Classification of methods to reduce clinical alarm signals for remote patient monitoring : a critical review
- Authors: Arora, Teena , Balasubramanian, Venki , Stranieri, Andrew , Shenhan, Mai , Buyya, Rajkumar , Islam, Sardar
- Date: 2023
- Type: Text , Book chapter
- Relation: Cloud Computing in Medical Imaging Chapter 10 p. 173-194
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Clinically prioritized data visualization in remote patient monitoring
- Authors: Arora, Teena , Balasubramanian, Venki , Stranieri, Andrew , Neupane, Arun
- Date: 2023
- Type: Text , Conference paper
- Relation: 19th IEEE International Conference on Wireless and Mobile Computing, Networking and Communications, WiMob 2023, Montreal, Canada, 21-23 June 2023, International Conference on Wireless and Mobile Computing, Networking and Communications Vol. 2023-June, p. 5-12
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- Description: Understanding and integrating physiological data collected from wearable sensors in remote patient monitoring (RPM) is challenging. Data streams may be interrupted due to the sensor's sensitivity, movement, and electromagnetic interference leading to inconsistent, missing, and inaccurate data. Existing approaches to summarize data flows into a single score such as the traditional Modified early warning score (MEWS) is limited. Data visualization approaches have the potential to address this challenge, but few studies have focused on visualization of RPM streams. The study presents a transformation of observed raw RPM physiological data into parameters identified as trust, frequency, slope, and trend. This facilitated visualization and enabled automated assessments of prioritized alerts. Experimental results have shown that the transformations led to the prioritization of clinically significant conditions, and improved visualization has the potential to better support clinical decisions compared with traditional MEWS. © 2023 IEEE.
Missing health data pattern matching technique for continuous remote patient monitoring
- Authors: Arora, Teena , Balasubramanian, Venki , Stranieri, Andrew
- Date: 2023
- Type: Text , Conference paper
- Relation: 20th International Conference on Smart Living and Public Health, ICOST 2023, Wonju, Korea, 7-8 July 2023, Digital Health Transformation, Smart Ageing, and Managing Disability, 20th International Conference, ICOST 2023, Wonju, South Korea, July 7–8, 2023, Proceedings Vol. 14237 LNCS, p. 130-143
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- Description: Remote patient monitoring (RPM) has been gaining popularity recently. However, health data acquisition is a significant challenge associated with patient monitoring. In continuous RPM, health data acquisition may miss health data during transmission. Missing data compromises the quality and reliability of patient risk assessment. Several studies suggested techniques for analyzing missing data; however, many are unsuitable for RPM. These techniques neglect the variability of missing data and provide biased results with imputation. Therefore, a holistic approach must consider the correlation and variability of the various vitals and avoid biased imputation. This paper proposes a coherent computation pattern-matching technique to identify and predict missing data patterns. The performance of the proposed approach is evaluated using data collected from a field trial. Results show that the technique can effectively identify and predict missing patterns. © 2023, The Author(s).
Deep learning model to empower student engagement in online synchronous learning environment
- Authors: Godly, Cinthia , Balasubramanian, Venki , Stranieri, Andrew , Saikrishna, Vidya , Mohammed, Rehena , Chackappan, Godly
- Date: 2022
- Type: Text , Conference paper
- Relation: 19th IEEE India Council International Conference, INDICON 2022, Kochi India, 24-26 November 2022, INDICON 2022 - 2022 IEEE 19th India Council International Conference
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- Description: Following the start of the pandemic, online synchronous learning has grown significantly. The higher education sector is searching for new creative ways to provide the information online because of the switch from face-to-face to online synchronous course delivery. Students are also becoming accustomed to studying online, and research has shown that synchronous online learning has a variety of effects on student engagement. For instance, according to statistics from the National Survey of Student Engagement, students are less likely to participate in collaborative learning, studentfaculty interactions, and conversations when learning online if they use quantitative reasoning during face-to-face instruction. Additionally, studies suggest that because they depend on their devices to take online classes, students feel more alienated from their lecturers. This has been linked to a drop in contacts with peers and teachers as a result. By using a cutting-edge deep learning model to predict learner engagement behaviour in a synchronous teaching environment, our research intends to improve online engagement. The model with a clever trigger will encourage the disengaged pupils to communicate with the teachers online. Smart triggers will be built around factors that have been found, focusing on disengaged students to engage them in real-time with automatic, personalized feedback. © 2022 IEEE.
Emerging point of care devices and artificial intelligence : prospects and challenges for public health
- Authors: Stranieri, Andrew , Venkatraman, Sitalakshmi , Minicz, John , Zarnegar, Armita , Firmin, Sally , Balasubramanian, Venki , Jelinek, Herbert
- Date: 2022
- Type: Text , Journal article
- Relation: Smart Health Vol. 24, no. (2022), p.
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- Description: Risk assessments for numerous conditions can now be performed cost-effectively and accurately using emerging point of care devices coupled with machine learning algorithms. In this article, the case is advanced that point of care testing in combination with risk assessments generated with artificial intelligence algorithms, applied to the universal screening of the general public for multiple conditions at one session, represents a new kind of in-expensive screening that can lead to the early detection of disease and other public health benefits. A case study of a diabetes screening clinic in a rural area of Australia is presented to illustrate its benefits. Universal, poly-aetiological screening is shown to meet the ten World Health Organisation criteria for screening programmes. © Elsevier Inc.
Remote patient monitoring for healthcare : a big challenge for big data
- Authors: Stranieri, Andrew , Balasubramanian, Venki
- Date: 2022
- Type: Text , Book chapter
- Relation: Research Anthology on Big Data Analytics, Architectures, and Applications Chapter 50 p. 1054-1070
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- Description: Remote patient monitoring involves the collection of data from wearable sensors that typically requires analysis in real time. The real-time analysis of data streaming continuously to a server challenges data mining algorithms that have mostly been developed for static data residing in central repositories. Remote patient monitoring also generates huge data sets that present storage and management problems. Although virtual records of every health event throughout an individual’s lifespan known as the electronic health record are rapidly emerging, few electronic records accommodate data from continuous remote patient monitoring. These factors combine to make data analytics with continuous patient data very challenging. In this chapter, benefits for data analytics inherent in the use of standards for clinical concepts for remote patient monitoring is presented. The openEHR standard that describes the way in which concepts are used in clinical practice is well suited to be adopted as the standard required to record meta-data about remote monitoring. The claim is advanced that this is likely to facilitate meaningful real time analyses with big remote patient monitoring data. The point is made by drawing on a case study involving the transmission of patient vital sign data collected from wearable sensors in an Indian hospital. © 2022 by IGI Global. All rights reserved.
A secured real-time IoMT application for monitoring isolated COVID-19 patients using edge computing
- Authors: Balasubramanian, Venki , Sulthana, Rehena , Stranieri, Andrew , Manoharan, G. , Arora, Teena , Srinivasan, Ram , Mahalakshmi, K. , Menon, Varun
- Date: 2021
- Type: Text , Conference paper
- Relation: 20th IEEE International Conference on Trust, Security and Privacy in Computing and Communications, TrustCom 2021, Shenyang, China, 20-22 October 2021, Proceedings - 2021 IEEE 20th International Conference on Trust, Security and Privacy in Computing and Communications, TrustCom 2021 p. 1227-1234
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- Description: Internet of Medical Things (IoMT) is an emerging technology whose capabilities to self-organize itself on-the-fly, to monitor the patient's vital health data without any manual entry and assist early human intervention gave birth to smart healthcare applications. The smart applications can be used to remotely monitor isolated patients during this COVID-19 pandemic. Remote patient monitoring provides an opportunity for COVID-19 patients to have vital signs and other indicators recorded regularly and inexpensively to provide rapid and early warning of conditions that require medical attention using secured edge and cloud computing. However, to gain the confidence of the users over these applications, the performance of healthcare applications should be evaluated in real-time. Our real-time implementation of IoMT based remote monitoring application using edge and cloud computing, along with empirical evaluation, show that COVID-19 patients can be monitored effectively not only with mobility but also helps the health care professionals to generate consolidated health data of the patient that can guide them to obtain medical attention. © 2021 IEEE.
Blockchain leveraged decentralized IoT eHealth framework
- Authors: Uddin, Ashraf , Stranieri, Andrew , Gondal, Iqbal , Balasubramanian, Venki
- Date: 2020
- Type: Text , Journal article
- Relation: Internet of Things Vol. 9, no. March 2020 p. 100159
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- Description: Blockchain technologies recently emerging for eHealth, can facilitate a secure, decentral- ized and patient-driven, record management system. However, Blockchain technologies cannot accommodate the storage of data generated from IoT devices in remote patient management (RPM) settings as this application requires a fast consensus mechanism, care- ful management of keys and enhanced protocols for privacy. In this paper, we propose a Blockchain leveraged decentralized eHealth architecture which comprises three layers: (1) The Sensing layer –Body Area Sensor Networks include medical sensors typically on or in a patient body transmitting data to a smartphone. (2) The NEAR processing layer –Edge Networks consist of devices at one hop from data sensing IoT devices. (3) The FAR pro- cessing layer –Core Networks comprise Cloud or other high computing servers). A Patient Agent (PA) software replicated on the three layers processes medical data to ensure reli- able, secure and private communication. The PA executes a lightweight Blockchain consen- sus mechanism and utilizes a Blockchain leveraged task-offloading algorithm to ensure pa- tient’s privacy while outsourcing tasks. Performance analysis of the decentralized eHealth architecture has been conducted to demonstrate the feasibility of the system in the pro- cessing and storage of RPM data.
Dynamically recommending repositories for health data : a machine learning model
- Authors: Uddin, Md Ashraf , Stranieri, Andrew , Gondal, Iqbal , Balasubramanian, Venki
- Date: 2020
- Type: Text , Conference proceedings
- Relation: 2020 Australasian Computer Science Week Multiconference, ACSW 2020
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- Description: Recently, a wide range of digital health record repositories has emerged. These include Electronic Health record managed by the government, Electronic Medical Record (EMR) managed by healthcare providers, Personal Health Record (PHR) managed directly by the patient and new Blockchain-based systems mainly managed by technologies. Health record repositories differ from one another on the level of security, privacy, and quality of services (QoS) they provide. Health data stored in these repositories also varies from patient to patient in sensitivity, and significance depending on medical, personal preference, and other factors. Decisions regarding which digital record repository is most appropriate for the storage of each data item at every point in time are complex and nuanced. The challenges are exacerbated with health data continuously streamed from wearable sensors. In this paper, we propose a recommendation model for health data storage that can accommodate patient preferences and make storage decisions rapidly, in real-time, even with streamed data. The model maps health data to be stored in the repositories. The mapping between health data features and characteristics of each repository is learned using a machine learning-based classifier mediated through clinical rules. Evaluation results demonstrate the model's feasibility. © 2020 ACM.
- Description: E1
Rapid health data repository allocation using predictive machine learning
- Authors: Uddin, Ashraf , Stranieri, Andrew , Gondal, Iqbal , Balasubramanian, Venki
- Date: 2020
- Type: Text , Journal article
- Relation: Health Informatics Journal Vol. 26, no. 4 (2020), p. 3009-3036
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- Description: Health-related data is stored in a number of repositories that are managed and controlled by different entities. For instance, Electronic Health Records are usually administered by governments. Electronic Medical Records are typically controlled by health care providers, whereas Personal Health Records are managed directly by patients. Recently, Blockchain-based health record systems largely regulated by technology have emerged as another type of repository. Repositories for storing health data differ from one another based on cost, level of security and quality of performance. Not only has the type of repositories increased in recent years, but the quantum of health data to be stored has increased. For instance, the advent of wearable sensors that capture physiological signs has resulted in an exponential growth in digital health data. The increase in the types of repository and amount of data has driven a need for intelligent processes to select appropriate repositories as data is collected. However, the storage allocation decision is complex and nuanced. The challenges are exacerbated when health data are continuously streamed, as is the case with wearable sensors. Although patients are not always solely responsible for determining which repository should be used, they typically have some input into this decision. Patients can be expected to have idiosyncratic preferences regarding storage decisions depending on their unique contexts. In this paper, we propose a predictive model for the storage of health data that can meet patient needs and make storage decisions rapidly, in real-time, even with data streaming from wearable sensors. The model is built with a machine learning classifier that learns the mapping between characteristics of health data and features of storage repositories from a training set generated synthetically from correlations evident from small samples of experts. Results from the evaluation demonstrate the viability of the machine learning technique used. © The Author(s) 2020.
A Decentralized Patient Agent Controlled Blockchain for Remote Patient Monitoring
- Authors: Uddin, Ashraf , Stranieri, Andrew , Gondal, Iqbal , Balasubramanian, Venki
- Date: 2019
- Type: Text , Conference proceedings
- Relation: 15th International Conference on Wireless and Mobile Computing, Networking and Communications, WiMob 2019 Vol. 2019-October, p. 207-214
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- Description: Blockchain emerging for healthcare provides a secure, decentralized and patient driven record management system. However, the storage of data generated from IoT devices in remote patient management applications requires a fast consensus mechanism. In this paper, we propose a lightweight consensus mechanism and a decentralized patient software agent to control a remote patient monitoring (RPM) system. The decentralized RPM architecture includes devices at three levels; 1) Body Area Sensor Network-medical sensors typically on or in patient's body transmitting data to a Smartphone, 2) Fog/Edge, and 3) Cloud. We propose that a Patient Agent(PA) software replicated on the Smartphone, Fog and Cloud servers processes medical data to ensure reliable, secure and private communication. Performance analysis has been conducted to demonstrate the feasibility of the proposed Blockchain leveraged, distributed Patient Agent controlled remote patient monitoring system. © 2019 IEEE.
- Description: E1
A lightweight blockchain based framework for underwater ioT
- Authors: Uddin, Md , Stranieri, Andrew , Gondal, Iqbal , Balasubramanian, Venki
- Date: 2019
- Type: Text , Journal article
- Relation: Electronics (Switzerland) Vol. 8, no. 12 (2019), p.
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- Description: The Internet of Things (IoT) has facilitated services without human intervention for a wide range of applications, including underwater monitoring, where sensors are located at various depths, and data must be transmitted to surface base stations for storage and processing. Ensuring that data transmitted across hierarchical sensor networks are kept secure and private without high computational cost remains a challenge. In this paper, we propose a multilevel sensor monitoring architecture. Our proposal includes a layer-based architecture consisting of Fog and Cloud elements to process and store and process the Internet of Underwater Things (IoUT) data securely with customized Blockchain technology. The secure routing of IoUT data through the hierarchical topology ensures the legitimacy of data sources. A security and performance analysis was performed to show that the architecture can collect data from IoUT devices in the monitoring region efficiently and securely. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.
An efficient selective miner consensus protocol in blockchain oriented iot smart monitoring
- Authors: Uddin, Ashraf , Stranieri, Andrew , Gondal, Iqbal , Balasubramanian, Venki
- Date: 2019
- Type: Text , Conference proceedings , Conference paper
- Relation: 2019 IEEE International Conference on Industrial Technology, ICIT 2019; Melbourne; Australia; 13th-15th February 2019 Vol. 2019-February, p. 1135-1142
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- Description: Blockchains have been widely used in Internet of Things(IoT) applications including smart cities, smart home and smart governance to provide high levels of security and privacy. In this article, we advance a Blockchain based decentralized architecture for the storage of IoT data produced from smart home/cities. The architecture includes a secure communication protocol using a sign-encryption technique between power constrained IoT devices and a Gateway. The sign encryption also preserves privacy. We propose that a Software Agent executing on the Gateway selects a Miner node using performance parameters of Miners. Simulations demonstrate that the recommended Miner selection outperforms Proof of Works selection used in Bitcoin and Random Miner Selection.
- Description: Proceedings of the IEEE International Conference on Industrial Technology
Blockchain leveraged task migration in body area sensor networks
- Authors: Uddin, Ashraf , Stranieri, Andrew , Gondal, Iqbal , Balasubramanian, Venki
- Date: 2019
- Type: Text , Conference proceedings , Conference paper
- Relation: 25th Asia-Pacific Conference on Communications, APCC 2019 p. 177-184
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- Description: Blockchain technologies emerging for healthcare support secure health data sharing with greater interoperability among different heterogeneous systems. However, the collection and storage of data generated from Body Area Sensor Net-works(BASN) for migration to high processing power computing services requires an efficient BASN architecture. We present a decentralized BASN architecture that involves devices at three levels; 1) Body Area Sensor Network-medical sensors typically on or in patient's body transmitting data to a Smartphone, 2) Fog/Edge, and 3) Cloud. We propose that a Patient Agent(PA) replicated on the Smartphone, Fog and Cloud servers processes medical data and execute a task offloading algorithm by leveraging a Blockchain. Performance analysis is conducted to demonstrate the feasibility of the proposed Blockchain leveraged, distributed Patient Agent controlled BASN. © 2019 IEEE.
- Description: E1
A patient agent to manage blockchains for remote patient monitoring
- Authors: Uddin, Ashraf , Stranieri, Andrew , Gondal, Iqbal , Balasubramanian, Venki
- Date: 2018
- Type: Text , Conference proceedings
- Relation: 7th International Conference on Global Telehealth, GT 2018; Colombo, Sri Lanka; 10th-11th October 2018; published in Studies in Health Technology and Informatics Vol. 254, p. 105-115
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- Description: Continuous monitoring of patient's physiological signs has the potential to augment traditional medical practice, particularly in developing countries that have a shortage of healthcare professionals. However, continuously streamed data presents additional security, storage and retrieval challenges and further inhibits initiatives to integrate data to form electronic health record systems. Blockchain technologies enable data to be stored securely and inexpensively without recourse to a trusted authority. Blockchain technologies also promise to provide architectures for electronic health records that do not require huge government expenditure that challenge developing nations. However, Blockchain deployment, particularly with streamed data challenges existing Blockchain algorithms that take too long to place data in a block, and have no mechanism to determine whether every data point in every stream should be stored in such a secure way. This article presents an architecture that involves a Patient Agent, coordinating the insertion of continuous data streams into Blockchains to form an electronic health record.
- Description: Studies in Health Technology and Informatics
Continuous patient monitoring with a patient centric agent : A block architecture
- Authors: Uddin, Ashraf , Stranieri, Andrew , Gondal, Iqbal , Balasubramanian, Venki
- Date: 2018
- Type: Text , Journal article
- Relation: IEEE Access Vol. 6, no. (2018), p. 32700-32726
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- Description: The Internet of Things (IoT) has facilitated services without human intervention for a wide range of applications, including continuous remote patient monitoring (RPM). However, the complexity of RPM architectures, the size of data sets generated and limited power capacity of devices make RPM challenging. In this paper, we propose a tier-based End to End architecture for continuous patient monitoring that has a patient centric agent (PCA) as its center piece. The PCA manages a blockchain component to preserve privacy when data streaming from body area sensors needs to be stored securely. The PCA based architecture includes a lightweight communication protocol to enforce security of data through different segments of a continuous, real time patient monitoring architecture. The architecture includes the insertion of data into a personal blockchain to facilitate data sharing amongst healthcare professionals and integration into electronic health records while ensuring privacy is maintained. The blockchain is customized for RPM with modifications that include having the PCA select a Miner to reduce computational effort, enabling the PCA to manage multiple blockchains for the same patient, and the modification of each block with a prefix tree to minimize energy consumption and incorporate secure transaction payments. Simulation results demonstrate that security and privacy can be enhanced in RPM with the PCA based End to End architecture.
Supporting regional aged care nursing staff to manage residents’ behavioural and psychological symptoms of dementia, in real time, using the nurses’ behavioural assistant (NBA) : A pilot site 'end-user attitudes’ trial
- Authors: Klein, Britt , Clinnick, Lisa , Chesler, Jessica , Stranieri, Andrew , Bignold, Adam , Dazeley, Richard , McLaren, Suzanne , Lauder, Sue , Balasubramanian, Venki
- Date: 2018
- Type: Text , Conference paper
- Relation: 2017 Global Telehealth Meeting, GT 201; Adelaide, Australia; 22nd-24th November 2017; published in Telehealth for our Ageing Society (part of the Studies in Health Technology and Informatics series) Vol. 246, p. 24-28
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- Description: Background: This regional pilot site ‘end-user attitudes’ study explored nurses’ experiences and impressions of using the Nurses’ Behavioural Assistant (NBA) (a knowledge-based, interactive ehealth system) to assist them to better respond to behavioural and psychological symptoms of dementia (BPSD) and will be reported here. Methods: Focus groups were conducted, followed by a four-week pilot site ‘end-user attitudes’ trial of the NBA at a regional aged care residential facility (ACRF). Brief interviews were conducted with consenting nursing staff. Results: Focus group feedback (N = 10) required only minor cosmetic changes to the NBA prototype. Post pilot site end-user interview data (N = 10) indicated that the regional ACRF nurses were positive and enthusiastic about the NBA, however several issues were also identified. Conclusions: Overall the results supported the utility of the NBA to promote a person centred care approach to managing BPSD. Slight modifications may be required to maximise its uptake across all ACRF nursing staff.
A count data model for heart rate variability forecasting and premature ventricular contraction detection
- Authors: Allami, Ragheed , Stranieri, Andrew , Balasubramanian, Venki , Jelinek, Herbert
- Date: 2017
- Type: Text , Journal article
- Relation: Signal Image and Video Processing Vol. 11, no. 8 (2017), p. 1427-1435
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- Description: Heart rate variability (HRV) measures including the standard deviation of inter-beat variations (SDNN) require at least 5 min of ECG recordings to accurately measure HRV. In this paper, we predict, using counts data derived from a 3-min ECG recording, the 5-min SDNN and also detect premature ventricular contraction (PVC) beats with a high degree of accuracy. The approach uses counts data combined with a Poisson-generated function that requires minimal computational resources and is well suited to remote patient monitoring with wearable sensors that have limited power, storage and processing capacity. The ease of use and accuracy of the algorithm provide opportunity for accurate assessment of HRV and reduce the time taken to review patients in real time. The PVC beat detection is implemented using the same count data model together with knowledge-based rules derived from clinical knowledge.
Atrial fibrillation analysis for real time patient monitoring
- Authors: Allami, Ragheed , Stranieri, Andrew , Marzbanrad, Faezeh , Balasubramanian, Venki , Jelinek, Herbert
- Date: 2017
- Type: Text , Conference proceedings , Conference paper
- Relation: 44th Computing in Cardiology Conference, CinC 2017 Vol. 44, p. 1-4
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- Description: Atrial Fibrillation (AF) can lead to life-threatening conditions such as stroke and heart failure. The instant recognition of life-threatening cardiac arrhythmias based on a 3-lead ECG to record a Lead II configuration for a few seconds is a challenging problem of clinical significance. Five consecutive ECG beats that were identified by a cardiologist to characterise an AF episode and five consecutive heartbeat intervals representing an irregular RR intervals episode were analysed. The detection and analysis of P waves as the morphological features of AF was executed based on two template matching methods. An AF detector was developed by combining the correlation coefficients based on the template matching methods and the standard deviation of the RR intervals. The AF detector was then applied to classify 5 consecutive beats as AF or non-AF based on thresholding the calculated irregularity. The proposed algorithm was tested on the MIT-BIH Atrial Fibrillation and the Challenge 2017 databases. The proposed method resulted in an improved sensitivity, specificity and accuracy of 97.60%, 98.20% and 99% respectively compared to recent published methods. In addition, the proposed method is suitable for real-time patient monitoring as it is computationally simple and requires only a few seconds of ECG recording to detect an AF rhythm. © 2017 IEEE Computer Society. All rights reserved.
A genetic algorithm-neural network wrapper approach for bundle branch block detection
- Authors: Allami, Ragheed , Stranieri, Andrew , Balasubramanian, Venki
- Date: 2016
- Type: Text , Conference paper
- Relation: Computing in Cardiology Conference (CinC), 2016; Vancouver, BC ;11-14 Sept. 2016, published in Computing in Cardiology p. 461-464
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- Description: An Electrocardiogram (ECG) records the electrical impulses of the heart and indicates rhythm anomalies for diagnostic purposes [1], [2]. A typical ECG tracing of the cardiac cycle consists of a P wave, QRS complex, and T wave [3]. Good performance of an ECG analyzing system depends heavily upon the accurate and reliable detection of the QRS complex, as well as the T and P waves [4]. A Bundle Branch Block (BBB) is a delay or obstruction along electrical impulse pathways of the heart manifesting in a prolonged QRS interval usually greater than 120ms. The automated detection and classification of a BBB is important for prompt, accurate diagnosis and treatment to reduce morbidity and mortality.