A Clinical Decision Support Framework for Heterogeneous Data Sources

Automating Prostate Cancer Grading: A Novel Deep Learning Framework for Automatic Prostate Cancer Grade Assessment using Classification and Segmentation

Prostate Cancer (PCa) is the second most common cancer in men and affects more than a million people each year. Grading prostate cancer is based on the Gleason grading system, a subjective and labor-intensive method for evaluating prostate tissue samples. The variability in diagnostic approaches underscores the urgent need for more reliable methods. By integrating deep learning technologies and developing automated systems, diagnostic precision can be improved, and human error minimized. The present work introduces a three-stage framework-based innovative deep-learning system for assessing PCa severity using the PANDA challenge dataset. After a meticulous selection process, 2699 usable cases were narrowed down from the initial 5160 cases after extensive data cleaning. There are three stages in the proposed framework: classification of PCa grades using deep neural networks (DNNs), segmentation of PCa grades, and computation of International Society for Urological Pathology (ISUP) grades using machine learning classifiers. Four classes of patches were classified and segmented (benign, Gleason 3, Gleason 4, and Gleason 5). Patch sampling at different sizes (500 × 500 and 1000 × 1000 pixels) was used to optimize the classification and segmentation processes. The segmentation performance of the proposed network is enhanced by a Self-organized operational neural network (Self-ONN) based DeepLabV3 architecture. Based on these predictions, the distribution percentages of each cancer grade within the whole slide images (WSI) were calculated. These features were then concatenated into machine learning classifiers to predict the final ISUP PCa grade. EfficientNet_b0 achieved the highest F1-score of 83.83% for classification, while DeepLabV3 + architecture based on self-ONN and EfficientNet encoder achieved the highest Dice Similarity Coefficient (DSC) score of 84.9% for segmentation. Using the RandomForest (RF) classifier, the proposed framework achieved a quadratic weighted kappa (QWK) score of 0.9215. Deep learning frameworks are being developed to grade PCa automatically and have shown promising results. In addition, it provides a prospective approach to a prognostic tool that can produce clinically significant results efficiently and reliably. Further investigations are needed to evaluate the framework's adaptability and effectiveness across various clinical scenarios.

Clinical Decision Support System in laboratory medicine

Clinical Decision Support Systems (CDSS) have been implemented in almost all healthcare settings. Laboratory medicine (LM), is one of the most important structured health data stores, but efforts are still needed to clarify the use and scope of these tools, especially in the laboratory setting. The aim is to clarify CDSS concept in LM, in the last decade. There is no consensus on the definition of CDSS in LM. A theoretical definition of CDSS in LM should capture the aim of driving significant improvements in LM mission, prevention, diagnosis, monitoring, and disease treatment. We identified the types, workflow and data sources of CDSS. The main applications of CDSS in LM were diagnostic support and clinical management, patient safety, workflow improvements, and cost containment. Laboratory professionals, with their expertise in quality improvement and quality assurance, have a chance to be leaders in CDSS.

AI-Driven Decision Support for Early Detection of Cardiac Events: Unveiling Patterns and Predicting Myocardial Ischemia

Cardiovascular diseases (CVDs) account for a significant portion of global mortality, emphasizing the need for effective strategies. This study focuses on myocardial infarction, pulmonary thromboembolism, and aortic stenosis, aiming to empower medical practitioners with tools for informed decision making and timely interventions. Drawing from data at Hospital Santa Maria, our approach combines exploratory data analysis (EDA) and predictive machine learning (ML) models, guided by the Cross-Industry Standard Process for Data Mining (CRISP-DM) methodology. EDA reveals intricate patterns and relationships specific to cardiovascular diseases. ML models achieve accuracies above 80%, providing a 13 min window to predict myocardial ischemia incidents and intervene proactively. This paper presents a Proof of Concept for real-time data and predictive capabilities in enhancing medical strategies.

Interpretable Machine Learning for Personalized Medical Recommendations: A LIME-Based Approach

Chronic diseases are increasingly major threats to older persons, seriously affecting their physical health and well-being. Hospitals have accumulated a wealth of health-related data, including patients' test reports, treatment histories, and diagnostic records, to better understand patients' health, safety, and disease progression. Extracting relevant information from this data enables physicians to provide personalized patient-treatment recommendations. While collaborative filtering techniques and classical algorithms such as naive Bayes, logistic regression, and decision trees have had notable success in health-recommendation systems, most current systems primarily inform users of their likely preferences without providing explanations. This paper proposes an approach of deep learning with a local interpretable model-agnostic explanations (LIME)-based interpretable recommendation system to solve this problem. Specifically, we apply the proposed approach to two chronic diseases common in older adults: heart disease and diabetes. After data preprocessing, we use six deep-learning algorithms to form interpretations. In the heart-disease data set, the actual model recommendation of multi-layer perceptron and gradient-boosting algorithm differs from the local model's recommendation of LIME, which can be used as its approximate prediction. From the feature importance of these two algorithms, it can be seen that the CholCheck, GenHith, and HighBP features are the most important for predicting heart disease. In the diabetes data set, the actual model predictions of the multi-layer perceptron and logistic-regression algorithm were little different from the local model's prediction of LIME, which can be used as its approximate recommendation. Moreover, from the feature importance of the two algorithms, it can be seen that the three features of glucose, BMI, and age were the most important for predicting heart disease. Next, LIME is used to determine the importance of each feature that affected the results of the calculated model. Subsequently, we present the contribution coefficients of these features to the final recommendation. By analyzing the impact of different patient characteristics on the recommendations, our proposed system elucidates the underlying reasons behind these recommendations and enhances patient trust. This approach has important implications for medical recommendation systems and encourages informed decision-making in healthcare.

Hybrid LSTM Self-Attention Mechanism Model for Forecasting the Reform of Scientific Research in Morocco

Education is the cultivation of people to promote and guarantee the development of society. Education reforms can play a vital role in the development of a country. However, it is crucial to continually monitor the educational model's performance by forecasting the outcome's progress. Machine learning-based models are currently a hot topic in improving the forecasting research area. Forecasting models can help to analyse the impact of future outcomes by showing yearly trends. For this study, we developed a hybrid, forecasting time-series model by long short-term memory (LSTM) network and self-attention mechanism (SAM) to monitor Morocco's educational reform. We analysed six universities' performance and provided a prediction model to evaluate the best-performing university's performance after implementing the latest reform, i.e., from 2015-2030. We forecasted the six universities' research outcomes and tested our proposed methodology's accuracy against other time-series models. Results show that our model performs better for predicting research outcomes. The percentage increase in university performance after nine years is discussed to help predict the best-performing university. Our proposed algorithm accuracy and performance are better than other algorithms like LSTM and RNN.

Learning from imbalanced fetal outcomes of systemic lupus erythematosus in artificial neural networks

OBJECTIVE

To explore an effective algorithm based on artificial neural network to pick correctly the minority of pregnant women with SLE suffering fetal loss outcomes from the majority with live birth and train a well behaved model as a clinical decision assistant.

METHODS

We integrated the thoughts of comparative and focused study into the artificial neural network and presented an effective algorithm aiming at imbalanced learning in small dataset.

RESULTS

We collected 469 non-trivial pregnant patients with SLE, where 420 had live-birth outcomes and the other 49 patients ended in fetal loss. A well trained imbalanced-learning model had a high sensitivity of 19/21 ([Formula: see text]) for the identification of patients with fetal loss outcomes.

DISCUSSION

The misprediction of the two patients was explainable. Algorithm improvements in artificial neural network framework enhanced the identification in imbalanced learning problems and the external validation increased the reliability of algorithm.

CONCLUSION

The well-trained model was fully qualified to assist healthcare providers to make timely and accurate decisions.

Privacy-Preserving K-Nearest Neighbors Training over Blockchain-Based Encrypted Health Data

Numerous works focus on the data privacy issue of the Internet of Things (IoT) when training a supervised Machine Learning (ML) classifier. Most of the existing solutions assume that the classifier’s training data can be obtained securely from different IoT data providers. The primary concern is data privacy when training a K-Nearest Neighbour (K-NN) classifier with IoT data from various entities. This paper proposes secure K-NN, which provides a privacy-preserving K-NN training over IoT data. It employs Blockchain technology with a partial homomorphic cryptosystem (PHC) known as Paillier in order to protect all participants (i.e., IoT data analyst C and IoT data provider P) data privacy. When C analyzes the IoT data of P, both participants’ privacy issue arises and requires a trusted third party. To protect each candidate’s privacy and remove the dependency on a third-party, we assemble secure building blocks in secure K-NN based on Blockchain technology. Firstly, a protected data-sharing platform is developed among various P, where encrypted IoT data is registered on a shared ledger. Secondly, the secure polynomial operation (SPO), secure biasing operations (SBO), and secure comparison (SC) are designed using the homomorphic property of Paillier. It shows that secure K-NN does not need any trusted third-party at the time of interaction, and rigorous security analysis demonstrates that secure K-NN protects sensitive data privacy for each P and C. The secure K-NN achieved 97.84%, 82.33%, and 76.33% precisions on BCWD, HDD, and DD datasets. The performance of secure K-NN is precisely similar to the general K-NN and outperforms all the previous state of art methods.

Diagnosis of Rare Diseases: a scoping review of clinical decision support systems

BACKGROUND

Rare Diseases (RDs), which are defined as diseases affecting no more than 5 out of 10,000 people, are often severe, chronic and life-threatening. A main problem is the delay in diagnosing RDs. Clinical decision support systems (CDSSs) for RDs are software systems to support clinicians in the diagnosis of patients with RDs. Due to their clinical importance, we conducted a scoping review to determine which CDSSs are available to support the diagnosis of RDs patients, whether the CDSSs are available to be used by clinicians and which functionalities and data are used to provide decision support.

METHODS

We searched PubMed for CDSSs in RDs published between December 16, 2008 and December 16, 2018. Only English articles, original peer reviewed journals and conference papers describing a clinical prototype or a routine use of CDSSs were included. For data charting, we used the data items "Objective and background of the publication/project", "System or project name", "Functionality", "Type of clinical data", "Rare Diseases covered", "Development status", "System availability", "Data entry and integration", "Last software update" and "Clinical usage".

RESULTS

The search identified 636 articles. After title and abstracting screening, as well as assessing the eligibility criteria for full-text screening, 22 articles describing 19 different CDSSs were identified. Three types of CDSSs were classified: "Analysis or comparison of genetic and phenotypic data," "machine learning" and "information retrieval". Twelve of nineteen CDSSs use phenotypic and genetic data, followed by clinical data, literature databases and patient questionnaires. Fourteen of nineteen CDSSs are fully developed systems and therefore publicly available. Data can be entered or uploaded manually in six CDSSs, whereas for four CDSSs no information for data integration was available. Only seven CDSSs allow further ways of data integration. thirteen CDSS do not provide information about clinical usage.

CONCLUSIONS

Different CDSS for various purposes are available, yet clinicians have to determine which is best for their patient. To allow a more precise usage, future research has to focus on CDSSs RDs data integration, clinical usage and updating clinical knowledge. It remains interesting which of the CDSSs will be used and maintained in the future.

Homecare Robotic Systems for Healthcare 4.0: Visions and Enabling Technologies

Powered by the technologies that have originated from manufacturing, the fourth revolution of healthcare technologies is happening (Healthcare 4.0). As an example of such revolution, new generation homecare robotic systems (HRS) based on the cyber-physical systems (CPS) with higher speed and more intelligent execution are emerging. In this article, the new visions and features of the CPS-based HRS are proposed. The latest progress in related enabling technologies is reviewed, including artificial intelligence, sensing fundamentals, materials and machines, cloud computing and communication, as well as motion capture and mapping. Finally, the future perspectives of the CPS-based HRS and the technical challenges faced in each technical area are discussed.