The analysis of EEG signal is a relevant problem in health informatics, and its development can help in detection of epileptic's seizures. The diagnosis is based on classification of EEG signal. Different methods and algorithms for classification of EEG signals with an accepted level of reliability and accuracy have been developed over years. All these methods have two steps that are signal preprocessing and classification. The goal of the preprocessing step is removing noise and reduction of the initial signal dimensionality. The signal dimensionality reduction is required by classification methods, but its result is a loss of small information before the classification. In this paper, an approach for EEG signal classification that takes this loss of information into account is considered. The novelty of the considered approach is usage of fuzzy classifier in the classification step. This classifier allows taking uncertainty of initial data into account, which is caused by loss of some information during dimensionality reduction of initial signal. However, application of fuzzy classifier needs modification of the preprocessing step because it requires data in fuzzy form. Therefore, fuzzification procedure is added to the preprocessing step. In this paper, Fuzzy Decision Tree (FDT) is used as the fuzzy classifier for the epileptic's seizure detection. Its application allows achieving 99.5% accuracy of the classification of epileptic's seizure. The comparison with other studies shows that FDT is very effective for task of epileptic's seizure detection.
A structure function is one of the possible mathematical models of systems in reliability engineering. A structure function maps sets of component states into system performance levels. Methods of system reliability evaluation based on structure function representation are well established. A structure function can be formed based on completely specified data about system behavior. Such data for most real-world systems are incomplete and uncertain. The typical example is analysis and evaluation of the human factor. Therefore, the structure function is not used in human reliability analysis (HRA) typically. In this paper, a method for structure function construction is proposed based on incomplete and uncertain data in HRA. The proposed method application is considered for healthcare to evaluate medical error. This method is developed using a fuzzy decision tree (FDT), which allows all possible component states to be classified into classes of system performance levels. The structure function is constructed based on the decision table, which is formed according to the FDT. A case study for this method is considered by evaluating the human factor in healthcare: complications in the familiarization and exploitation of a new device in a hospital department are analyzed and evaluated. This evaluation shows the decreasing of medical errors in diagnosis after one year of device exploitation and a slight decrease in quality of diagnosis after two months of device exploitation. Numerical values of probabilities of medical error are calculated based on the proposed approach.
Objectives: To propose the optimal timing to consider tracheostomy insertion for weaning of mechanically ventilated patients recovering from coronavirus disease 2019 pneumonia. We investigated the relationship between duration of mechanical ventilation prior to tracheostomy insertion and in-hospital mortality. In addition, we present a machine learning approach to facilitate decision-making. Design: Prospective cohort study. Setting: Guy’s & St Thomas’ Hospital, London, United Kingdom. Patients: Consecutive patients admitted with acute respiratory failure secondary to coronavirus disease 2019 requiring mechanical ventilation between March 3, 2020, and May 5, 2020. Interventions: Baseline characteristics and temporal trends in markers of disease severity were prospectively recorded. Tracheostomy was performed for anticipated prolonged ventilatory wean when levels of respiratory support were favorable. Decision tree was constructed using C4.5 algorithm, and its classification performance has been evaluated by a leave-one-out cross-validation technique. Measurements and Main Results: One-hundred seventy-six patients required mechanical ventilation for acute respiratory failure, of which 87 patients (49.4%) underwent tracheostomy. We identified that optimal timing for tracheostomy insertion is between day 13 and day 17. Presence of fibrosis on CT scan (odds ratio, 13.26; 95% CI [3.61–48.91]; p ≤ 0.0001) and Pao 2:Fio 2 ratio (odds ratio, 0.98; 95% CI [0.95–0.99]; p = 0.008) were independently associated with tracheostomy insertion. Cox multiple regression analysis showed that chronic obstructive pulmonary disease (hazard ratio, 6.56; 95% CI [1.04–41.59]; p = 0.046), ischemic heart disease (hazard ratio, 4.62; 95% CI [1.19–17.87]; p = 0.027), positive end-expiratory pressure (hazard ratio, 1.26; 95% CI [1.02–1.57]; p = 0.034), Pao 2:Fio 2 ratio (hazard ratio, 0.98; 95% CI [0.97–0.99]; p = 0.003), and C-reactive protein (hazard ratio, 1.01; 95% CI [1–1.01]; p = 0.005) were independent late predictors of in-hospital mortality. Conclusions: We propose that the optimal window for consideration of tracheostomy for ventilatory weaning is between day 13 and 17. Late predictors of mortality may serve as adverse factors when considering tracheostomy, and our decision tree provides a degree of decision support for clinicians.
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