, lower frequencies after level 3, exhibits a significant difference in the spectrum of a normal and pathological subject. With this band, a detection rate of 91.28 % is obtained with one feature, and the obtained result is higher than all other frequency bands. Moreover, an accuracy of 92.45 % and an area under receiver operating characteristic curve (AUC) of 95.06 % is acquired when the FD of all levels is fused. Likewise, when the FD of all levels is combined with 22 Multi-Dimensional Voice Program (MDVP) parameters, an improvement of 2.26 % in accuracy and 1.45 % in AUC is observed.
This study focuses on the situation of health information exchange (HIE) in the context of a nationwide network. It aims to create a security framework that can be implemented to ensure the safe transmission of health information across the boundaries of care providers in Malaysia and other countries. First, a critique of the major elements of nationwide health information networks is presented from the perspective of security, along with such topics as the importance of HIE, issues, and main approaches. Second, a systematic evaluation is conducted on the security solutions that can be utilized in the proposed nationwide network. Finally, a secure framework for health information transmission is proposed within a central cloud-based model, which is compatible with the Malaysian telehealth strategy. The outcome of this analysis indicates that a complete security framework for a global structure of HIE is yet to be defined and implemented. Our proposed framework represents such an endeavor and suggests specific techniques to achieve this goal.
The growing worldwide population has increased the need for technologies, computerised software algorithms and smart devices that can monitor and assist patients anytime and anywhere and thus enable them to lead independent lives. The real-time remote monitoring of patients is an important issue in telemedicine. In the provision of healthcare services, patient prioritisation poses a significant challenge because of the complex decision-making process it involves when patients are considered 'big data'. To our knowledge, no study has highlighted the link between 'big data' characteristics and real-time remote healthcare monitoring in the patient prioritisation process, as well as the inherent challenges involved. Thus, we present comprehensive insights into the elements of big data characteristics according to the six 'Vs': volume, velocity, variety, veracity, value and variability. Each of these elements is presented and connected to a related part in the study of the connection between patient prioritisation and real-time remote healthcare monitoring systems. Then, we determine the weak points and recommend solutions as potential future work. This study makes the following contributions. (1) The link between big data characteristics and real-time remote healthcare monitoring in the patient prioritisation process is described. (2) The open issues and challenges for big data used in the patient prioritisation process are emphasised. (3) As a recommended solution, decision making using multiple criteria, such as vital signs and chief complaints, is utilised to prioritise the big data of patients with chronic diseases on the basis of the most urgent cases.
This study presents a systematic literature review of access control for electronic health record systems to protect patient's privacy. Articles from 2006 to 2016 were extracted from the ACM Digital Library, IEEE Xplore Digital Library, Science Direct, MEDLINE, and MetaPress using broad eligibility criteria, and chosen for inclusion based on analysis of ISO22600. Cryptographic standards and methods were left outside the scope of this review. Three broad classes of models are being actively investigated and developed: access control for electronic health records, access control for interoperability, and access control for risk analysis. Traditional role-based access control models are extended with spatial, temporal, probabilistic, dynamic, and semantic aspects to capture contextual information and provide granular access control. Maintenance of audit trails and facilities for overriding normal roles to allow full access in emergency cases are common features. Access privilege frameworks utilizing ontology-based knowledge representation for defining the rules have attracted considerable interest, due to the higher level of abstraction that makes it possible to model domain knowledge and validate access requests efficiently.
An improved genetic algorithm procedure is introduced in this work based on the theory of the most highly fit parents (both male and female) are most likely to produce healthiest offspring. It avoids the destruction of near optimal information and promotes further search around the potential region by encouraging the exchange of highly important information among the fittest solution. A novel crossover technique called Segmented Multi-chromosome Crossover is also introduced. It maintains the information contained in gene segments and allows offspring to inherit information from multiple parent chromosomes. The improved GA is applied for the automatic and simultaneous parameter optimization and feature selection of multi-layer perceptron network in medical disease diagnosis. Compared to the previous works, the average accuracy of the proposed algorithm is the best among all algorithms for diabetes and heart dataset, and the second best for cancer dataset.