Quality Assessment of ECG Compression Techniques Using a Wavelet-Based Diagnostic Measure

Diagnostic quality assessment for low-dimensional ECG representations

There have been several attempts to quantify the diagnostic distortion caused by algorithms that perform low-dimensional electrocardiogram (ECG) representation. However, there is no universally accepted quantitative measure that allows the diagnostic distortion arising from denoising, compression, and ECG beat representation algorithms to be determined. Hence, the main objective of this work was to develop a framework to enable biomedical engineers to efficiently and reliably assess diagnostic distortion resulting from ECG processing algorithms. We propose a semiautomatic framework for quantifying the diagnostic resemblance between original and denoised/reconstructed ECGs. Evaluation of the ECG must be done manually, but is kept simple and does not require medical training. In a case study, we quantified the agreement between raw and reconstructed (denoised) ECG recordings by means of kappa-based statistical tests. The proposed methodology takes into account that the observers may agree by chance alone. Consequently, for the case study, our statistical analysis reports the "true", beyond-chance agreement in contrast to other, less robust measures, such as simple percent agreement calculations. Our framework allows efficient assessment of clinically important diagnostic distortion, a potential side effect of ECG (pre-)processing algorithms. Accurate quantification of a possible diagnostic loss is critical to any subsequent ECG signal analysis, for instance, the detection of ischemic ST episodes in long-term ECG recordings.

Adaptive Sampling of the Electrocardiogram Based on Generalized Perceptual Features

A non-uniform distribution of diagnostic information in the electrocardiogram (ECG) has been commonly accepted and is the background to several compression, denoising and watermarking methods. Gaze tracking is a widely recognized method for identification of an observer's preferences and interest areas. The statistics of experts' scanpaths were found to be a convenient quantitative estimate of medical information density for each particular component (i.e., wave) of the ECG record. In this paper we propose the application of generalized perceptual features to control the adaptive sampling of a digital ECG. Firstly, based on temporal distribution of the information density, local ECG bandwidth is estimated and projected to the actual positions of components in heartbeat representation. Next, the local sampling frequency is calculated pointwise and the ECG is adaptively low-pass filtered in all simultaneous channels. Finally, sample values are interpolated at new time positions forming a non-uniform time series. In evaluation of perceptual sampling, an inverse transform was used for the reconstruction of regularly sampled ECG with a percent root-mean-square difference (PRD) error of 3-5% (for compression ratios 3.0-4.7, respectively). Nevertheless, tests performed with the use of the CSE Database show good reproducibility of ECG diagnostic features, within the IEC 60601-2-25:2015 requirements, thanks to the occurrence of distortions in less relevant parts of the cardiac cycle.

A morphologically robust chaotic map based approach to embed patient's confidential data securely in non-QRS regions of ECG signal

In e-healthcare paradigm, the physiological signals along with patient's personal information need to be transmitted to remote healthcare centres. Before sharing this sensitive information over the unsecured channel, it is prerequisite to protect it from unauthorised access. The proposed method explores ECG signal as the cover signal to hide patient's personal information without disturbing its diagnostic features. Chaotic maps are used to randomly select the embedding locations in the non-QRS region while excluding the sensitive QRS region of ECG train. Optimum Location Selection algorithm has been designed to select the embedding locations in non-QRS embedding region. The proposed algorithm is thoroughly examined and the distortion is measured in terms of statistical parameters and clinical measures such as PRD, PRDN, PRD1024, PSNR, SNR, MSE, MAE, KL-Divergence, WWPRD and WEDD. The robustness of the algorithm is verified using the parameters such as key space and key sensitivity. The implementation has been extensively tested on all the 48 records of the standard MIT-BIH Arrhythmia database, abnormal databases [CU-VT, BIDMC-CHF and PTB (leads I, II and III)] and self-recorded data of 20 subjects. The algorithm yields average PRD, MSE, KL-Divergence, PSNR, WWPRD and WEDD of 4.7 × 10^-3, 1.13 × 10^-5, 1.29 × 10^-5, 50.28, 0.15 and 0.04 at an average maximum EC of 0.45(96876 bits) on MIT-BIH Arrhythmia database and 0.016, 3.38 × 10^-5, 1.8 × 10^-4, 46.03, 0.13 and 0.03 respectively at an average maximum EC of 0.47 (102571 bits) on self-recorded data which clearly reveals the competency of the proposed algorithm in comparison with the other state of the art ECG steganography approaches.

Algorithm and VLSI Architecture Design of Low-Power SPIHT Decoder for mHealth Applications

A real-time cost and power-efficient (CPE) set partitioning in hierarchical trees (SPIHT) decoder design with low hardware complexity and low-power dissipation is introduced in one-dimension (1-D) wavelet-based quality-assured electrocardiograph (ECG) compression systems for mobile health (mHealth) applications. However, current SPIHT coding architectures are designed for image/video processing. These architectures require a large amount of memory as well as complicated sorting algorithms, which both require time-consuming tasks and are unsuitable for mobile ECG applications. Based on our previously modified SPIHT coding work, which used flags and check bits to reduce memory requirements and coding complexity by merging three search processes into one step. Therefore, to achieve the real-time design goal for mobile ECG applications, in this paper, we first introduce a hardware-oriented SPIHT decoding algorithm that is suitable for decoding the previously presented SPIHT coding work. Accordingly, an appropriate low-power hardware architecture is developed to implement a real-time high-performance and low-cost SPIHT VLSI design for our proposed decoder algorithm, which is appropriate for mobile ECG applications. Using the distinct ECG signals in the MIT-BIH arrhythmia database (sampling rate of 360 Hz), the final simulation and VLSI implementation results reveal that the proposed CPE SPIHT decoder design outperforms the state-of-the-art designs in terms of the average decoding time, the decoding quality, the VLSI speed, and the power consumption. Most importantly, the design can be exploited to a 1-D 1024 × 1 wavelet-based quality-assured ECG data compression system.

A Comparative Analysis of Methods for Evaluation of ECG Signal Quality after Compression

The assessment of ECG signal quality after compression is an essential part of the compression process. Compression facilitates the signal archiving, speeds up signal transmission, and reduces the energy consumption. Conversely, lossy compression distorts the signals. Therefore, it is necessary to express the compression performance through both compression efficiency and signal quality. This paper provides an overview of objective algorithms for the assessment of both ECG signal quality after compression and compression efficiency. In this area, there is a lack of standardization, and there is no extensive review as such. 40 methods were tested in terms of their suitability for quality assessment. For this purpose, the whole CSE database was used. The tested signals were compressed using an algorithm based on SPIHT with varying efficiency. As a reference, compressed signals were manually assessed by two experts and classified into three quality groups. Owing to the experts' classification, we determined corresponding ranges of selected quality evaluation methods' values. The suitability of the methods for quality assessment was evaluated based on five criteria. For the assessment of ECG signal quality after compression, we recommend using a combination of these methods: PSim SDNN, QS, SNR1, MSE, PRDN1, MAX, STDERR, and WEDD SWT.

Robust cardiac event change detection method for long-term healthcare monitoring applications

A long-term continuous cardiac health monitoring system highly demands more battery power for real-time transmission of electrocardiogram (ECG) signals and increases bandwidth, treatment costs and traffic load of the diagnostic server. In this Letter, the authors present an automated low-complexity robust cardiac event change detection (CECD) method that can continuously detect specific changes in PQRST morphological patterns and heart rhythms and then enable transmission/storing of the recorded ECG signals. The proposed CECD method consists of four stages: ECG signal quality assessment, R-peak detection and beat waveform extraction, temporal and RR interval feature extraction and cardiac event change decision. The proposed method is tested and validated using both normal and abnormal ECG signals including different types of arrhythmia beats, heart rates and signal quality. Results show that the method achieves an average sensitivity of 99.76%, positive predictivity of 94.58% and overall accuracy of 94.32% in determining the changes in heartbeat waveforms of the ECG signals.

Steganography in arrhythmic electrocardiogram signal

Security and privacy of patient data is a vital requirement during exchange/storage of medical information over communication network. Steganography method hides patient data into a cover signal to prevent unauthenticated accesses during data transfer. This study evaluates the performance of ECG steganography to ensure secured transmission of patient data where an abnormal ECG signal is used as cover signal. The novelty of this work is to hide patient data into two dimensional matrix of an abnormal ECG signal using Discrete Wavelet Transform and Singular Value Decomposition based steganography method. A 2D ECG is constructed according to Tompkins QRS detection algorithm. The missed R peaks are computed using RR interval during 2D conversion. The abnormal ECG signals are obtained from the MIT-BIH arrhythmia database. Metrics such as Peak Signal to Noise Ratio, Percentage Residual Difference, Kullback-Leibler distance and Bit Error Rate are used to evaluate the performance of the proposed approach.

Exploiting multi-lead electrocardiogram correlations using robust third-order tensor decomposition

In this Letter, a robust third-order tensor decomposition of multi-lead electrocardiogram (MECG) comprising of 12-leads is proposed to reduce the dimension of the storage data. An order-3 tensor structure is employed to represent the MECG data by rearranging the MECG information in three dimensions. The three-dimensions of the formed tensor represent the number of leads, beats and samples of some fixed ECG duration. Dimension reduction of such an arrangement exploits correlations present among the successive beats (intra-beat and inter-beat) and across the leads (inter-lead). The higher-order singular value decomposition is used to decompose the tensor data. In addition, multiscale analysis has been added for effective care of ECG information. It grossly segments the ECG characteristic waves (P-wave, QRS-complex, ST-segment and T-wave etc.) into different sub-bands. In the meantime, it separates high-frequency noise components into lower-order sub-bands which helps in removing noise from the original data. For evaluation purposes, we have used the publicly available PTB diagnostic database. The proposed method outperforms the existing algorithms where compression ratio is under 10 for MECG data. Results show that the original MECG data volume can be reduced by more than 45 times with acceptable diagnostic distortion level.

A reconfigurable medically cohesive biomedical front-end with ΣΔ ADC in 0.18µm CMOS

This paper presents a generic programmable analog front-end (AFE) for acquisition and digitization of various biopotential signals. This includes a lead-off detection circuit, an ultra-low current capacitively coupled signal conditioning stage with programmable gain and bandwidth, a new mixed signal automatic gain control (AGC) mechanism and a medically cohesive reconfigurable ΣΔ ADC. The full system is designed in UMC 0.18μm CMOS. The AFE achieves an overall linearity of more 10 bits with 0.47μW power consumption. The ADC provides 2(nd) order noise-shaping while using single integrator and an ENOB of ~11 bits with 5μW power consumption. The system was successfully verified for various ECG signals from PTB database. This system is intended for portable batteryless u-Healthcare devices.

Discrete wavelet transform and singular value decomposition based ECG steganography for secured patient information transmission

ECG Steganography provides secured transmission of secret information such as patient personal information through ECG signals. This paper proposes an approach that uses discrete wavelet transform to decompose signals and singular value decomposition (SVD) to embed the secret information into the decomposed ECG signal. The novelty of the proposed method is to embed the watermark using SVD into the two dimensional (2D) ECG image. The embedding of secret information in a selected sub band of the decomposed ECG is achieved by replacing the singular values of the decomposed cover image by the singular values of the secret data. The performance assessment of the proposed approach allows understanding the suitable sub-band to hide secret data and the signal degradation that will affect diagnosability. Performance is measured using metrics like Kullback-Leibler divergence (KL), percentage residual difference (PRD), peak signal to noise ratio (PSNR) and bit error rate (BER). A dynamic location selection approach for embedding the singular values is also discussed. The proposed approach is demonstrated on a MIT-BIH database and the observations validate that HH is the ideal sub-band to hide data. It is also observed that the signal degradation (less than 0.6%) is very less in the proposed approach even with the secret data being as large as the sub band size. So, it does not affect the diagnosability and is reliable to transmit patient information.

Wavelet-Based ECG Steganography for Protecting Patient Confidential Information in Point-of-Care Systems

With the growing number of aging population and a significant portion of that suffering from cardiac diseases, it is conceivable that remote ECG patient monitoring systems are expected to be widely used as point-of-care (PoC) applications in hospitals around the world. Therefore, huge amount of ECG signal collected by body sensor networks from remote patients at homes will be transmitted along with other physiological readings such as blood pressure, temperature, glucose level, etc., and diagnosed by those remote patient monitoring systems. It is utterly important that patient confidentiality is protected while data are being transmitted over the public network as well as when they are stored in hospital servers used by remote monitoring systems. In this paper, a wavelet-based steganography technique has been introduced which combines encryption and scrambling technique to protect patient confidential data. The proposed method allows ECG signal to hide its corresponding patient confidential data and other physiological information thus guaranteeing the integration between ECG and the rest. To evaluate the effectiveness of the proposed technique on the ECG signal, two distortion measurement metrics have been used: the percentage residual difference and the wavelet weighted PRD. It is found that the proposed technique provides high-security protection for patients data with low (less than 1%) distortion and ECG data remain diagnosable after watermarking (i.e., hiding patient confidential data) and as well as after watermarks (i.e., hidden data) are removed from the watermarked data.

Assurance of energy efficiency and data security for ECG transmission in BASNs

With the technological advancement in body area sensor networks (BASNs), low cost high quality electrocardiographic (ECG) diagnosis systems have become important equipment for healthcare service providers. However, energy consumption and data security with ECG systems in BASNs are still two major challenges to tackle. In this study, we investigate the properties of compressed ECG data for energy saving as an effort to devise a selective encryption mechanism and a two-rate unequal error protection (UEP) scheme. The proposed selective encryption mechanism provides a simple and yet effective security solution for an ECG sensor-based communication platform, where only one percent of data is encrypted without compromising ECG data security. This part of the encrypted data is essential to ECG data quality due to its unequally important contribution to distortion reduction. The two-rate UEP scheme achieves a significant additional energy saving due to its unequal investment of communication energy to the outcomes of the selective encryption, and thus, it maintains a high ECG data transmission quality. Our results show the improvements in communication energy saving of about 40%, and demonstrate a higher transmission quality and security measured in terms of wavelet-based weighted percent root-mean-squared difference.

Automatic real-time ECG coding methodology guaranteeing signal interpretation quality

This paper introduces a new methodology for compressing ECG signals in an automatic way guaranteeing signal interpretation quality. The approach is based on noise estimation in the ECG signal that is used as a compression threshold in the coding stage. The Set Partitioning in Hierarchical Trees algorithm is used to code the signal in the wavelet domain. Forty different ECG records from two different ECG databases commonly used in ECG compression have been considered to validate the approach. Three cardiologists have participated in the clinical trial using mean opinion score tests in order to rate the signals quality. Results showed that the approach not only achieves very good ECG reconstruction quality but also enhances the visual quality of the ECG signal.

A linear quality control design for high efficient wavelet-based ECG data compression

In ECG data compression, maintaining reconstructed signal with desired quality is crucial for clinical application. In this paper, a linear quality control design based on the reversible round-off non-recursive discrete periodized wavelet transform (RRO-NRDPWT) is proposed for high efficient ECG data compression. With the advantages of error propagation resistance and octave coefficient normalization, RRO-NRDPWT enables the non-linear quantization control to obtain an approximately linear distortion by using a single control variable. Based on the linear programming, a linear quantization scale prediction model is presented for the quality control of reconstructed ECG signal. Following the use of the MIT-BIH arrhythmia database, the experimental results show that the proposed system, with lower computational complexity, can obtain much better quality control performance than that of other wavelet-based systems.