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  1. Mohktar MS, Redmond SJ, Antoniades NC, Rochford PD, Pretto JJ, Basilakis J, et al.
    Artif Intell Med, 2015 Jan;63(1):51-9.
    PMID: 25704112 DOI: 10.1016/j.artmed.2014.12.003
    BACKGROUND: The use of telehealth technologies to remotely monitor patients suffering chronic diseases may enable preemptive treatment of worsening health conditions before a significant deterioration in the subject's health status occurs, requiring hospital admission.
    OBJECTIVE: The objective of this study was to develop and validate a classification algorithm for the early identification of patients, with a background of chronic obstructive pulmonary disease (COPD), who appear to be at high risk of an imminent exacerbation event. The algorithm attempts to predict the patient's condition one day in advance, based on a comparison of their current physiological measurements against the distribution of their measurements over the previous month.
    METHOD: The proposed algorithm, which uses a classification and regression tree (CART), has been validated using telehealth measurement data recorded from patients with moderate/severe COPD living at home. The data were collected from February 2007 to January 2008, using a telehealth home monitoring unit.
    RESULTS: The CART algorithm can classify home telehealth measurement data into either a 'low risk' or 'high risk' category with 71.8% accuracy, 80.4% specificity and 61.1% sensitivity. The algorithm was able to detect a 'high risk' condition one day prior to patients actually being observed as having a worsening in their COPD condition, as defined by symptom and medication records.
    CONCLUSION: The CART analyses have shown that features extracted from three types of physiological measurements; forced expiratory volume in 1s (FEV1), arterial oxygen saturation (SPO2) and weight have the most predictive power in stratifying the patients condition. This CART algorithm for early detection could trigger the initiation of timely treatment, thereby potentially reducing exacerbation severity and recovery time and improving the patient's health. This study highlights the potential usefulness of automated analysis of home telehealth data in the early detection of exacerbation events among COPD patients.
  2. Mat-Isa NA, Mashor MY, Othman NH
    Artif Intell Med, 2008 Jan;42(1):1-11.
    PMID: 17996432
    This paper proposes to develop an automated diagnostic system for cervical pre-cancerous. METHODS AND DATA SAMPLES: The proposed automated diagnostic system consists of two parts; an automatic feature extraction and an intelligent diagnostic. In the automatic feature extraction, the system automatically extracts four cervical cells features (i.e. nucleus size, nucleus grey level, cytoplasm size and cytoplasm grey level). A new features extraction algorithm called region-growing-based features extraction (RGBFE) is proposed to extract the cervical cells features. The extracted features will then be fed as input data to the intelligent diagnostic part. A new artificial neural network (ANN) architecture called hierarchical hybrid multilayered perceptron (H(2)MLP) network is proposed to predict the cervical pre-cancerous stage into three classes, namely normal, low grade intra-epithelial squamous lesion (LSIL) and high grade intra-epithelial squamous lesion (HSIL). We empirically assess the capability of the proposed diagnostic system using 550 reported cases (211 normal cases, 143 LSIL cases and 196 HSIL cases).
  3. Lim CP, Harrison RF, Kennedy RL
    Artif Intell Med, 1997 Nov;11(3):215-39.
    PMID: 9413607
    This paper presents a study of the application of autonomously learning multiple neural network systems to medical pattern classification tasks. In our earlier work, a hybrid neural network architecture has been developed for on-line learning and probability estimation tasks. The network has been shown to be capable of asymptotically achieving the Bayes optimal classification rates, on-line, in a number of benchmark classification experiments. In the context of pattern classification, however, the concept of multiple classifier systems has been proposed to improve the performance of a single classifier. Thus, three decision combination algorithms have been implemented to produce a multiple neural network classifier system. Here the applicability of the system is assessed using patient records in two medical domains. The first task is the prognosis of patients admitted to coronary care units; whereas the second is the prediction of survival in trauma patients. The results are compared with those from logistic regression models, and implications of the system as a useful clinical diagnostic tool are discussed.
  4. Ebrahimkhani S, Jaward MH, Cicuttini FM, Dharmaratne A, Wang Y, de Herrera AGS
    Artif Intell Med, 2020 06;106:101851.
    PMID: 32593389 DOI: 10.1016/j.artmed.2020.101851
    In this paper, we review the state-of-the-art approaches for knee articular cartilage segmentation from conventional techniques to deep learning (DL) based techniques. Knee articular cartilage segmentation on magnetic resonance (MR) images is of great importance in early diagnosis of osteoarthritis (OA). Besides, segmentation allows estimating the articular cartilage loss rate which is utilised in clinical practice for assessing the disease progression and morphological changes. It has been traditionally applied in quantifying longitudinal knee OA progression pattern to detect and assess the articular cartilage thickness and volume. Topics covered include various image processing algorithms and major features of different segmentation techniques, feature computations and the performance evaluation metrics. This paper is intended to provide researchers with a broad overview of the currently existing methods in the field, as well as to highlight the shortcomings and potential considerations in the application at clinical practice. The survey showed that state-of-the-art techniques based on DL outperform the other segmentation methods. The analysis of the existing methods reveals that integration of DL-based algorithms with other traditional model-based approaches has achieved the best results (mean Dice similarity coefficient (DSC) between 85.8% and 90%).
  5. Sahran S, Albashish D, Abdullah A, Shukor NA, Hayati Md Pauzi S
    Artif Intell Med, 2018 05;87:78-90.
    PMID: 29680688 DOI: 10.1016/j.artmed.2018.04.002
    OBJECTIVE: Feature selection (FS) methods are widely used in grading and diagnosing prostate histopathological images. In this context, FS is based on the texture features obtained from the lumen, nuclei, cytoplasm and stroma, all of which are important tissue components. However, it is difficult to represent the high-dimensional textures of these tissue components. To solve this problem, we propose a new FS method that enables the selection of features with minimal redundancy in the tissue components.

    METHODOLOGY: We categorise tissue images based on the texture of individual tissue components via the construction of a single classifier and also construct an ensemble learning model by merging the values obtained by each classifier. Another issue that arises is overfitting due to the high-dimensional texture of individual tissue components. We propose a new FS method, SVM-RFE(AC), that integrates a Support Vector Machine-Recursive Feature Elimination (SVM-RFE) embedded procedure with an absolute cosine (AC) filter method to prevent redundancy in the selected features of the SV-RFE and an unoptimised classifier in the AC.

    RESULTS: We conducted experiments on H&E histopathological prostate and colon cancer images with respect to three prostate classifications, namely benign vs. grade 3, benign vs. grade 4 and grade 3 vs. grade 4. The colon benchmark dataset requires a distinction between grades 1 and 2, which are the most difficult cases to distinguish in the colon domain. The results obtained by both the single and ensemble classification models (which uses the product rule as its merging method) confirm that the proposed SVM-RFE(AC) is superior to the other SVM and SVM-RFE-based methods.

    CONCLUSION: We developed an FS method based on SVM-RFE and AC and successfully showed that its use enabled the identification of the most crucial texture feature of each tissue component. Thus, it makes possible the distinction between multiple Gleason grades (e.g. grade 3 vs. grade 4) and its performance is far superior to other reported FS methods.

  6. Rajendra Acharya U, Meiburger KM, Wei Koh JE, Vicnesh J, Ciaccio EJ, Shu Lih O, et al.
    Artif Intell Med, 2019 09;100:101724.
    PMID: 31607348 DOI: 10.1016/j.artmed.2019.101724
    Cardiovascular diseases are the primary cause of death globally. These are often associated with atherosclerosis. This inflammation process triggers important variations in the coronary arteries (CA) and can lead to coronary artery disease (CAD). The presence of CA calcification (CAC) has recently been shown to be a strong predictor of CAD. In this clinical setting, computed tomography angiography (CTA) has begun to play a crucial role as a non-intrusive imaging method to characterize and study CA plaques. Herein, we describe an automated algorithm to classify plaque as either normal, calcified, or non-calcified using 2646 CTA images acquired from 73 patients. The automated technique is based on various features that are extracted from the Gabor transform of the acquired CTA images. Specifically, seven features are extracted from the Gabor coefficients : energy, and Kapur, Max, Rényi, Shannon, Vajda, and Yager entropies. The features were then ordered based on the F-value and input to numerous classification methods to achieve the best classification accuracy with the least number of features. Moreover, two well-known feature reduction techniques were employed, and the features acquired were also ranked according to F-value and input to several classifiers. The best classification results were obtained using all computed features without the employment of feature reduction, using a probabilistic neural network. An accuracy, positive predictive value, sensitivity, and specificity of 89.09%, 91.70%, 91.83% and 83.70% was obtained, respectively. Based on these results, it is evident that the technique can be helpful in the automated classification of plaques present in CTA images, and may become an important tool to reduce procedural costs and patient radiation dose. This could also aid clinicians in plaque diagnostics.
  7. Jahmunah V, Lih Oh S, Rajinikanth V, Ciaccio EJ, Hao Cheong K, Arunkumar N, et al.
    Artif Intell Med, 2019 09;100:101698.
    PMID: 31607349 DOI: 10.1016/j.artmed.2019.07.006
    Examination of the brain's condition with the Electroencephalogram (EEG) can be helpful to predict abnormality and cerebral activities. The purpose of this study was to develop an Automated Diagnostic Tool (ADT) to investigate and classify the EEG signal patterns into normal and schizophrenia classes. The ADT implements a sequence of events, such as EEG series splitting, non-linear features mining, t-test assisted feature selection, classification and validation. The proposed ADT is employed to evaluate a 19-channel EEG signal collected from normal and schizophrenia class volunteers. A dataset was created by splitting the raw 19-channel EEG into a sequence of 6250 sample points, which was helpful to produce 1142 features of normal and schizophrenia class patterns. Non-linear feature extraction was then implemented to mine 157 features from each EEG pattern, from which 14 of the principal features were identified based on significance. Finally, a signal classification practice with Decision-Tree (DT), Linear-Discriminant analysis (LD), k-Nearest-Neighbour (KNN), Probabilistic-Neural-Network (PNN), and Support-Vector-Machine (SVM) with various kernels was implemented. The experimental outcome showed that the SVM with Radial-Basis-Function (SVM-RBF) offered a superior average performance value of 92.91% on the considered EEG dataset, as compared to other classifiers implemented in this work.
  8. Gharaei N, Ismail W, Grosan C, Hendradi R
    Artif Intell Med, 2021 10;120:102151.
    PMID: 34629147 DOI: 10.1016/j.artmed.2021.102151
    Tele-rehabilitation is an alternative to the conventional rehabilitation service that helps patients in remote areas to access a service that is practical in terms of logistics and cost, in a controlled environment. It includes the usage of mobile phones or other wireless devices that are applied to rehabilitation exercises. Such applications or software include exercises in the form of virtual games, treatment monitoring based on the rehabilitation progress and data analysis. However, nowadays, physiotherapists use a default profiling setting for patients carrying out rehabilitation, due to lack of information. Medical Interactive Rehabilitation Assistant (MIRA) is a computer-based (virtual reality) rehabilitation platform. The profile setting includes: a level of difficulty, percentage of tolerance and maximum range. To the best of our knowledge, there is a lack of optimization in the parameter values setting of MIRA exergames that could enhance patients' performance. Generally, non-optimal profile setting leads to reduced effectiveness. Therefore, this study aims to develop a method that optimizes the profile setting of each patient according to the estimated (desired) optimal results. The proposed method is developed using unsupervised and supervised machine learning techniques. We use Self-Organizing Map (SOM) to cluster patient records into several distinct clusters. K-fold cross validation is applied to construct the prediction models. Classification And Regression Tree (CART) is utilized to predict the patient's optimal input setting for playing the MIRA games. The combination of these techniques seems to improve the efficiency of the standard (default) way in predicting the optimal settings for exergames. To evaluate the proposed method, we conduct an experiment with data collected from a rehabilitation center. We use three metrics to quantify the quality of the results: R-squared (R2), Mean Absolute Error (MAE) and Root Mean Square Error (RMSE). The results of experimental analysis demonstrate that the proposed method is effective in predicting the adequate parameter setting in MIRA platform. The method has potential to be implemented as an intelligent system for MIRA prediction in healthcare. Moreover, the method could be extended to similar platforms for which data is available to train our method on.
  9. Nordin N, Zainol Z, Mohd Noor MH, Chan LF
    Artif Intell Med, 2022 10;132:102395.
    PMID: 36207078 DOI: 10.1016/j.artmed.2022.102395
    BACKGROUND: Early detection and prediction of suicidal behaviour are key factors in suicide control. In conjunction with recent advances in the field of artificial intelligence, there is increasing research into how machine learning can assist in the detection, prediction and treatment of suicidal behaviour. Therefore, this study aims to provide a comprehensive review of the literature exploring machine learning techniques in the study of suicidal behaviour prediction.

    METHODS: A search of four databases was conducted: Web of Science, PubMed, Dimensions, and Scopus for research papers dated between January 2016 and September 2021. The search keywords are 'data mining', 'machine learning' in combination with 'suicidal behaviour', 'suicide', 'suicide attempt', 'suicidal ideation', 'suicide plan' and 'self-harm'. The studies that used machine learning techniques were synthesized according to the countries of the articles, sample description, sample size, classification tasks, number of features used to develop the models, types of machine learning techniques, and evaluation of performance metrics.

    RESULTS: Thirty-five empirical articles met the criteria to be included in the current review. We provide a general overview of machine learning techniques, examine the feature categories, describe methodological challenges, and suggest areas for improvement and research directions. Ensemble prediction models have been shown to be more accurate and useful than single prediction models.

    CONCLUSIONS: Machine learning has great potential for improving estimates of future suicidal behaviour and monitoring changes in risk over time. Further research can address important challenges and potential opportunities that may contribute to significant advances in suicide prediction.

  10. Latif MHA, Faye I
    Artif Intell Med, 2021 Dec;122:102213.
    PMID: 34823835 DOI: 10.1016/j.artmed.2021.102213
    Improving longevity is one of the greatest achievements in humanity. Because of this, the population is growing older, and the ubiquity of knee osteoarthritis (OA) is on the rise. Nonetheless, the understanding and ability to investigate potential precursors of knee OA have been impeded by time-consuming and laborious manual delineation processes which are prone to poor reproducibility. A method for automatic segmentation of the tibiofemoral joint using magnetic resonance imaging (MRI) is presented in this work. The proposed method utilizes a deeply supervised 2D-3D ensemble U-Net, which consists of foreground class oversampling, deep supervision loss branches, and Gaussian weighted softmax score aggregation. It was designed, optimized, and tested on 507 3D double echo steady-state (DESS) MR volumes using a two-fold cross-validation approach. A state-of-the-art segmentation accuracy measured as Dice similarity coefficient (DSC) for the femur bone (98.6 ± 0.27%), tibia bone (98.8 ± 0.31%), femoral cartilage (90.3 ± 2.89%), and tibial cartilage (86.7 ± 4.07%) is achieved. Notably, the proposed method yields sub-voxel accuracy for an average symmetric surface distance (ASD) less than 0.36 mm. The model performance is not affected by the severity of radiographic osteoarthritis (rOA) grades or the presence of pathophysiological changes. The proposed method offers an accurate segmentation with high time efficiency (~62 s) per 3D volume, which is well suited for efficient processing and analysis of the large prospective cohorts of the Osteoarthritis Initiative (OAI).
  11. Mumtaz W, Saad MNBM, Kamel N, Ali SSA, Malik AS
    Artif Intell Med, 2018 01;84:79-89.
    PMID: 29169647 DOI: 10.1016/j.artmed.2017.11.002
    BACKGROUND: The abnormal alcohol consumption could cause toxicity and could alter the human brain's structure and function, termed as alcohol used disorder (AUD). Unfortunately, the conventional screening methods for AUD patients are subjective and manual. Hence, to perform automatic screening of AUD patients, objective methods are needed. The electroencephalographic (EEG) data have been utilized to study the differences of brain signals between alcoholics and healthy controls that could further developed as an automatic screening tool for alcoholics.

    METHOD: In this work, resting-state EEG-derived features were utilized as input data to the proposed feature selection and classification method. The aim was to perform automatic classification of AUD patients and healthy controls. The validation of the proposed method involved real-EEG data acquired from 30 AUD patients and 30 age-matched healthy controls. The resting-state EEG-derived features such as synchronization likelihood (SL) were computed involving 19 scalp locations resulted into 513 features. Furthermore, the features were rank-ordered to select the most discriminant features involving a rank-based feature selection method according to a criterion, i.e., receiver operating characteristics (ROC). Consequently, a reduced set of most discriminant features was identified and utilized further during classification of AUD patients and healthy controls. In this study, three different classification models such as Support Vector Machine (SVM), Naïve Bayesian (NB), and Logistic Regression (LR) were used.

    RESULTS: The study resulted into SVM classification accuracy=98%, sensitivity=99.9%, specificity=95%, and f-measure=0.97; LR classification accuracy=91.7%, sensitivity=86.66%, specificity=96.6%, and f-measure=0.90; NB classification accuracy=93.6%, sensitivity=100%, specificity=87.9%, and f-measure=0.95.

    CONCLUSION: The SL features could be utilized as objective markers to screen the AUD patients and healthy controls.

  12. Md Saleh NI, Ab Ghani H, Jilani Z
    Artif Intell Med, 2022 Oct;132:102394.
    PMID: 36207072 DOI: 10.1016/j.artmed.2022.102394
    Outbreaks of the COVID-19 pandemic caused by the SARS-CoV-2 infection that started in Wuhan, China, have quickly spread worldwide. The current situation has contributed to a dynamic rate of hospital admissions. Global efforts by Artificial Intelligence (AI) and Machine Learning (ML) communities to develop solutions to assist COVID-19-related research have escalated ever since. However, despite overwhelming efforts from the AI and ML community, many machine learning-based AI systems have been designed as black boxes. This paper proposes a model that utilizes Formal Concept Analysis (FCA) to explain a machine learning technique called Long-short Term Memory (LSTM) on a dataset of hospital admissions due to COVID-19 in the United Kingdom. This paper intends to increase the transparency of decision-making in the era of ML by using the proposed LSTM-FCA explainable model. Both LSTM and FCA are able to evaluate the data and explain the model to make the results more understandable and interpretable. The results and discussions are helpful and may lead to new research to optimize the use of ML in various real-world applications and to contain the disease.
  13. Albahri AS, Hamid RA, Albahri OS, Zaidan AA
    Artif Intell Med, 2021 Jan;111:101983.
    PMID: 33461683 DOI: 10.1016/j.artmed.2020.101983
    CONTEXT AND BACKGROUND: Corona virus (COVID) has rapidly gained a foothold and caused a global pandemic. Particularists try their best to tackle this global crisis. New challenges outlined from various medical perspectives may require a novel design solution. Asymptomatic COVID-19 carriers show different health conditions and no symptoms; hence, a differentiation process is required to avert the risk of chronic virus carriers.

    OBJECTIVES: Laboratory criteria and patient dataset are compulsory in constructing a new framework. Prioritisation is a popular topic and a complex issue for patients with COVID-19, especially for asymptomatic carriers due to multi-laboratory criteria, criterion importance and trade-off amongst these criteria. This study presents new integrated decision-making framework that handles the prioritisation of patients with COVID-19 and can detect the health conditions of asymptomatic carriers.

    METHODS: The methodology includes four phases. Firstly, eight important laboratory criteria are chosen using two feature selection approaches. Real and simulation datasets from various medical perspectives are integrated to produce a new dataset involving 56 patients with different health conditions and can be used to check asymptomatic cases that can be detected within the prioritisation configuration. The first phase aims to develop a new decision matrix depending on the intersection between 'multi-laboratory criteria' and 'COVID-19 patient list'. In the second phase, entropy is utilised to set the objective weight, and TOPSIS is adapted to prioritise patients in the third phase. Finally, objective validation is performed.

    RESULTS: The patients are prioritised based on the selected criteria in descending order of health situation starting from the worst to the best. The proposed framework can discriminate among mild, serious and critical conditions and put patients in a queue while considering asymptomatic carriers. Validation findings revealed that the patients are classified into four equal groups and showed significant differences in their scores, indicating the validity of ranking.

    CONCLUSIONS: This study implies and discusses the numerous benefits of the suggested framework in detecting/recognising the health condition of patients prior to discharge, supporting the hospitalisation characteristics, managing patient care and optimising clinical prediction rule.

  14. Sarsam SM, Al-Samarraie H, Alzahrani AI, Shibghatullah AS
    Artif Intell Med, 2022 Dec;134:102428.
    PMID: 36462907 DOI: 10.1016/j.artmed.2022.102428
    Social media sites, such as Twitter, provide the means for users to share their stories, feelings, and health conditions during the disease course. Anemia, the most common type of blood disorder, is recognized as a major public health problem all over the world. Yet very few studies have explored the potential of recognizing anemia from online posts. This study proposed a novel mechanism for recognizing anemia based on the associations between disease symptoms and patients' emotions posted on the Twitter platform. We used k-means and Latent Dirichlet Allocation (LDA) algorithms to group similar tweets and to identify hidden disease topics. Both disease emotions and symptoms were mapped using the Apriori algorithm. The proposed approach was evaluated using a number of classifiers. A higher prediction accuracy of 98.96 % was achieved using Sequential Minimal Optimization (SMO). The results revealed that fear and sadness emotions are dominant among anemic patients. The proposed mechanism is the first of its kind to diagnose anemia using textual information posted on social media sites. It can advance the development of intelligent health monitoring systems and clinical decision-support systems.
  15. Liu H, Huang J, Li Q, Guan X, Tseng M
    Artif Intell Med, 2024 Feb;148:102776.
    PMID: 38325925 DOI: 10.1016/j.artmed.2024.102776
    This study proposes a deep convolutional neural network for the automatic segmentation of glioblastoma brain tumors, aiming sat replacing the manual segmentation method that is both time-consuming and labor-intensive. There are many challenges for automatic segmentation to finely segment sub-regions from multi-sequence magnetic resonance images because of the complexity and variability of glioblastomas, such as the loss of boundary information, misclassified regions, and subregion size. To overcome these challenges, this study introduces a spatial pyramid module and attention mechanism to the automatic segmentation algorithm, which focuses on multi-scale spatial details and context information. The proposed method has been tested in the public benchmarks BraTS 2018, BraTS 2019, BraTS 2020 and BraTS 2021 datasets. The Dice score on the enhanced tumor, whole tumor, and tumor core were respectively 79.90 %, 89.63 %, and 85.89 % on the BraTS 2018 dataset, respectively 77.14 %, 89.58 %, and 83.33 % on the BraTS 2019 dataset, and respectively 77.80 %, 90.04 %, and 83.18 % on the BraTS 2020 dataset, and respectively 83.48 %, 90.70 %, and 88.94 % on the BraTS 2021 dataset offering performance on par with that of state-of-the-art methods with only 1.90 M parameters. In addition, our approach significantly reduced the requirements for experimental equipment, and the average time taken to segment one case was only 1.48 s; these two benefits rendered the proposed network intensely competitive for clinical practice.
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