This study aims to provide security solutions for implementing electronic medical records (EMRs). E-Health organizations could utilize the proposed method and implement recommended solutions in medical/health systems. Majority of the required security features of EMRs were noted. The methods used were tested against each of these security features. In implementing the system, the combination that satisfied all of the security features of EMRs was selected. Secure implementation and management of EMRs facilitate the safeguarding of the confidentiality, integrity, and availability of e-health organization systems. Health practitioners, patients, and visitors can use the information system facilities safely and with confidence anytime and anywhere. After critically reviewing security and data transmission methods, a new hybrid method was proposed to be implemented on EMR systems. This method will enhance the robustness, security, and integration of EMR systems. The hybrid of simple object access protocol/extensible markup language (XML) with advanced encryption standard and secure hash algorithm version 1 has achieved the security requirements of an EMR system with the capability of integrating with other systems through the design of XML messages.
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.
An improved and efficient method is presented in this paper to achieve a better trade-off between noise removal and edge preservation, thereby detecting the tumor region of MRI brain images automatically. Compass operator has been used in the fourth order Partial Differential Equation (PDE) based denoising technique to preserve the anatomically significant information at the edges. A new morphological technique is also introduced for stripping skull region from the brain images, which consequently leading to the process of detecting tumor accurately. Finally, automatic seeded region growing segmentation based on an improved single seed point selection algorithm is applied to detect the tumor. The method is tested on publicly available MRI brain images and it gives an average PSNR (Peak Signal to Noise Ratio) of 36.49. The obtained results also show detection accuracy of 99.46%, which is a significant improvement than that of the existing results.
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.
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.
Cardiovascular disease (CVD) is the major cause of death globally. More people die of CVDs each year than from any other disease. Over 80% of CVD deaths occur in low and middle income countries and occur almost equally in male and female. In this paper, different computational models based on Bayesian Networks, Multilayer Perceptron,Radial Basis Function and Logistic Regression methods are presented to predict early risk detection of the cardiovascular event. A total of 929 (626 male and 303 female) heart attack data are used to construct the models.The models are tested using combined as well as separate male and female data. Among the models used, it is found that the Multilayer Perceptron model yields the best accuracy result.
In the present paper, a fuzzy rule-based system (FRBS) is designed to serve as a decision support system for Coronary heart disease (CHD) diagnosis that not only considers the decision accuracy of the rules but also their transparency at the same time. To achieve the two above mentioned objectives, we apply a multi-objective genetic algorithm to optimize both the accuracy and transparency of the FRBS. In addition and to help assess the certainty and the importance of each rule by the physician, an extended format of fuzzy rules that incorporates the degree of decision certainty and importance or support of each rule at the consequent part of the rules is introduced. Furthermore, a new way for employing Ensemble Classifiers Strategy (ECS) method is proposed to enhance the classification ability of the FRBS. The results show that the generated rules are humanly understandable while their accuracy compared favorably with other benchmark classification methods. In addition, the produced FRBS is able to identify the uncertainty cases so that the physician can give a special consideration to deal with them and this will result in a better management of efforts and tasks. Furthermore, employing ECS has specifically improved the ability of FRBS to detect patients with CHD which is desirable feature for any CHD diagnosis system.
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.
Developing tools to assist physically disabled and immobilized people through facial expression is a challenging area of research and has attracted many researchers recently. In this paper, luminance stickers based facial expression recognition is proposed. Recognition of facial expression is carried out by employing Discrete Wavelet Transform (DWT) as a feature extraction method. Different wavelet families with their different orders (db1 to db20, Coif1 to Coif 5 and Sym2 to Sym8) are utilized to investigate their performance in recognizing facial expression and to evaluate their computational time. Standard deviation is computed for the coefficients of first level of wavelet decomposition for every order of wavelet family. This standard deviation is used to form a set of feature vectors for classification. In this study, conventional validation and cross validation are performed to evaluate the efficiency of the suggested feature vectors. Three different classifiers namely Artificial Neural Network (ANN), k-Nearest Neighborhood (kNN) and Linear Discriminant Analysis (LDA) are used to classify a set of eight facial expressions. The experimental results demonstrate that the proposed method gives very promising classification accuracies.
The goal of this paper is to discuss and compare three feature extraction methods: Linear Predictive Coefficients (LPC), Linear Prediction Cepstral Coefficients (LPCC) and Weighted Linear Prediction Cepstral Coefficients (WLPCC) for recognizing the stuttered events. Speech samples from the University College London Archive of Stuttered Speech (UCLASS) were used for our analysis. The stuttered events were identified through manual segmentation and were used for feature extraction. Two simple classifiers namely, k-nearest neighbour (kNN) and Linear Discriminant Analysis (LDA) were employed for speech dysfluencies classification. Conventional validation method was used for testing the reliability of the classifier results. The study on the effect of different frame length, percentage of overlapping, value of ã in a first order pre-emphasizer and different order p were discussed. The speech dysfluencies classification accuracy was found to be improved by applying statistical normalization before feature extraction. The experimental investigation elucidated LPC, LPCC and WLPCC features can be used for identifying the stuttered events and WLPCC features slightly outperforms LPCC features and LPC features.
Studies related to healthcare ICT integration in Malaysia are relatively little, thus this paper provide a literature review of the integration of information and communication technologies (ICT) in the healthcare sector in Malaysia through the hospital information system (HIS). Our study emphasized on secondary data to investigate the factors related to ICT integration in healthcare through HIS. Therefore this paper aimed to gather an in depth understanding of issues related to HIS adoption, and contributing in fostering HIS adoption in Malaysia and other countries. This paper provides a direction for future research to study the correlation of factors affecting HIS adoption. Finally a research model is proposed using current adoption theories and external factors from human, technology, and organization perspectives.
An important preliminary step in the diagnosis of leukemia is the visual examination of the patient's peripheral blood smear under the microscope. Morphological changes in the white blood cells can be an indicator of the nature and severity of the disease. Manual techniques are labor intensive, slow, error prone and costly. A computerized system can be used as a supportive tool for the specialist in order to enhance and accelerate the morphological analysis process. This research present a new method that integrates color features with the morphological reconstruction to localize and isolate lymphoblast cells from a microscope image that contains many cells. The localization and segmentation are conducted using a proposed method that consists of an integration of several digital image processing techniques. 180 microscopic blood images were tested, and the proposed framework managed to obtain 100% accuracy for the localization of the lymphoblast cells and separate it from the image scene. The results obtained indicate that the proposed method can be safely used for the purpose of lymphoblast cells localization and segmentation and subsequently, aiding the diagnosis of leukemia.
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.
With the dramatic increase of the worldwide threat of dengue disease, it has been very crucial to correctly diagnose the dengue patients in order to decrease the disease severity. However, it has been a great challenge for the physicians to identify the level of risk in dengue patients due to overlapping of the medical classification criteria. Therefore, this study aims to construct a noninvasive diagnostic system to assist the physicians for classifying the risk in dengue patients. Systematic producers have been followed to develop the system. Firstly, the assessment of the significant predictors associated with the level of risk in dengue patients was carried out utilizing the statistical analyses technique. Secondly, Multilayer perceptron neural network models trained via Levenberg-Marquardt and Scaled Conjugate Gradient algorithms was employed for constructing the diagnostic system. Finally, precise tuning for the models' parameters was conducted in order to achieve the optimal performance. As a result, 9 noninvasive predictors were found to be significantly associated with the level of risk in dengue patients. By employing those predictors, 75% prediction accuracy has been achieved for classifying the risk in dengue patients using Scaled Conjugate Gradient algorithm while 70.7% prediction accuracy were achieved by using Levenberg-Marquardt algorithm.
The increasing number of diabetic retinopathy (DR) cases world wide demands the development of an automated decision support system for quick and cost-effective screening of DR. We present an automatic screening system for detecting the early stage of DR, which is known as non-proliferative diabetic retinopathy (NPDR). The proposed system involves processing of fundus images for extraction of abnormal signs, such as hard exudates, cotton wool spots, and large plaque of hard exudates. A rule based classifier is used for classifying the DR into two classes, namely, normal and abnormal. The abnormal NPDR is further classified into three levels, namely, mild, moderate, and severe. To evaluate the performance of the proposed decision support framework, the algorithms have been tested on the images of STARE database. The results obtained from this study show that the proposed system can detect the bright lesions with an average accuracy of about 97%. The study further shows promising results in classifying the bright lesions correctly according to NPDR severity levels.
Due to increasing number of diabetic retinopathy cases, ophthalmologists are experiencing serious problem to automatically extract the features from the retinal images. Optic disc (OD), exudates, and cotton wool spots are the main features of fundus images which are used for diagnosing eye diseases, such as diabetic retinopathy and glaucoma. In this paper, a new algorithm for the extraction of these bright objects from fundus images based on marker-controlled watershed segmentation is presented. The proposed algorithm makes use of average filtering and contrast adjustment as preprocessing steps. The concept of the markers is used to modify the gradient before the watershed transformation is applied. The performance of the proposed algorithm is evaluated using the test images of STARE and DRIVE databases. It is shown that the proposed method can yield an average sensitivity value of about 95%, which is comparable to those obtained by the known methods.
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.
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.
Current trends in medicine, specifically in the electronic handling of medical applications, ranging from digital imaging, paperless hospital administration and electronic medical records, telemedicine, to computer-aided diagnosis, creates a burden on the network. Distributed Service Architectures, such as Intelligent Network (IN), Telecommunication Information Networking Architecture (TINA) and Open Service Access (OSA), are able to meet this new challenge. Distribution enables computational tasks to be spread among multiple processors; hence, performance is an important issue. This paper proposes a novel approach in load balancing, the Random Sender Initiated Algorithm, for distribution of tasks among several nodes sharing the same computational object (CO) instances in Distributed Service Architectures. Simulations illustrate that the proposed algorithm produces better network performance than the benchmark load balancing algorithms-the Random Node Selection Algorithm and the Shortest Queue Algorithm, especially under medium and heavily loaded conditions.
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.