A new hybrid case-based reasoning approach for medical diagnosis systems

AI-Assisted Detection of Interproximal, Occlusal, and Secondary Caries on Bite-Wing Radiographs: A Single-Shot Deep Learning Approach

Tooth decay is a common oral disease worldwide, but errors in diagnosis can often be made in dental clinics, which can lead to a delay in treatment. This study aims to use artificial intelligence (AI) for the automated detection and localization of secondary, occlusal, and interproximal (D1, D2, D3) caries types on bite-wing radiographs. The eight hundred and sixty bite-wing radiographs were collected from the School of Dentistry database. Pre-processing and data augmentation operations were performed. Interproximal (D1, D2, D3), secondary, and occlusal caries on bite-wing radiographs were annotated by two oral radiologists. The data were split into 80% for training, 10% for validation, and 10% for testing. The AI-based training process was conducted using the YOLOv8 algorithm. A clinical decision support system interface was designed using the Python PyQT5 library, allowing for the use of dental caries detection without the need for complex programming procedures. In the test images, the average precision, average sensitivity, and average F1 score values for secondary, occlusal, and interproximal caries were obtained as 0.977, 0.932, and 0.954, respectively. The AI-based dental caries detection system yielded highly successful results in the test, receiving full approval from dentists for clinical use. YOLOv8 has the potential to increase sensitivity and reliability while reducing the burden on dentists and can prevent diagnostic errors in dental clinics.

Uncharted Aspects of Human Intelligence in Knowledge-Based “Intelligent” Systems

This paper briefly surveys several prominent modeling approaches to knowledge-based intelligent systems (KBIS) design and, especially, expert systems and the breakthroughs that have most broadened and improved their applications. We argue that the implementation of technology that aims to emulate rudimentary aspects of human intelligence has enhanced KBIS design, but that weaknesses remain that could be addressed with existing research in cognitive science. For example, we propose that systems based on representational plasticity, functional dynamism, domain specificity, creativity, and concept learning, with their theoretical and experimental rigor, can best characterize the problem-solving capabilities of humans and can best overcome five key limitations currently exhibited by knowledge-based intelligent systems. We begin with a brief survey of the relevant work related to KBIS design and then discuss these five shortcomings with new suggestions for how to integrate results from cognitive science to resolve each of them. Our ultimate goal is to increase awareness and direct attention to areas of theoretical and experimental cognitive research that are fundamentally relevant to the goals underlying KBISes.

Fuzzy case-based reasoning approach for finding COVID-19 patients priority in hospitals at source shortage period

In this research article, we introduced an algorithm to evaluate COVID-19 patients admission in hospitals at source shortage period. Many researchers have expressed their conclusions from different perspectives on various factors such as spatial changes, climate risks, preparedness, blood type, age and comorbidities that may be contributing to COVID-19 mortality rate. However, as the number of people coming to the hospital for COVID-19 treatment increases, the mortality rate is likely to increase due to the lack of medical facilities. In order to provide medical assistance in this situation, we need to consider not only the extent of the disease impact, but also other important factors. No method has yet been proposed to calculate the priority of patients taking into account all the factors. We have provided a solution to this in this research article. Based on eight key factors, we provide a way to determine priorities. In order to achieve the effectiveness and practicability of the proposed method, we studied individuals with different results on all factors. The sigmoid function helps to easily construct factors at different levels. In addition, the cobweb solution model allows us to see the potential of our proposed algorithm very clearly. Using the method we introduced, it is easier to sort high-risk individuals to low-risk individuals. This will make it easier to deal with problems that arise when the number of patients in hospitals continues to increase. It can reduce the mortality of COVID-19 patients. Medical professionals can be very helpful in making the best decisions.

Construction of a Chaotic Map-Based Authentication Protocol for TMIS

Upgraded network technology presents an advanced technological platform for telecare medicine information systems (TMIS) for patients. However, TMIS generally suffers various attacks since the information being shared through the insecure channel. Recently, many authentication techniques have been proposed relying on the chaotic map. However, many of these designs are not secure against the known attacks. In spite of the fact that some of the constructions attain low computation overhead, they cannot establish an anonymous communication and many of them fail to ensure forward secrecy. In this work, our aim is to present authentication and key agreement protocol for TMIS utilizing a chaotic map to achieve both security and efficiency. The underlying security assumptions are chaotic theory assumptions. This scheme supports forward secrecy and a secure session is established with just two messages of exchange. Moreover, we present a comparative analysis of related authentication techniques.

Novel Case-Based Reasoning System for Public Health Emergencies

Purpose

Several threatening infectious diseases, including influenza, Ebola, SARS, and COVID-19, have affected human society over the past decades. These disease outbreaks naturally inspire a demand for sustained and advanced safety and suppression measures. To protect public health and safety, further research developments on emergency analysis methods and approaches for effective emergency treatment generation are urgently needed to mitigate the severity of the pandemic and save lives.

Methods

To address these issues, a novel case-based reasoning (CBR) system is proposed using three phases. In the first phase, the similarity between the current case and the historical cases is calculated under a variety of heterogeneous information. In the second phase, a filter approach based on grey clustering analysis is created to retrieve relevant cases. In the third phase, the cases retrieved are taken as initial host nests in a cuckoo search (CS) algorithm, and our system searches an optimal solution through iteration of this algorithm.

Results

The proposed model is compared with a CBR method improved by particle swarm optimization (PSO) and a CBR method improved by a differential evolution algorithm (DE), to confirm the efficiency of our CS algorithm in adapting solutions for public health emergencies. The results show that the proposed model is better than the existing algorithms.

Conclusion

The proposed model improves the speed of case retrieval using grey clustering and increases solution accuracy with CS algorithms. The present research can contribute to government, CDC, and infectious disease emergency management fields with regard to the implementation of fast and accurate public biohazard prevention and control measures based on a variety of heterogeneous information.

Similarity measures and attribute selection for case-based reasoning in transcatheter aortic valve implantation

In a clinical decision support system, the purpose of case-based reasoning is to help clinicians make convenient decisions for diagnoses or interventional gestures. Past experience, which is represented by a case-base of previous patients, is exploited to solve similar current problems using four steps-retrieve, reuse, revise, and retain. The proposed case-based reasoning has been focused on transcatheter aortic valve implantation to respond to clinical issues pertaining vascular access and prosthesis choices. The computation of a relevant similarity measure is an essential processing step employed to obtain a set of retrieved cases from a case-base. A hierarchical similarity measure that is based on a clinical decision tree is proposed to better integrate the clinical knowledge, especially in terms of case representation, case selection and attributes weighting. A case-base of 138 patients is used to evaluate the case-based reasoning performance, and retrieve- and reuse-based criteria have been considered. The sensitivity for the vascular access and the prosthesis choice is found to 0.88 and 0.94, respectively, with the use of the hierarchical similarity measure as opposed to 0.53 and 0.79 for the standard similarity measure. Ninety percent of the suggested solutions are correctly classified for the proposed metric when four cases are retrieved. Using a dedicated similarity measure, with relevant and weighted attributes selected through a clinical decision tree, the set of retrieved cases, and consequently, the decision suggested by the case-based reasoning are substantially improved over state-of-the-art similarity measures.

A case-based reasoning system based on weighted heterogeneous value distance metric for breast cancer diagnosis

OBJECTIVE

We present the implementation and application of a case-based reasoning (CBR) system for breast cancer related diagnoses. By retrieving similar cases in a breast cancer decision support system, oncologists can obtain powerful information or knowledge, complementing their own experiential knowledge, in their medical decision making.

METHODS

We observed two problems in applying standard CBR to this context: the abundance of different types of attributes and the difficulty in eliciting appropriate attribute weights from human experts. We therefore used a distance measure named weighted heterogeneous value distance metric, which can better deal with both continuous and discrete attributes simultaneously than the standard Euclidean distance, and a genetic algorithm for learning the attribute weights involved in this distance measure automatically. We evaluated our CBR system in two case studies, related to benign/malignant tumor prediction and secondary cancer prediction, respectively.

RESULT

Weighted heterogeneous value distance metric with genetic algorithm for weight learning outperformed several alternative attribute matching methods and several classification methods by at least 3.4%, reaching 0.938, 0.883, 0.933, and 0.984 in the first case study, and 0.927, 0.842, 0.939, and 0.989 in the second case study, in terms of accuracy, sensitivity×specificity, F measure, and area under the receiver operating characteristic curve, respectively.

CONCLUSION

The evaluation result indicates the potential of CBR in the breast cancer diagnosis domain.

Role of Soft Computing Approaches in HealthCare Domain: A Mini Review

In the present era, soft computing approaches play a vital role in solving the different kinds of problems and provide promising solutions. Due to popularity of soft computing approaches, these approaches have also been applied in healthcare data for effectively diagnosing the diseases and obtaining better results in comparison to traditional approaches. Soft computing approaches have the ability to adapt itself according to problem domain. Another aspect is a good balance between exploration and exploitation processes. These aspects make soft computing approaches more powerful, reliable and efficient. The above mentioned characteristics make the soft computing approaches more suitable and competent for health care data. The first objective of this review paper is to identify the various soft computing approaches which are used for diagnosing and predicting the diseases. Second objective is to identify various diseases for which these approaches are applied. Third objective is to categories the soft computing approaches for clinical support system. In literature, it is found that large number of soft computing approaches have been applied for effectively diagnosing and predicting the diseases from healthcare data. Some of these are particle swarm optimization, genetic algorithm, artificial neural network, support vector machine etc. A detailed discussion on these approaches are presented in literature section. This work summarizes various soft computing approaches used in healthcare domain in last one decade. These approaches are categorized in five different categories based on the methodology, these are classification model based system, expert system, fuzzy and neuro fuzzy system, rule based system and case based system. Lot of techniques are discussed in above mentioned categories and all discussed techniques are summarized in the form of tables also. This work also focuses on accuracy rate of soft computing technique and tabular information is provided for each category including author details, technique, disease and utility/accuracy.

A comprehensive identification-evidence based alternative for HIV/AIDS treatment with HAART in the healthcare industries

BACKGROUND AND OBJECTIVE

The HIV/AIDS-related issue has given rise to a priority concern in which potential new therapies are increasingly highlighted to lessen the negative impact of highly active anti-retroviral therapy (HAART) in the healthcare industry. With the motivation of "medical applications," this study focuses on the main advanced feature selection techniques and classification approaches that reflect a new architecture, and a trial to build a hybrid model for interested parties.

METHODS

This study first uses an integrated linear-nonlinear feature selection technique to identify the determinants influencing HAART medication and utilizes organizations of different condition-attributes to generate a hybrid model based on a rough set classifier to study evolving HIV/AIDS research in order to improve classification performance.

RESULTS

The proposed model makes use of a real data set from Taiwan's specialist medical center. The experimental results show that the proposed model yields a satisfactory result that is superior to the listed methods, and the core condition-attributes PVL, CD4, Code, Age, Year, PLT, and Sex were identified in the HIV/AIDS data set. In addition, the decision rule set created can be referenced as a knowledge-based healthcare service system as the best of evidence-based practices in the workflow of current clinical diagnosis.

CONCLUSIONS

This study highlights the importance of these key factors and provides the rationale that the proposed model is an effective alternative to analyzing sustained HAART medication in follow-up studies of HIV/AIDS treatment in practice.

An Improved CAD System for Breast Cancer Diagnosis Based on Generalized Pseudo-Zernike Moment and Ada-DEWNN Classifier

In this paper, a novel framework of computer-aided diagnosis (CAD) system has been presented for the classification of benign/malignant breast tissues. The properties of the generalized pseudo-Zernike moments (GPZM) and pseudo-Zernike moments (PZM) are utilized as suitable texture descriptors of the suspicious region in the mammogram. An improved classifier- adaptive differential evolution wavelet neural network (Ada-DEWNN) is proposed to improve the classification accuracy of the CAD system. The efficiency of the proposed system is tested on mammograms from the Mammographic Image Analysis Society (mini-MIAS) database using the leave-one-out cross validation as well as on mammograms from the Digital Database for Screening Mammography (DDSM) database using 10-fold cross validation. The proposed method on MIAS-database attains a fair accuracy of 0.8938 and AUC of 0.935 (95 % CI = 0.8213-0.9831). The proposed method is also tested for in-plane rotation and found to be highly rotation invariant. In addition, the proposed classifier is tested and compared with some well-known existing methods using receiver operating characteristic (ROC) analysis using DDSM- database. It is concluded the proposed classifier has better area under the curve (AUC) (0.9289) and highly précised with 95 % CI, 0.8216 to 0.9834 and 0.0384 standard error.

A clinical decision support system for the diagnosis of probable migraine and probable tension-type headache based on case-based reasoning

BACKGROUND

The overlap between probable migraine (PM) and probable tension-type headache (PTTH) often confuses physicians in clinical practice. Although clinical decision support systems (CDSSs) have been proven to be helpful in the diagnosis of primary headaches, the existing guideline-based headache disorder CDSSs do not perform adequately due to this overlapping issue. Thus, in this study, a CDSS based on case-based reasoning (CBR) was developed in order to solve this problem.

METHODS

First, a case library consisting of 676 clinical cases, 56.95% of which had been diagnosed with PM and 43.05% of which had been diagnosed with PTTH, was constructed, screened by a three-member panel, and weighted by engineers. Next, the resulting case library was used to diagnose current cases based on their similarities to the previous cases. The test dataset was composed of an additional 222 historical cases, 76.1% of which had been diagnosed with PM and 23.9% of which had been diagnosed with PTTH. The cases that comprised the case library as well as the test dataset were actual clinical cases obtained from the International Headache Center in Chinese PLA General Hospital.

RESULTS

The results indicated that the PM and PTTH recall rates were equal to 97.02% and 77.78%, which were 34.31% and 16.91% higher than that of the guideline-based CDSS, respectively. Furthermore, the PM and PTTH precision rates were equal to 93.14% and 89.36%, which were7.09% and 15.68% higher than that of the guideline-based CDSS, respectively. Comparing CBR CDSS and guideline-based CDSS, the p-value of PM diagnoses was equal to 0.019, while that of PTTH diagnoses was equal to 0.002, which indicated that there was a significant difference between the two approaches.

CONCLUSIONS

The experimental results indicated that the CBR CDSS developed in this study diagnosed PM and PTTH with a high degree of accuracy and performed better than the guideline-based CDSS. This system could be used as a diagnostic tool to assist general practitioners in distinguishing PM from PTTH.

Developing and using expert systems and neural networks in medicine: a review on benefits and challenges

Complicacy of clinical decisions justifies utilization of information systems such as artificial intelligence (e.g. expert systems and neural networks) to achieve better decisions, however, application of these systems in the medical domain faces some challenges. We aimed at to review the applications of these systems in the medical domain and discuss about such challenges. Following a brief introduction of expert systems and neural networks by representing few examples, the challenges of these systems in the medical domain are discussed. We found that the applications of expert systems and artificial neural networks have been increased in the medical domain. These systems have shown many advantages such as utilization of experts' knowledge, gaining rare knowledge, more time for assessment of the decision, more consistent decisions, and shorter decision-making process. In spite of all these advantages, there are challenges ahead of developing and using such systems including maintenance, required experts, inputting patients' data into the system, problems for knowledge acquisition, problems in modeling medical knowledge, evaluation and validation of system performance, wrong recommendations and responsibility, limited domains of such systems and necessity of integrating such systems into the routine work flows. We concluded that expert systems and neural networks can be successfully used in medicine; however, there are many concerns and questions to be answered through future studies and discussions.

A clinical decision support system with an integrated EMR for diagnosis of peripheral neuropathy

The prevalence of peripheral neuropathy in general population is ever increasing. The diagnosis and classification of peripheral neuropathies is often difficult as it involves careful clinical and electro-diagnostic examination by an expert neurologist. In developing countries a large percentage of the disease remains undiagnosed due to lack of adequate number of experts. In this study a novel clinical decision support system has been developed using a fuzzy expert system. The study was done to provide a solution to the demand of systems that can improve health care by accurate diagnosis in limited time, in the absence of specialists. It employs a graphical user interface and a fuzzy logic controller with rule viewer for identification of the type of peripheral neuropathy. An integrated medical records database is also developed for the storage and retrieval of the data. The system consists of 24 input fields, which includes the clinical values of the diagnostic test and the clinical symptoms. The output field is the disease diagnosis, whether it is Motor (Demyelinating/Axonopathy) neuropathy, sensory (Demyelinating/Axonopathy) neuropathy, mixed type or a normal case. The results obtained were compared with the expert's opinion and the system showed 93.27 % accuracy. The study aims at showing that Fuzzy Expert Systems may prove useful in providing diagnostic and predictive medical opinions. It enables the clinicians to arrive at a better diagnosis as it keeps the expert knowledge in an intelligent system to be used efficiently and effectively.