Intelligent Emotion and Sensory Remote Prioritisation for Patients with Multiple Chronic Diseases

An intelligent remote prioritization for patients with high-risk multiple chronic diseases is proposed in this research, based on emotion and sensory measurements and multi-criteria decision making. The methodology comprises two phases: (1) a case study is discussed through the adoption of a multi-criteria decision matrix for high-risk level patients; (2) the technique for reorganizing opinion order to interval levels (TROOIL) is modified by combining it with an extended fuzzy-weighted zero-inconsistency (FWZIC) method over fractional orthotriple fuzzy sets to address objective weighting issues associated with the original TROOIL. In the first hierarchy level, chronic heart disease is identified as the most important criterion, followed by emotion-based criteria in the second. The third hierarchy level shows that Peaks is identified as the most important sensor-based criterion and chest pain as the most important emotion criterion. Low blood pressure disease is identified as the most important criterion for patient prioritization, with the most severe cases being prioritized. The results are evaluated using systematic ranking and sensitivity analysis.

Systematic review of MCDM approach applied to the medical case studies of COVID-19: trends, bibliographic analysis, challenges, motivations, recommendations, and future directions

When COVID-19 spread in China in December 2019, thousands of studies have focused on this pandemic. Each presents a unique perspective that reflects the pandemic's main scientific disciplines. For example, social scientists are concerned with reducing the psychological impact on the human mental state especially during lockdown periods. Computer scientists focus on establishing fast and accurate computerized tools to assist in diagnosing, preventing, and recovering from the disease. Medical scientists and doctors, or the frontliners, are the main heroes who received, treated, and worked with the millions of cases at the expense of their own health. Some of them have continued to work even at the expense of their lives. All these studies enforce the multidisciplinary work where scientists from different academic disciplines (social, environmental, technological, etc.) join forces to produce research for beneficial outcomes during the crisis. One of the many branches is computer science along with its various technologies, including artificial intelligence, Internet of Things, big data, decision support systems (DSS), and many more. Among the most notable DSS utilization is those related to multicriterion decision making (MCDM), which is applied in various applications and across many contexts, including business, social, technological and medical. Owing to its importance in developing proper decision regimens and prevention strategies with precise judgment, it is deemed a noteworthy topic of extensive exploration, especially in the context of COVID-19-related medical applications. The present study is a comprehensive review of COVID-19-related medical case studies with MCDM using a systematic review protocol. PRISMA methodology is utilized to obtain a final set of (n = 35) articles from four major scientific databases (ScienceDirect, IEEE Xplore, Scopus, and Web of Science). The final set of articles is categorized into taxonomy comprising five groups: (1) diagnosis (n = 6), (2) safety (n = 11), (3) hospital (n = 8), (4) treatment (n = 4), and (5) review (n = 3). A bibliographic analysis is also presented on the basis of annual scientific production, country scientific production, co-occurrence, and co-authorship. A comprehensive discussion is also presented to discuss the main challenges, motivations, and recommendations in using MCDM research in COVID-19-related medial case studies. Lastly, we identify critical research gaps with their corresponding solutions and detailed methodologies to serve as a guide for future directions. In conclusion, MCDM can be utilized in the medical field effectively to optimize the resources and make the best choices particularly during pandemics and natural disasters.

Federated Learning for IoMT Applications: A Standardisation and Benchmarking Framework of Intrusion Detection Systems

Efficient evaluation for machine learning (ML)-based intrusion detection systems (IDSs) for federated learning (FL) in the Internet of Medical Things (IoMTs) environment falls under the standardisation and multicriteria decision-making (MCDM) problems. Thus, this study is developing an MCDM framework for standardising and benchmarking the ML-based IDSs used in the FL architecture of IoMT applications. In the methodology, firstly, the evaluation criteria of ML-based IDSs are standardised using the fuzzy Delphi method (FDM). Secondly, the evaluation decision matrix (DM) is formulated based on the intersection of standardised evaluation criteria and a list of ML-based IDSs. Such formulation is achieved using a dataset with 125,973 records, and each record comprises 41 features. Thirdly, the integration of MCDM methods is formulated to determine the importance weights of the main and sub standardised security and performance criteria, followed by benchmarking and selecting the optimal ML-based IDSs. In this phase, the Borda voting method is used to unify the different ranks and perform a group benchmarking context. The following results are confirmed. (1) Using FDM, 17 out of 20 evaluation criteria (14 for security and 3 for performance) reach the consensus of experts. (2) The area under curve criterion has the lowest set of weights, whilst the CPU time criterion has the highest one. (3) VIKOR group ranking shows that the BayesNet is a best classifier, whilst SVM is the last choice. For evaluation, three assessments, namely, systematic ranking, computational cost and comparative analysis, are used.

Integration of fuzzy-weighted zero-inconsistency and fuzzy decision by opinion score methods under a q-rung orthopair environment: A distribution case study of COVID-19 vaccine doses

Owing to the limitations of Pythagorean fuzzy and intuitionistic fuzzy sets, scientists have developed a distinct and successive fuzzy set called the q-rung orthopair fuzzy set (q-ROFS), which eliminates restrictions encountered by decision-makers in multicriteria decision making (MCDM) methods and facilitates the representation of complex uncertain information in real-world circumstances. Given its advantages and flexibility, this study has extended two considerable MCDM methods the fuzzy-weighted zero-inconsistency (FWZIC) method and fuzzy decision by opinion score method (FDOSM) under the fuzzy environment of q-ROFS. The extensions were called q-rung orthopair fuzzy-weighted zero-inconsistency (q-ROFWZIC) method and q-rung orthopair fuzzy decision by opinion score method (q-ROFDOSM). The methodology formulated had two phases. The first phase 'development' presented the sequential steps of each method thoroughly.The q-ROFWZIC method was formulated and used in determining the weights of evaluation criteria and then integrated into the q-ROFDOSM for the prioritisation of alternatives on the basis of the weighted criteria. In the second phase, a case study regarding the MCDM problem of coronavirus disease 2019 (COVID-19) vaccine distribution was performed. The purpose was to provide fair allocation of COVID-19 vaccine doses. A decision matrix based on an intersection of 'recipients list' and 'COVID-19 distribution criteria' was adopted. The proposed methods were evaluated according to systematic ranking assessment and sensitivity analysis, which revealed that the ranking was subject to a systematic ranking that is supported by high correlation results over different scenarios with variations in the weights of criteria.

Based on neutrosophic fuzzy environment: a new development of FWZIC and FDOSM for benchmarking smart e-tourism applications

The task of benchmarking smart e-tourism applications based on multiple smart key concept attributes is considered a multi-attribute decision-making (MADM) problem. Although the literature review has evaluated and benchmarked these applications, data ambiguity and vagueness continue to be unresolved issues. The robustness of the fuzzy decision by opinion score method (FDOSM) and fuzzy weighted with zero inconsistency (FWZIC) is proven compared with that of other MADM methods. Thus, this study extends FDOSM and FWZIC under a new fuzzy environment to address the mentioned issues whilst benchmarking the applications. The neutrosophic fuzzy set is used for this purpose because of its high ability to handle ambiguous and vague information comprehensively. Fundamentally, the proposed methodology comprises two phases. The first phase adopts and describes the decision matrices of the smart e-tourism applications. The second phase presents the proposed framework in two sections. In the first section, the weight of each attribute of smart e-tourism applications is calculated through the neutrosophic FWZIC (NS-FWZIC) method. The second section employs the weights determined by the NS-FWZIC method to benchmark all the applications per each category (tourism marketing and smart-based tourism recommendation system categories) through the neutrosophic FDOSM (NS-FDOSM). Findings reveal that: (1) the NS-FWZIC method effectively weights the applications’ attributes. Real time receives the highest importance weight (0.402), whereas augmented reality has the lowest weight (0.005). The remaining attributes are distributed in between. (2) In the context of group decision-making, NS-FDOSM is used to uniform the variation found in the individual benchmarking results of the applications across all categories. Systematic ranking, sensitivity analysis and comparison analysis assessments are used to evaluate the robustness of the proposed work. Finally, the limitations of this study are discussed along with several future directions.

Rescuing emergency cases of COVID-19 patients: An intelligent real-time MSC transfusion framework based on multicriteria decision-making methods

Mesenchymal stem cells (MSCs) have shown promising ability to treat critical cases of coronavirus disease 2019 (COVID-19) by regenerating lung cells and reducing immune system overreaction. However, two main challenges need to be addressed first before MSCs can be efficiently transfused to the most critical cases of COVID-19. First is the selection of suitable MSC sources that can meet the standards of stem cell criteria. Second is differentiating COVID-19 patients into different emergency levels automatically and prioritising them in each emergency level. This study presents an efficient real-time MSC transfusion framework based on multicriteria decision-making(MCDM) methods. In the methodology, the testing phase represents the ability to adhere to plastic surfaces, the upregulation and downregulation of specific surface protein markers and finally the ability to differentiate into different kinds of cells. In the development phase, firstly, two scenarios of an augmented dataset based on the medical perspective are generated to produce 80 patients with different emergency levels. Secondly, an automated triage algorithm based on a formal medical guideline is proposed for real-time monitoring of COVID-19 patients with different emergency levels (i.e. mild, moderate, severe and critical) considering the improvement and deterioration procedures from one level to another. Thirdly, a unique decision matrix for each triage level (except mild) is constructed on the basis of the intersection between the evaluation criteria of each emergency level and list of COVID-19 patients. Thereafter, MCDM methods (i.e. analytic hierarchy process [AHP] and vlsekriterijumska optimizcija i kaompromisno resenje [VIKOR]) are integrated to assign subjective weights for the evaluation criteria within each triage level and then prioritise the COVID-19 patients on the basis of individual and group decision-making(GDM) contexts. Results show that: (1) in both scenarios, the proposed algorithm effectively classified the patients into four emergency levels, including mild, moderate, severe and critical, taking into consideration the improvement and deterioration cases. (2) On the basis of experts’ perspectives, clear differences in most individual prioritisations for patients with different emergency levels in both scenarios were found. (3) In both scenarios, COVID-19 patients were prioritised identically between the internal and external group VIKOR. During the evaluation, the statistical objective method indicated that the patient prioritisations underwent systematic ranking. Moreover, comparison analysis with previous work proved the efficiency of the proposed framework. Thus, the real-time MSC transfusion for COVID-19 patients can follow the order achieved in the group VIKOR results.

Multi-perspectives systematic review on the applications of sentiment analysis for vaccine hesitancy

A substantial impediment to widespread Coronavirus disease (COVID-19) vaccination is vaccine hesitancy. Many researchers across scientific disciplines have presented countless studies in favor of COVID-19 vaccination, but misinformation on social media could hinder vaccination efforts and increase vaccine hesitancy. Nevertheless, studying people's perceptions on social media to understand their sentiment presents a powerful medium for researchers to identify the causes of vaccine hesitancy and therefore develop appropriate public health messages and interventions. To the best of the authors' knowledge, previous studies have presented vaccine hesitancy in specific cases or within one scientific discipline (i.e., social, medical, and technological). No previous study has presented findings via sentiment analysis for multiple scientific disciplines as follows: (1) social, (2) medical, public health, and (3) technology sciences. Therefore, this research aimed to review and analyze articles related to different vaccine hesitancy cases in the last 11 years and understand the application of sentiment analysis on the most important literature findings. Articles were systematically searched in Web of Science, Scopus, PubMed, IEEEXplore, ScienceDirect, and Ovid from January 1, 2010, to July 2021. A total of 30 articles were selected on the basis of inclusion and exclusion criteria. These articles were formed into a taxonomy of literature, along with challenges, motivations, and recommendations for social, medical, and public health and technology sciences. Significant patterns were identified, and opportunities were promoted towards the understanding of this phenomenon.

Telehealth utilization during the Covid-19 pandemic: A systematic review

During the coronavirus disease (COVID-19) pandemic, different technologies, including telehealth, are maximised to mitigate the risks and consequences of the disease. Telehealth has been widely utilised because of its usability and safety in providing healthcare services during the COVID-19 pandemic. However, a systematic literature review which provides extensive evidence on the impact of COVID-19 through telehealth and which covers multiple directions in a large-scale research remains lacking. This study aims to review telehealth literature comprehensively since the pandemic started. It also aims to map the research landscape into a coherent taxonomy and characterise this emerging field in terms of motivations, open challenges and recommendations. Articles related to telehealth during the COVID-19 pandemic were systematically searched in the WOS, IEEE, Science Direct, Springer and Scopus databases. The final set included (n = 86) articles discussing telehealth applications with respect to (i) control (n = 25), (ii) technology (n = 14) and (iii) medical procedure (n = 47). Since the beginning of the pandemic, telehealth has been presented in diverse cases. However, it still warrants further attention. Regardless of category, the articles focused on the challenges which hinder the maximisation of telehealth in such times and how to address them. With the rapid increase in the utilization of telehealth in different specialised hospitals and clinics, a potential framework which reflects the authors' implications of the future application and opportunities of telehealth has been established. This article improves our understanding and reveals the full potential of telehealth during these difficult times and beyond.

Based on T-spherical fuzzy environment: A combination of FWZIC and FDOSM for prioritising COVID-19 vaccine dose recipients

The problem complexity of multi-criteria decision-making (MCDM) has been raised in the distribution of coronavirus disease 2019 (COVID-19) vaccines, which required solid and robust MCDM methods. Compared with other MCDM methods, the fuzzy-weighted zero-inconsistency (FWZIC) method and fuzzy decision by opinion score method (FDOSM) have demonstrated their solidity in solving different MCDM challenges. However, the fuzzy sets used in these methods have neglected the refusal concept and limited the restrictions on their constants. To end this, considering the advantage of the T-spherical fuzzy sets (T-SFSs) in handling the uncertainty in the data and obtaining information with more degree of freedom, this study has extended FWZIC and FDOSM methods into the T-SFSs environment (called T-SFWZIC and T-SFDOSM) to be used in the distribution of COVID-19 vaccines. The methodology was formulated on the basis of decision matrix adoption and development phases. The first phase described the adopted decision matrix used in the COVID-19 vaccine distribution. The second phase presented the sequential formulation steps of T-SFWZIC used for weighting the distribution criteria followed by T-SFDOSM utilised for prioritising the vaccine recipients. Results revealed the following: (1) T-SFWZIC effectively weighted the vaccine distribution criteria based on several parameters including T = 2, T = 4, T = 6, T = 8, and T = 10. Amongst all parameters, the age criterion received the highest weight, whereas the geographic locations severity criterion has the lowest weight. (2) According to the T parameters, a considerable variance has occurred on the vaccine recipient orders, indicating that the existence of T values affected the vaccine distribution. (3) In the individual context of T-SFDOSM, no unique prioritisation was observed based on the obtained opinions of each expert. (4) The group context of T-SFDOSM used in the prioritisation of vaccine recipients was considered the final distribution result as it unified the differences found in an individual context. The evaluation was performed based on systematic ranking assessment and sensitivity analysis. This evaluation showed that the prioritisation results based on each T parameter were subject to a systematic ranking that is supported by high correlation results over all discussed scenarios of changing criteria weights values.

Sentiment analysis and its applications in fighting COVID-19 and infectious diseases: A systematic review

The COVID-19 pandemic caused by the novel coronavirus SARS-CoV-2 occurred unexpectedly in China in December 2019. Tens of millions of confirmed cases and more than hundreds of thousands of confirmed deaths are reported worldwide according to the World Health Organisation. News about the virus is spreading all over social media websites. Consequently, these social media outlets are experiencing and presenting different views, opinions and emotions during various outbreak-related incidents. For computer scientists and researchers, big data are valuable assets for understanding people's sentiments regarding current events, especially those related to the pandemic. Therefore, analysing these sentiments will yield remarkable findings. To the best of our knowledge, previous related studies have focused on one kind of infectious disease. No previous study has examined multiple diseases via sentiment analysis. Accordingly, this research aimed to review and analyse articles about the occurrence of different types of infectious diseases, such as epidemics, pandemics, viruses or outbreaks, during the last 10 years, understand the application of sentiment analysis and obtain the most important literature findings. Articles on related topics were systematically searched in five major databases, namely, ScienceDirect, PubMed, Web of Science, IEEE Xplore and Scopus, from 1 January 2010 to 30 June 2020. These indices were considered sufficiently extensive and reliable to cover our scope of the literature. Articles were selected based on our inclusion and exclusion criteria for the systematic review, with a total of n = 28 articles selected. All these articles were formed into a coherent taxonomy to describe the corresponding current standpoints in the literature in accordance with four main categories: lexicon-based models, machine learning-based models, hybrid-based models and individuals. The obtained articles were categorised into motivations related to disease mitigation, data analysis and challenges faced by researchers with respect to data, social media platforms and community. Other aspects, such as the protocol being followed by the systematic review and demographic statistics of the literature distribution, were included in the review. Interesting patterns were observed in the literature, and the identified articles were grouped accordingly. This study emphasised the current standpoint and opportunities for research in this area and promoted additional efforts towards the understanding of this research field.

PSO-Blockchain-based image steganography: towards a new method to secure updating and sharing COVID-19 data in decentralised hospitals intelligence architecture

Secure updating and sharing for large amounts of healthcare information (such as medical data on coronavirus disease 2019 [COVID-19]) in efficient and secure transmission are important but challenging in communication channels amongst hospitals. In particular, in addressing the above challenges, two issues are faced, namely, those related to confidentiality and integrity of their health data and to network failure that may cause concerns about data availability. To the authors' knowledge, no study provides secure updating and sharing solution for large amounts of healthcare information in communication channels amongst hospitals. Therefore, this study proposes and discusses a novel steganography-based blockchain method in the spatial domain as a solution. The novelty of the proposed method is the removal and addition of new particles in the particle swarm optimisation (PSO) algorithm. In addition, hash function can hide secret medical COVID-19 data in hospital databases whilst providing confidentiality with high embedding capacity and high image quality. Moreover, stego images with hash data and blockchain technology are used in updating and sharing medical COVID-19 data between hospitals in the network to improve the level of confidentiality and protect the integrity of medical COVID-19 data in grey-scale images, achieve data availability if any connection failure occurs in a single point of the network and eliminate the central point (third party) in the network during transmission. The proposed method is discussed in three stages. Firstly, the pre-hiding stage estimates the embedding capacity of each host image. Secondly, the secret COVID-19 data hiding stage uses PSO algorithm and hash function. Thirdly, the transmission stage transfers the stego images based on blockchain technology and updates all nodes (hospitals) in the network. As proof of concept for the case study, the authors adopted the latest COVID-19 research published in the Computer Methods and Programs in Biomedicine journal, which presents a rescue framework within hospitals for the storage and transfusion of the best convalescent plasma to the most critical patients with COVID-19 on the basis of biological requirements. The validation and evaluation of the proposed method are discussed.

Convalescent-plasma-transfusion intelligent framework for rescuing COVID-19 patients across centralised/decentralised telemedicine hospitals based on AHP-group TOPSIS and matching component

As coronavirus disease 2019 (COVID-19) spreads across the world, the transfusion of efficient convalescent plasma (CP) to the most critical patients can be the primary approach to preventing the virus spread and treating the disease, and this strategy is considered as an intelligent computing concern. In providing an automated intelligent computing solution to select the appropriate CP for the most critical patients with COVID-19, two challenges aspects are bound to be faced: (1) distributed hospital management aspects (including scalability and management issues for prioritising COVID-19 patients and donors simultaneously), and (2) technical aspects (including the lack of COVID-19 dataset availability of patients and donors and an accurate matching process amongst them considering all blood types). Based on previous reports, no study has provided a solution for CP-transfusion-rescue intelligent framework during this pandemic that has addressed said challenges and issues. This study aimed to propose a novel CP-transfusion intelligent framework for rescuing COVID-19 patients across centralised/decentralised telemedicine hospitals based on the matching component process to provide an efficient CP from eligible donors to the most critical patients using multicriteria decision-making (MCDM) methods. A dataset, including COVID-19 patients/donors that have met the important criteria in the virology field, must be augmented to improve the developed framework. Four consecutive phases conclude the methodology. In the first phase, a new COVID-19 dataset is generated on the basis of medical-reference ranges by specialised experts in the virology field. The simulation data are classified into 80 patients and 80 donors on the basis of the five biomarker criteria with four blood types (i.e., A, B, AB, and O) and produced for COVID-19 case study. In the second phase, the identification scenario of patient/donor distributions across four centralised/decentralised telemedicine hospitals is identified 'as a proof of concept'. In the third phase, three stages are conducted to develop a CP-transfusion-rescue framework. In the first stage, two decision matrices are adopted and developed on the basis of the five 'serological/protein biomarker' criteria for the prioritisation of patient/donor lists. In the second stage, MCDM techniques are analysed to adopt individual and group decision making based on integrated AHP-TOPSIS as suitable methods. In the third stage, the intelligent matching components amongst patients/donors are developed on the basis of four distinct rules. In the final phase, the guideline of the objective validation steps is reported. The intelligent framework implies the benefits and strength weights of biomarker criteria to the priority configuration results and can obtain efficient CPs for the most critical patients. The execution of matching components possesses the scalability and balancing presentation within centralised/decentralised hospitals. The objective validation results indicate that the ranking is valid.

Detection-based prioritisation: Framework of multi-laboratory characteristics for asymptomatic COVID-19 carriers based on integrated Entropy-TOPSIS methods

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.

Helping doctors hasten COVID-19 treatment: Towards a rescue framework for the transfusion of best convalescent plasma to the most critical patients based on biological requirements via ml and novel MCDM methods

CONTEXT

People who have recently recovered from the threat of deteriorating coronavirus disease-2019 (COVID-19) have antibodies to the coronavirus circulating in their blood. Thus, the transfusion of these antibodies to deteriorating patients could theoretically help boost their immune system. Biologically, two challenges need to be surmounted to allow convalescent plasma (CP) transfusion to rescue the most severe COVID-19 patients. First, convalescent subjects must meet donor selection plasma criteria and comply with national health requirements and known standard routine procedures. Second, multi-criteria decision-making (MCDM) problems should be considered in the selection of the most suitable CP and the prioritisation of patients with COVID-19.

OBJECTIVE

This paper presents a rescue framework for the transfusion of the best CP to the most critical patients with COVID-19 on the basis of biological requirements by using machine learning and novel MCDM methods.

METHOD

The proposed framework is illustrated on the basis of two distinct and consecutive phases (i.e. testing and development). In testing, ABO compatibility is assessed after classifying donors into the four blood types, namely, A, B, AB and O, to indicate the suitability and safety of plasma for administration in order to refine the CP tested list repository. The development phase includes patient and donor sides. In the patient side, prioritisation is performed using a contracted patient decision matrix constructed between 'serological/protein biomarkers and the ratio of the partial pressure of oxygen in arterial blood to fractional inspired oxygen criteria' and 'patient list based on novel MCDM method known as subjective and objective decision by opinion score method'. Then, the patients with the most urgent need are classified into the four blood types and matched with a tested CP list from the test phase in the donor side. Thereafter, the prioritisation of CP tested list is performed using the contracted CP decision matrix.

RESULT

An intelligence-integrated concept is proposed to identify the most appropriate CP for corresponding prioritised patients with COVID-19 to help doctors hasten treatments.

DISCUSSION

The proposed framework implies the benefits of providing effective care and prevention of the extremely rapidly spreading COVID-19 from affecting patients and the medical sector.

Role of biological Data Mining and Machine Learning Techniques in Detecting and Diagnosing the Novel Coronavirus (COVID-19): A Systematic Review

Coronaviruses (CoVs) are a large family of viruses that are common in many animal species, including camels, cattle, cats and bats. Animal CoVs, such as Middle East respiratory syndrome-CoV, severe acute respiratory syndrome (SARS)-CoV, and the new virus named SARS-CoV-2, rarely infect and spread among humans. On January 30, 2020, the International Health Regulations Emergency Committee of the World Health Organisation declared the outbreak of the resulting disease from this new CoV called ‘COVID-19’, as a ‘public health emergency of international concern’. This global pandemic has affected almost the whole planet and caused the death of more than 315,131 patients as of the date of this article. In this context, publishers, journals and researchers are urged to research different domains and stop the spread of this deadly virus. The increasing interest in developing artificial intelligence (AI) applications has addressed several medical problems. However, such applications remain insufficient given the high potential threat posed by this virus to global public health. This systematic review addresses automated AI applications based on data mining and machine learning (ML) algorithms for detecting and diagnosing COVID-19. We aimed to obtain an overview of this critical virus, address the limitations of utilising data mining and ML algorithms, and provide the health sector with the benefits of this technique. We used five databases, namely, IEEE Xplore, Web of Science, PubMed, ScienceDirect and Scopus and performed three sequences of search queries between 2010 and 2020. Accurate exclusion criteria and selection strategy were applied to screen the obtained 1305 articles. Only eight articles were fully evaluated and included in this review, and this number only emphasised the insufficiency of research in this important area. After analysing all included studies, the results were distributed following the year of publication and the commonly used data mining and ML algorithms. The results found in all papers were discussed to find the gaps in all reviewed papers. Characteristics, such as motivations, challenges, limitations, recommendations, case studies, and features and classes used, were analysed in detail. This study reviewed the state-of-the-art techniques for CoV prediction algorithms based on data mining and ML assessment. The reliability and acceptability of extracted information and datasets from implemented technologies in the literature were considered. Findings showed that researchers must proceed with insights they gain, focus on identifying solutions for CoV problems, and introduce new improvements. The growing emphasis on data mining and ML techniques in medical fields can provide the right environment for change and improvement.

Novel technique for reorganisation of opinion order to interval levels for solving several instances representing prioritisation in patients with multiple chronic diseases

CONTEXT

Telemedicine has been increasingly used in healthcare to provide services to patients remotely. However, prioritising patients with multiple chronic diseases (MCDs) in telemedicine environment is challenging because it includes decision-making (DM) with regard to the emergency degree of each chronic disease for every patient.

OBJECTIVE

This paper proposes a novel technique for reorganisation of opinion order to interval levels (TROOIL) to prioritise the patients with MCDs in real-time remote health-monitoring system.

METHODS

The proposed TROOIL technique comprises six steps for prioritisation of patients with MCDs: (1) conversion of actual data into intervals; (2) rule generation; (3) rule ordering; (4) expert rule validation; (5) data reorganisation; and (6) criteria weighting and ranking alternatives within each rule. The secondary dataset of 500 patients from the most relevant study in a remote prioritisation area was adopted. The dataset contains three diseases, namely, chronic heart disease, high blood pressure (BP) and low BP.

RESULTS

The proposed TROOIL is an effective technique for prioritising patients with MCDs. In the objective validation, remarkable differences were recognised among the groups' scores, indicating identical ranking results. In the evaluation of issues within all scenarios, the proposed framework has an advantage of 22.95% over the benchmark framework.

DISCUSSION

Patients with the most severe MCD were treated first on the basis of their highest priority levels. The treatment for patients with less severe cases was delayed more than that for other patients.

CONCLUSIONS

The proposed TROOIL technique can deal with multiple DM problems in prioritisation of patients with MCDs.

A Systematic Review for Enabling of Develop a Blockchain Technology in Healthcare Application: Taxonomy, Substantially Analysis, Motivations, Challenges, Recommendations and Future Direction

Blockchain in healthcare applications requires robust security and privacy mechanism for high-level authentication, interoperability and medical records sharing to comply with the strict legal requirements of the Health Insurance Portability and Accountability Act of 1996. Blockchain technology in the healthcare industry has received considerable research attention in recent years. This study conducts a review to substantially analyse and map the research landscape of current technologies, mainly the use of blockchain in healthcare applications, into a coherent taxonomy. The present study systematically searches all relevant research articles on blockchain in healthcare applications in three accessible databases, namely, ScienceDirect, IEEE and Web of Science, by using the defined keywords 'blockchain', 'healthcare' and 'electronic health records' and their variations. The final set of collected articles related to the use of blockchain in healthcare application is divided into three categories. The first category includes articles (i.e. 43/58 scientific articles) that attempted to develop and design healthcare applications integrating blockchain, particularly those on new architecture, system designs, framework, scheme, model, platform, approach, protocol and algorithm. The second category includes studies (i.e., 6/58 scientific articles) that attempted to evaluate and analyse the adoption of blockchain in the healthcare system. Finally, the third category comprises review and survey articles (i.e., 6/58 scientific articles) related to the integration of blockchain into healthcare applications. The final articles for review are discussed on the basis of five aspects: (1) year of publication, (2) nationality of authors, (3) publishing house or journal, (4) purpose of using blockchain in health applications and the corresponding contributions and ⁽⁵⁾ problem types and proposed solutions. Additionally, this study provides identified motivations, open challenges and recommendations on the use of blockchain in healthcare applications. The current research contributes to the literature by providing a detailed review of feasible alternatives and identifying the research gaps. Accordingly, researchers and developers are provided with appealing opportunities to further develop decentralised healthcare applications through a comprehensive discussion of about the importance of blockchain and its integration into various healthcare applications.

Mobile Patient Monitoring Systems from a Benchmarking Aspect: Challenges, Open Issues and Recommended Solutions

This paper presents comprehensive insights into mobile patient monitoring systems (MPMSs) from evaluation and benchmarking aspects on the basis of two critical directions. The current evaluation criteria of MPMSs based on the architectural components of MPMSs and possible solutions are discussed. This review highlights four serious issues, namely, multiple evaluation criteria, criterion importance, unmeasurable criteria and data variation, in MPMS benchmarking. Multicriteria decision-making (MCDM) analysis techniques are proposed as effective solutions to solve these issues from a methodological aspect. This methodological aspect involves a framework for benchmarking MPMSs on the basis of MCDM to rank available MPMSs and select a suitable one. The benchmarking framework is discussed in four steps. Firstly, pre-processing and identification procedures are presented. Secondly, the procedure of weight calculation based on the best-worst method (BWM) is described. Thirdly, the development of a benchmark framework by using the VIKOR method is introduced. Lastly, the proposed framework is validated.

Smart Home-based IoT for Real-time and Secure Remote Health Monitoring of Triage and Priority System using Body Sensors: Multi-driven Systematic Review

The Internet of Things (IoT) has been identified in various applications across different domains, such as in the healthcare sector. IoT has also been recognised for its revolution in reshaping modern healthcare with aspiring wide range prospects, including economical, technological and social. This study aims to establish IoT-based smart home security solutions for real-time health monitoring technologies in telemedicine architecture. A multilayer taxonomy is driven and conducted in this study. In the first layer, a comprehensive analysis on telemedicine, which focuses on the client and server sides, shows that other studies associated with IoT-based smart home applications have several limitations that remain unaddressed. Particularly, remote patient monitoring in healthcare applications presents various facilities and benefits by adopting IoT-based smart home technologies without compromising the security requirements and potentially large number of risks. An extensive search is conducted to identify articles that handle these issues, related applications are comprehensively reviewed and a coherent taxonomy for these articles is established. A total number of (n = 3064) are gathered between 2007 and 2017 for most reliable databases, such as ScienceDirect, Web of Science and Institute of Electrical and Electronic Engineer Xplore databases. Then, the articles based on IoT studies that are associated with telemedicine applications are filtered. Nine articles are selected and classified into two categories. The first category, which accounts for 22.22% (n = 2/9), includes surveys on telemedicine articles and their applications. The second category, which accounts for 77.78% (n = 7/9), includes articles on the client and server sides of telemedicine architecture. The collected studies reveal the essential requirement in constructing another taxonomy layer and review IoT-based smart home security studies. Therefore, IoT-based smart home security features are introduced and analysed in the second layer. The security of smart home design based on IoT applications is an aspect that represents a crucial matter for general occupants of smart homes, in which studies are required to provide a better solution with patient security, privacy protection and security of users' entities from being stolen or compromised. Innovative technologies have dispersed limitations related to this matter. The existing gaps and trends in this area should be investigated to provide valuable visions for technical environments and researchers. Thus, 67 articles are obtained in the second layer of our taxonomy and are classified into six categories. In the first category, 25.37% (n = 17/67) of the articles focus on architecture design. In the second category, 17.91% (n = 12/67) includes security analysis articles that investigate the research status in the security area of IoT-based smart home applications. In the third category, 10.44% (n = 7/67) includes articles about security schemes. In the fourth category, 17.91% (n = 12/67) comprises security examination. In the fifth category, 13.43% (n = 9/67) analyses security protocols. In the final category, 14.92% (n = 10/67) analyses the security framework. Then, the identified basic characteristics of this emerging field are presented and provided in the following aspects. Open challenges experienced on the development of IoT-based smart home security are addressed to be adopted fully in telemedicine applications. Then, the requirements are provided to increase researcher's interest in this study area. On this basis, a number of recommendations for different parties are described to provide insights on the next steps that should be considered to enhance the security of smart homes based on IoT. A map matching for both taxonomies is developed in this study to determine the novel risks and benefits of IoT-based smart home security for real-time remote health monitoring within client and server sides in telemedicine applications.

Sensor-Based mHealth Authentication for Real-Time Remote Healthcare Monitoring System: A Multilayer Systematic Review

The new and groundbreaking real-time remote healthcare monitoring system on sensor-based mobile health (mHealth) authentication in telemedicine has considerably bounded and dispersed communication components. mHealth, an attractive part in telemedicine architecture, plays an imperative role in patient security and privacy and adapts different sensing technologies through many built-in sensors. This study aims to improve sensor-based defence and attack mechanisms to ensure patient privacy in client side when using mHealth. Thus, a multilayer taxonomy was conducted to attain the goal of this study. Within the first layer, real-time remote monitoring studies based on sensor technology for telemedicine application were reviewed and analysed to examine these technologies and provide researchers with a clear vision of security- and privacy-based sensors in the telemedicine area. An extensive search was conducted to find articles about security and privacy issues, review related applications comprehensively and establish the coherent taxonomy of these articles. ScienceDirect, IEEE Xplore and Web of Science databases were investigated for articles on mHealth in telemedicine-based sensor. A total of 3064 papers were collected from 2007 to 2017. The retrieved articles were filtered according to the security and privacy of sensor-based telemedicine applications. A total of 19 articles were selected and classified into two categories. The first category, 57.89% (n = 11/19), included survey on telemedicine articles and their applications. The second category, 42.1% (n = 8/19), included articles contributed to the three-tiered architecture of telemedicine. The collected studies improved the essential need to add another taxonomy layer and review the sensor-based smartphone authentication studies. This map matching for both taxonomies was developed for this study to investigate sensor field comprehensively and gain access to novel risks and benefits of the mHealth security in telemedicine application. The literature on sensor-based smartphones in the second layer of our taxonomy was analysed and reviewed. A total of 599 papers were collected from 2007 to 2017. In this layer, we obtained a final set of 81 articles classified into three categories. The first category of the articles [86.41% (n = 70/81)], where sensor-based smartphones were examined by utilising orientation sensors for user authentication, was used. The second category [7.40% (n = 6/81)] included attack articles, which were not intensively included in our literature analysis. The third category [8.64% (n = 7/81)] included 'other' articles. Factors were considered to understand fully the various contextual aspects of the field in published studies. The characteristics included the motivation and challenges related to sensor-based authentication of smartphones encountered by researchers and the recommendations to strengthen this critical area of research. Finally, many studies on the sensor-based smartphone in the second layer have focused on enhancing accurate authentication because sensor-based smartphones require sensors that could authentically secure mHealth.

Real-Time Medical Systems Based on Human Biometric Steganography: a Systematic Review

In real-time medical systems, the role of biometric technology is significant in authentication systems because it is used in verifying the identity of people through their biometric features. The biometric technology provides crucial properties for biometric features that can support the process of personal identification. The storage of biometric template within a central database makes it vulnerable to attack which can also occur during data transmission. Therefore, an alternative mechanism of protection becomes important to develop. On this basis, this study focuses on providing a detailed analysis of the extant literature (2013-2018) to identify the taxonomy and research distribution. Furthermore, this study also seeks to ascertain the challenges and motivations associated with biometric steganography in real-time medical systems to provide recommendations that can enhance the efficient use of real-time medical systems in biometric steganography and its applications. A review of articles on human biometric steganography in real-time medical systems obtained from three main databases (IEEE Xplore, ScienceDirect and Web of Science) is conducted according to an appropriate review protocol. Then, 41 related articles are selected by using exclusion and inclusion criteria. Majority of the studies reviewed had been conducted in the field of data-hiding (particularly steganography) technologies. In this review, various steganographic methods that have been applied in different human biometrics are investigated. Thereafter, these methods are categorised according to taxonomy, and the results are presented on the basis of human steganography biometric real-time medical systems, testing and evaluation methods, significance of use and applications and techniques. Finally, recommendations on how the challenges associated with data hiding can be addressed are provided to enhance the efficiency of using biometric information processed in any authentication real-time medical system. These recommendations are expected to be immensely helpful to developers, company users and researchers.

Real-Time Remote Health Monitoring Systems Using Body Sensor Information and Finger Vein Biometric Verification: A Multi-Layer Systematic Review

The development of wireless body area sensor networks is imperative for modern telemedicine. However, attackers and cybercriminals are gradually becoming aware in attacking telemedicine systems, and the black market value of protected health information has the highest price nowadays. Security remains a formidable challenge to be resolved. Intelligent home environments make up one of the major application areas of pervasive computing. Security and privacy are the two most important issues in the remote monitoring and control of intelligent home environments for clients and servers in telemedicine architecture. The personal authentication approach that uses the finger vein pattern is a newly investigated biometric technique. This type of biometric has many advantages over other types (explained in detail later on) and is suitable for different human categories and ages. This study aims to establish a secure verification method for real-time monitoring systems to be used for the authentication of patients and other members who are working in telemedicine systems. The process begins with the sensor based on Tiers 1 and 2 (client side) in the telemedicine architecture and ends with patient verification in Tier 3 (server side) via finger vein biometric technology to ensure patient security on both sides. Multilayer taxonomy is conducted in this research to attain the study's goal. In the first layer, real-time remote monitoring studies based on the sensor technology used in telemedicine applications are reviewed and analysed to provide researchers a clear vision of security and privacy based on sensors in telemedicine. An extensive search is conducted to identify articles that deal with security and privacy issues, related applications are reviewed comprehensively and a coherent taxonomy of these articles is established. ScienceDirect, IEEE Xplore and Web of Science databases are checked for articles on mHealth in telemedicine based on sensors. A total of 3064 papers are collected from 2007 to 2017. The retrieved articles are filtered according to the security and privacy of telemedicine applications based on sensors. Nineteen articles are selected and classified into two categories. The first category, which accounts for 57.89% (n = 11/19), includes surveys on telemedicine articles and their applications. The second category, accounting for 42.1% (n = 8/19), includes articles on the three-tiered architecture of telemedicine. The collected studies reveal the essential need to construct another taxonomy layer and review studies on finger vein biometric verification systems. This map-matching for both taxonomies is developed for this study to go deeply into the sensor field and determine novel risks and benefits for patient security and privacy on client and server sides in telemedicine applications. In the second layer of our taxonomy, the literature on finger vein biometric verification systems is analysed and reviewed. In this layer, we obtain a final set of 65 articles classified into four categories. In the first category, 80% (n = 52/65) of the articles focus on development and design. In the second category, 12.30% (n = 8/65) includes evaluation and comparative articles. These articles are not intensively included in our literature analysis. In the third category, 4.61% (n = 3/65) includes articles about analytical studies. In the fourth category, 3.07% (n = 2/65) comprises reviews and surveys. This study aims to provide researchers with an up-to-date overview of studies that have been conducted on (user/patient) authentication to enhance the security level in telemedicine or any information system. In the current study, taxonomy is presented by explaining previous studies. Moreover, this review highlights the motivations, challenges and recommendations related to finger vein biometric verification systems and determines the gaps in this research direction (protection of finger vein templates in real time), which represent a new research direction in this area.

A review of disability EEG based wheelchair control system: Coherent taxonomy, open challenges and recommendations

CONTEXT

Intelligent wheelchair technology has recently been utilised to address several mobility problems. Techniques based on brain-computer interface (BCI) are currently used to develop electric wheelchairs. Using human brain control in wheelchairs for people with disability has elicited widespread attention due to its flexibility.

OBJECTIVE

This study aims to determine the background of recent studies on wheelchair control based on BCI for disability and map the literature survey into a coherent taxonomy. The study intends to identify the most important aspects in this emerging field as an impetus for using BCI for disability in electric-powered wheelchair (EPW) control, which remains a challenge. The study also attempts to provide recommendations for solving other existing limitations and challenges.

METHODS

We systematically searched all articles about EPW control based on BCI for disability in three popular databases: ScienceDirect, IEEE and Web of Science. These databases contain numerous articles that considerably influenced this field and cover most of the relevant theoretical and technical issues.

RESULTS

We selected 100 articles on the basis of our inclusion and exclusion criteria. A large set of articles (55) discussed on developing real-time wheelchair control systems based on BCI for disability signals. Another set of articles (25) focused on analysing BCI for disability signals for wheelchair control. The third set of articles (14) considered the simulation of wheelchair control based on BCI for disability signals. Four articles designed a framework for wheelchair control based on BCI for disability signals. Finally, one article reviewed concerns regarding wheelchair control based on BCI for disability signals.

DISCUSSION

Since 2007, researchers have pursued the possibility of using BCI for disability in EPW control through different approaches. Regardless of type, articles have focused on addressing limitations that impede the full efficiency of BCI for disability and recommended solutions for these limitations.

CONCLUSIONS

Studies on wheelchair control based on BCI for disability considerably influence society due to the large number of people with disability. Therefore, we aim to provide researchers and developers with a clear understanding of this platform and highlight the challenges and gaps in the current and future studies.

Systematic Review of an Automated Multiclass Detection and Classification System for Acute Leukaemia in Terms of Evaluation and Benchmarking, Open Challenges, Issues and Methodological Aspects

This study aims to systematically review prior research on the evaluation and benchmarking of automated acute leukaemia classification tasks. The review depends on three reliable search engines: ScienceDirect, Web of Science and IEEE Xplore. A research taxonomy developed for the review considers a wide perspective for automated detection and classification of acute leukaemia research and reflects the usage trends in the evaluation criteria in this field. The developed taxonomy consists of three main research directions in this domain. The taxonomy involves two phases. The first phase includes all three research directions. The second one demonstrates all the criteria used for evaluating acute leukaemia classification. The final set of studies includes 83 investigations, most of which focused on enhancing the accuracy and performance of detection and classification through proposed methods or systems. Few efforts were made to undertake the evaluation issues. According to the final set of articles, three groups of articles represented the main research directions in this domain: 56 articles highlighted the proposed methods, 22 articles involved proposals for system development and 5 papers centred on evaluation and comparison. The other taxonomy side included 16 main and sub-evaluation and benchmarking criteria. This review highlights three serious issues in the evaluation and benchmarking of multiclass classification of acute leukaemia, namely, conflicting criteria, evaluation criteria and criteria importance. It also determines the weakness of benchmarking tools. To solve these issues, multicriteria decision-making (MCDM) analysis techniques were proposed as effective recommended solutions in the methodological aspect. This methodological aspect involves a proposed decision support system based on MCDM for evaluation and benchmarking to select suitable multiclass classification models for acute leukaemia. The said support system is examined and has three sequential phases. Phase One presents the identification procedure and process for establishing a decision matrix based on a crossover of evaluation criteria and acute leukaemia multiclass classification models. Phase Two describes the decision matrix development for the selection of acute leukaemia classification models based on the integrated Best and worst method (BWM) and VIKOR. Phase Three entails the validation of the proposed system.

Real-Time Remote Health-Monitoring Systems in a Medical Centre: A Review of the Provision of Healthcare Services-Based Body Sensor Information, Open Challenges and Methodological Aspects

Promoting patient care is a priority for all healthcare providers with the overall purpose of realising a high degree of patient satisfaction. A medical centre server is a remote computer that enables hospitals and physicians to analyse data in real time and offer appropriate services to patients. The server can also manage, organise and support professionals in telemedicine. Therefore, a remote medical centre server plays a crucial role in sustainably delivering quality healthcare services in telemedicine. This article presents a comprehensive review of the provision of healthcare services in telemedicine applications, especially in the medical centre server. Moreover, it highlights the open issues and challenges related to providing healthcare services in the medical centre server within telemedicine. Methodological aspects to control and manage the process of healthcare service provision and three distinct and successive phases are presented. The first phase presents the identification process to propose a decision matrix (DM) on the basis of a crossover of 'multi-healthcare services' and 'hospital list' within intelligent data and service management centre (Tier 4). The second phase discusses the development of a DM for hospital selection on the basis of integrated VIKOR-Analytic Hierarchy Process (AHP) methods. Finally, the last phase examines the validation process for the proposed framework.

A Systematic Review for Human EEG Brain Signals Based Emotion Classification, Feature Extraction, Brain Condition, Group Comparison

The study of electroencephalography (EEG) signals is not a new topic. However, the analysis of human emotions upon exposure to music considered as important direction. Although distributed in various academic databases, research on this concept is limited. To extend research in this area, the researchers explored and analysed the academic articles published within the mentioned scope. Thus, in this paper a systematic review is carried out to map and draw the research scenery for EEG human emotion into a taxonomy. Systematically searched all articles about the, EEG human emotion based music in three main databases: ScienceDirect, Web of Science and IEEE Xplore from 1999 to 2016. These databases feature academic studies that used EEG to measure brain signals, with a focus on the effects of music on human emotions. The screening and filtering of articles were performed in three iterations. In the first iteration, duplicate articles were excluded. In the second iteration, the articles were filtered according to their titles and abstracts, and articles outside of the scope of our domain were excluded. In the third iteration, the articles were filtered by reading the full text and excluding articles outside of the scope of our domain and which do not meet our criteria. Based on inclusion and exclusion criteria, 100 articles were selected and separated into five classes. The first class includes 39 articles (39%) consists of emotion, wherein various emotions are classified using artificial intelligence (AI). The second class includes 21 articles (21%) is composed of studies that use EEG techniques. This class is named 'brain condition'. The third class includes eight articles (8%) is related to feature extraction, which is a step before emotion classification. That this process makes use of classifiers should be noted. However, these articles are not listed under the first class because these eight articles focus on feature extraction rather than classifier accuracy. The fourth class includes 26 articles (26%) comprises studies that compare between or among two or more groups to identify and discover human emotion-based EEG. The final class includes six articles (6%) represents articles that study music as a stimulus and its impact on brain signals. Then, discussed the five main categories which are action types, age of the participants, and number size of the participants, duration of recording and listening to music and lastly countries or authors' nationality that published these previous studies. it afterward recognizes the main characteristics of this promising area of science in: motivation of using EEG process for measuring human brain signals, open challenges obstructing employment and recommendations to improve the utilization of EEG process.

A review of the automated detection and classification of acute leukaemia: Coherent taxonomy, datasets, validation and performance measurements, motivation, open challenges and recommendations

CONTEXT

Acute leukaemia diagnosis is a field requiring automated solutions, tools and methods and the ability to facilitate early detection and even prediction. Many studies have focused on the automatic detection and classification of acute leukaemia and their subtypes to promote enable highly accurate diagnosis.

OBJECTIVE

This study aimed to review and analyse literature related to the detection and classification of acute leukaemia. The factors that were considered to improve understanding on the field's various contextual aspects in published studies and characteristics were motivation, open challenges that confronted researchers and recommendations presented to researchers to enhance this vital research area.

METHODS

We systematically searched all articles about the classification and detection of acute leukaemia, as well as their evaluation and benchmarking, in three main databases: ScienceDirect, Web of Science and IEEE Xplore from 2007 to 2017. These indices were considered to be sufficiently extensive to encompass our field of literature.

RESULTS

Based on our inclusion and exclusion criteria, 89 articles were selected. Most studies (58/89) focused on the methods or algorithms of acute leukaemia classification, a number of papers (22/89) covered the developed systems for the detection or diagnosis of acute leukaemia and few papers (5/89) presented evaluation and comparative studies. The smallest portion (4/89) of articles comprised reviews and surveys.

DISCUSSION

Acute leukaemia diagnosis, which is a field requiring automated solutions, tools and methods, entails the ability to facilitate early detection or even prediction. Many studies have been performed on the automatic detection and classification of acute leukaemia and their subtypes to promote accurate diagnosis.

CONCLUSIONS

Research areas on medical-image classification vary, but they are all equally vital. We expect this systematic review to help emphasise current research opportunities and thus extend and create additional research fields.

Systematic Review of Real-time Remote Health Monitoring System in Triage and Priority-Based Sensor Technology: Taxonomy, Open Challenges, Motivation and Recommendations

The new and ground-breaking real-time remote monitoring in triage and priority-based sensor technology used in telemedicine have significantly bounded and dispersed communication components. To examine these technologies and provide researchers with a clear vision of this area, we must first be aware of the utilised approaches and existing limitations in this line of research. To this end, an extensive search was conducted to find articles dealing with (a) telemedicine, (b) triage, (c) priority and (d) sensor; (e) comprehensively review related applications and establish the coherent taxonomy of these articles. ScienceDirect, IEEE Xplore and Web of Science databases were checked for articles on triage and priority-based sensor technology in telemedicine. The retrieved articles were filtered according to the type of telemedicine technology explored. A total of 150 articles were selected and classified into two categories. The first category includes reviews and surveys of triage and priority-based sensor technology in telemedicine. The second category includes articles on the three-tiered architecture of telemedicine. Tier 1 represents the users. Sensors acquire the vital signs of the users and send them to Tier 2, which is the personal gateway that uses local area network protocols or wireless body area network. Medical data are sent from Tier 2 to Tier 3, which is the healthcare provider in medical institutes. Then, the motivation for using triage and priority-based sensor technology in telemedicine, the issues related to the obstruction of its application and the development and utilisation of telemedicine are examined on the basis of the findings presented in the literature.

Based on Real Time Remote Health Monitoring Systems: A New Approach for Prioritization "Large Scales Data" Patients with Chronic Heart Diseases Using Body Sensors and Communication Technology

This paper presents a new approach to prioritize "Large-scale Data" of patients with chronic heart diseases by using body sensors and communication technology during disasters and peak seasons. An evaluation matrix is used for emergency evaluation and large-scale data scoring of patients with chronic heart diseases in telemedicine environment. However, one major problem in the emergency evaluation of these patients is establishing a reasonable threshold for patients with the most and least critical conditions. This threshold can be used to detect the highest and lowest priority levels when all the scores of patients are identical during disasters and peak seasons. A practical study was performed on 500 patients with chronic heart diseases and different symptoms, and their emergency levels were evaluated based on four main measurements: electrocardiogram, oxygen saturation sensor, blood pressure monitoring, and non-sensory measurement tool, namely, text frame. Data alignment was conducted for the raw data and decision-making matrix by converting each extracted feature into an integer. This integer represents their state in the triage level based on medical guidelines to determine the features from different sources in a platform. The patients were then scored based on a decision matrix by using multi-criteria decision-making techniques, namely, integrated multi-layer for analytic hierarchy process (MLAHP) and technique for order performance by similarity to ideal solution (TOPSIS). For subjective validation, cardiologists were consulted to confirm the ranking results. For objective validation, mean ± standard deviation was computed to check the accuracy of the systematic ranking. This study provides scenarios and checklist benchmarking to evaluate the proposed and existing prioritization methods. Experimental results revealed the following. (1) The integration of TOPSIS and MLAHP effectively and systematically solved the patient settings on triage and prioritization problems. (2) In subjective validation, the first five patients assigned to the doctors were the most urgent cases that required the highest priority, whereas the last five patients were the least urgent cases and were given the lowest priority. In objective validation, scores significantly differed between the groups, indicating that the ranking results were identical. (3) For the first, second, and third scenarios, the proposed method exhibited an advantage over the benchmark method with percentages of 40%, 60%, and 100%, respectively. In conclusion, patients with the most and least urgent cases received the highest and lowest priority levels, respectively.

Based Real Time Remote Health Monitoring Systems: A Review on Patients Prioritization and Related "Big Data" Using Body Sensors information and Communication Technology

The growing worldwide population has increased the need for technologies, computerised software algorithms and smart devices that can monitor and assist patients anytime and anywhere and thus enable them to lead independent lives. The real-time remote monitoring of patients is an important issue in telemedicine. In the provision of healthcare services, patient prioritisation poses a significant challenge because of the complex decision-making process it involves when patients are considered 'big data'. To our knowledge, no study has highlighted the link between 'big data' characteristics and real-time remote healthcare monitoring in the patient prioritisation process, as well as the inherent challenges involved. Thus, we present comprehensive insights into the elements of big data characteristics according to the six 'Vs': volume, velocity, variety, veracity, value and variability. Each of these elements is presented and connected to a related part in the study of the connection between patient prioritisation and real-time remote healthcare monitoring systems. Then, we determine the weak points and recommend solutions as potential future work. This study makes the following contributions. (1) The link between big data characteristics and real-time remote healthcare monitoring in the patient prioritisation process is described. (2) The open issues and challenges for big data used in the patient prioritisation process are emphasised. (3) As a recommended solution, decision making using multiple criteria, such as vital signs and chief complaints, is utilised to prioritise the big data of patients with chronic diseases on the basis of the most urgent cases.

A distributed framework for health information exchange using smartphone technologies

Nationwide health information exchange (NHIE) continues to be a persistent concern for government agencies, despite the many efforts and the conceived benefits of sharing patient data among healthcare providers. Difficulties in ensuring global connectivity, interoperability, and concerns on security have always hampered the government from successfully deploying NHIE. By looking at NHIE from a fresh perspective and bearing in mind the pervasiveness and power of modern mobile platforms, this paper proposes a new approach to NHIE that builds on the notion of consumer-mediated HIE, albeit without the focus on central health record banks. With the growing acceptance of smartphones as reliable, indispensable, and most personal devices, we suggest to leverage the concept of mobile personal health records (PHRs installed on smartphones) to the next level. We envision mPHRs that take the form of distributed storage units for health information, under the full control and direct possession of patients, who can have ready access to their personal data whenever needed. However, for the actual exchange of data with health information systems managed by healthcare providers, the latter have to be interoperable with patient-carried mPHRs. Computer industry has long ago solved a similar problem of interoperability between peripheral devices and operating systems. We borrow from that solution the idea of providing special interfaces between mPHRs and provider systems. This interface enables the two entities to communicate with no change to either end. The design and operation of the proposed approach is explained. Additional pointers on potential implementations are provided, and issues that pertain to any solution to implement NHIE are discussed.

An evaluation and selection problems of OSS-LMS packages

The evaluation and selection of inappropriate open source software in learning management system (OSS-LMS) packages adversely affect the business processes and functions of an organization. Thus, comprehensive insights into the evaluation and selection of OSS-LMS packages are presented in this paper on the basis of three directions. First, available OSS-LMSs are ascertained from published papers. Second, the criteria for evaluating OSS-LMS packages are specified.according to two aspects: the criteria are identified and established, followed by a crossover between them to highlight the gaps between the evaluation criteria for OSS-LMS packages and the selection problems. Third, the abilities of selection methods that appear fit to solve the problems of OSS-LMS packages based on the multi-criteria evaluation and selection problem are discussed to select the best OSS-LMS packages. Results indicate the following: (1) a list of active OSS-LMS packages; (2) the gaps on the evaluation criteria used for LMS and other problems (consisting of main groups with sub-criteria); (3) use of multi-attribute or multi-criteria decision-making (MADM/MCDM) techniques in the framework of the evaluation and selection of the OSS in education as recommended solutions.

The landscape of research on smartphone medical apps: Coherent taxonomy, motivations, open challenges and recommendations

OBJECTIVE

To survey researchers' efforts in response to the new and disruptive technology of smartphone medical apps, mapping the research landscape form the literature into a coherent taxonomy, and finding out basic characteristics of this emerging field represented on: motivation of using smartphone apps in medicine and healthcare, open challenges that hinder the utility, and the recommendations to improve the acceptance and use of medical apps in the literature.

METHODS

We performed a focused search for every article on (1) smartphone (2) medical or health-related (3) app, in four major databases: MEDLINE, Web of Science, ScienceDirect, and IEEE Xplore. Those databases are deemed broad enough to cover both medical and technical literature.

RESULTS

The final set included 133 articles. Most articles (68/133) are reviews and surveys that refer to actual apps or the literature to describe medical apps for a specific specialty, disease, or purpose; or to provide a general overview of the technology. Another group (43/133) carried various studies, from evaluation of apps to exploration of desired features when developing them. Few researchers (17/133) presented actual attempts to develop medical apps, or shared their experiences in doing so. The smallest portion (5/133) proposed general frameworks addressing the production or operation of apps.

DISCUSSION

Since 2010, researchers followed the trend of medical apps in several ways, though leaving areas or aspect for further attention. Regardless of their category, articles focus on the challenges that hinder the full utility of medical apps and do recommend mitigations to them.

CONCLUSIONS

Research on smartphone medical apps is active and various. We hope that this survey contribute to the understanding of the available options and gaps for other researchers to join this line of research.

A security framework for nationwide health information exchange based on telehealth strategy

This study focuses on the situation of health information exchange (HIE) in the context of a nationwide network. It aims to create a security framework that can be implemented to ensure the safe transmission of health information across the boundaries of care providers in Malaysia and other countries. First, a critique of the major elements of nationwide health information networks is presented from the perspective of security, along with such topics as the importance of HIE, issues, and main approaches. Second, a systematic evaluation is conducted on the security solutions that can be utilized in the proposed nationwide network. Finally, a secure framework for health information transmission is proposed within a central cloud-based model, which is compatible with the Malaysian telehealth strategy. The outcome of this analysis indicates that a complete security framework for a global structure of HIE is yet to be defined and implemented. Our proposed framework represents such an endeavor and suggests specific techniques to achieve this goal.

Evaluation and selection of open-source EMR software packages based on integrated AHP and TOPSIS

Evaluating and selecting software packages that meet the requirements of an organization are difficult aspects of software engineering process. Selecting the wrong open-source EMR software package can be costly and may adversely affect business processes and functioning of the organization. This study aims to evaluate and select open-source EMR software packages based on multi-criteria decision-making. A hands-on study was performed and a set of open-source EMR software packages were implemented locally on separate virtual machines to examine the systems more closely. Several measures as evaluation basis were specified, and the systems were selected based a set of metric outcomes using Integrated Analytic Hierarchy Process (AHP) and TOPSIS. The experimental results showed that GNUmed and OpenEMR software can provide better basis on ranking score records than other open-source EMR software packages.

Open source EMR software: profiling, insights and hands-on analysis

BACKGROUND

The use of open source software in health informatics is increasingly advocated by authors in the literature. Although there is no clear evidence of the superiority of the current open source applications in the healthcare field, the number of available open source applications online is growing and they are gaining greater prominence. This repertoire of open source options is of a great value for any future-planner interested in adopting an electronic medical/health record system, whether selecting an existent application or building a new one. The following questions arise. How do the available open source options compare to each other with respect to functionality, usability and security? Can an implementer of an open source application find sufficient support both as a user and as a developer, and to what extent? Does the available literature provide adequate answers to such questions? This review attempts to shed some light on these aspects.

OBJECTIVE

The objective of this study is to provide more comprehensive guidance from an implementer perspective toward the available alternatives of open source healthcare software, particularly in the field of electronic medical/health records.

METHODS

The design of this study is twofold. In the first part, we profile the published literature on a sample of existent and active open source software in the healthcare area. The purpose of this part is to provide a summary of the available guides and studies relative to the sampled systems, and to identify any gaps in the published literature with respect to our research questions. In the second part, we investigate those alternative systems relative to a set of metrics, by actually installing the software and reporting a hands-on experience of the installation process, usability, as well as other factors.

RESULTS

The literature covers many aspects of open source software implementation and utilization in healthcare practice. Roughly, those aspects could be distilled into a basic taxonomy, making the literature landscape more perceivable. Nevertheless, the surveyed articles fall short of fulfilling the targeted objective of providing clear reference to potential implementers. The hands-on study contributed a more detailed comparative guide relative to our set of assessment measures. Overall, no system seems to satisfy an industry-standard measure, particularly in security and interoperability. The systems, as software applications, feel similar from a usability perspective and share a common set of functionality, though they vary considerably in community support and activity.

CONCLUSION

More detailed analysis of popular open source software can benefit the potential implementers of electronic health/medical records systems. The number of examined systems and the measures by which to compare them vary across studies, but still rewarding insights start to emerge. Our work is one step toward that goal. Our overall conclusion is that open source options in the medical field are still far behind the highly acknowledged open source products in other domains, e.g. operating systems market share.

An enhanced security solution for electronic medical records based on AES hybrid technique with SOAP/XML and SHA-1

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.