Artificial Intelligence Applications in Type 2 Diabetes Mellitus Care: Focus on Machine Learning Methods / 대한의료정보학회지

OBJECTIVES: The incidence of type 2 diabetes mellitus has increased significantly in recent years. With the development of artificial intelligence applications in healthcare, they are used for diagnosis, therapeutic decision making, and outcome prediction, especially in type 2 diabetes mellitus. This study aimed to identify the artificial intelligence (AI) applications for type 2 diabetes mellitus care. METHODS: This is a review conducted in 2018. We searched the PubMed, Web of Science, and Embase scientific databases, based on a combination of related mesh terms. The article selection process was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Finally, 31 articles were selected after inclusion and exclusion criteria were applied. Data gathering was done by using a data extraction form. Data were summarized and reported based on the study objectives. RESULTS: The main applications of AI for type 2 diabetes mellitus care were screening and diagnosis in different stages. Among all of the reviewed AI methods, machine learning methods with 71% (n = 22) were the most commonly applied techniques. Many applications were in multi method forms (23%). Among the machine learning algorithms applications, support vector machine (21%) and naive Bayesian (19%) were the most commonly used methods. The most important variables that were used in the selected studies were body mass index, fasting blood sugar, blood pressure, HbA1c, triglycerides, low-density lipoprotein, high-density lipoprotein, and demographic variables. CONCLUSIONS: It is recommended to select optimal algorithms by testing various techniques. Support vector machine and naive Bayesian might achieve better performance than other applications due to the type of variables and targets in diabetes-related outcomes classification.

Modification of the Conventional Influenza Epidemic Models Using Environmental Parameters in Iran / 대한의료정보학회지

OBJECTIVES: The association between the spread of infectious diseases and climate parameters has been widely studied in recent decades. In this paper, we formulate, exploit, and compare three variations of the susceptible-infected-recovered (SIR) model incorporating climate data. The SIR model is a well-studied model to investigate the dynamics of influenza viruses; however, the improved versions of the classic model have been developed by introducing external factors into the model. METHODS: The modification models are derived by multiplying a linear combination of three complementary factors, namely, temperature (T), precipitation (P), and humidity (H) by the transmission rate. The performance of these proposed models is evaluated against the standard model for two outbreak seasons. RESULTS: The values of the root-mean-square error (RMSE) and the Akaike information criterion (AIC) improved as they declined from 8.76 to 7.05 and from 98.12 to 93.01 for season 2013/14, respectively. Similarly, for season 2014/15, the RMSE and AIC decreased from 8.10 to 6.45 and from 117.73 to 107.91, respectively. The estimated values of R(t) in the framework of the standard and modified SIR models are also compared. CONCLUSIONS: Through simulations, we determined that among the studied environmental factors, precipitation showed the strongest correlation with the transmission dynamics of influenza. Moreover, the SIR+P+T model is the most efficient for simulating the behavioral dynamics of influenza in the area of interest.

Predicting Length of Stay in Intensive Care Units after Cardiac Surgery: Comparison of Artificial Neural Networks and Adaptive Neuro-fuzzy System / 대한의료정보학회지

OBJECTIVES: Accurate prediction of patients' length of stay is highly important. This study compared the performance of artificial neural network and adaptive neuro-fuzzy system algorithms to predict patients' length of stay in intensive care units (ICU) after cardiac surgery. METHODS: A cross-sectional, analytical, and applied study was conducted. The required data were collected from 311 cardiac patients admitted to intensive care units after surgery at three hospitals of Shiraz, Iran, through a non-random convenience sampling method during the second quarter of 2016. Following the initial processing of influential factors, models were created and evaluated. RESULTS: The results showed that the adaptive neuro-fuzzy algorithm (with mean squared error [MSE] = 7 and R = 0.88) resulted in the creation of a more precise model than the artificial neural network (with MSE = 21 and R = 0.60). CONCLUSIONS: The adaptive neuro-fuzzy algorithm produces a more accurate model as it applies both the capabilities of a neural network architecture and experts' knowledge as a hybrid algorithm. It identifies nonlinear components, yielding remarkable results for prediction the length of stay, which is a useful calculation output to support ICU management, enabling higher quality of administration and cost reduction.

Systematic Review of Data Mining Applications in Patient-Centered Mobile-Based Information Systems / 대한의료정보학회지

OBJECTIVES: Smartphones represent a promising technology for patient-centered healthcare. It is claimed that data mining techniques have improved mobile apps to address patients’ needs at subgroup and individual levels. This study reviewed the current literature regarding data mining applications in patient-centered mobile-based information systems. METHODS: We systematically searched PubMed, Scopus, and Web of Science for original studies reported from 2014 to 2016. After screening 226 records at the title/abstract level, the full texts of 92 relevant papers were retrieved and checked against inclusion criteria. Finally, 30 papers were included in this study and reviewed. RESULTS: Data mining techniques have been reported in development of mobile health apps for three main purposes: data analysis for follow-up and monitoring, early diagnosis and detection for screening purpose, classification/prediction of outcomes, and risk calculation (n = 27); data collection (n = 3); and provision of recommendations (n = 2). The most accurate and frequently applied data mining method was support vector machine; however, decision tree has shown superior performance to enhance mobile apps applied for patients’ self-management. CONCLUSIONS: Embedded data-mining-based feature in mobile apps, such as case detection, prediction/classification, risk estimation, or collection of patient data, particularly during self-management, would save, apply, and analyze patient data during and after care. More intelligent methods, such as artificial neural networks, fuzzy logic, and genetic algorithms, and even the hybrid methods may result in more patients-centered recommendations, providing education, guidance, alerts, and awareness of personalized output.

comparative study of perceived social support and self-efficacy among women with wanted and unwanted pregnancy

Background: Unwanted pregnancy induces adverse attitudes regarding pregnancy which is a natural event by increasing mental and socio-economic difficulties. Insufficient maternal care and low adjustment to parental role are known as consequences of unwanted pregnancy. Perceived social support and self-efficacy in pregnancy influence health related behaviors and may play a crucial role in adaptation to pregnancy; this study was conducted to examine and compare the self-efficacy and social support among two groups of women with wanted and unwanted pregnancy

Methods: This analytical descriptive research was conducted on 315 women referred to 13 health centers in the east and west of Ahvaz in 2011. Data were collected via random stratified sampling method through interview. The instrument of this study was a questionnaire in three distinct parts including demographic, modified Persian version of Vaux General social support [Chronbach's alpha =0.80] and Persian version of self-efficacy scale [Chronbach's alpha =0.80]. Data were analyzed through independent t-test and ANOVA. A P<0.05 was considered significant

Results: The mean age of the subjects was 25.8 +/- 5.6; unwanted pregnancy occurred in 135 women [42.2%]. The mean scores of social support in the two given groups with wanted and unwanted pregnancy were 26.62 +/- 4.16 and 22.28 +/- 7.57, respectively [P<0.001]. Furthermore, the mean scores of self-efficacy for the wanted pregnancy group was 37.77 +/- 6.66 and for unwanted pregnancy group it was 31.03 +/- 6.31 [P<0.001]. Women and their husbands' age, the number of male offspring in family and marriage years were significantly different in the two groups [P<0.05]

Conclusion: This study showed that unwanted pregnant women are more likely to be exposed to low level of perceived social support and self-efficacy. Therefore more studies and interventions are recommended to be conducted to analyze the effect of family and friends' supports on unwanted pregnant women's perceived social support and self-efficacy and its adverse consequences

HPV infection among patients with high grade cervical intraepithelial neoplasia and squamous cell carcinoma of cervix

Cervical cancer is the second most common cancer of the women worldwide. It is also an important cause of cancer-related mortality in women, after breast cancer. Nearly half million of new cases are identified yearly. The incidence rate in developing countries is greater than the developed countries. Epidemiologic studies have shown that the association of genital human papilloma virus [HPV] with cervical cancer is strong, independent of other risk factors, and consistent in several countries. The aim of this study was to determine the frequency of HPV in patients with high grade cervical intraepithelial neoplasia [CINIII, CIN II] and squamous cell carcinoma [SCC] of cervix. Hundred specimens from patients with SCC and CINIII, CIN II, confirmed by histological review, referring to Mirza Koochak Khan Hospital from 1999-2004 were enrolled in a cross sectional study. Polymerase chain reaction was utilized for identification and typing of HPV DNA. To increase the sensitivity of HPV detection, nested PCRs were performed using MY09/MY11 as outer and GP5/GP6 as inner primers. It was possible to extract 77 of 100 specimens that HPV DNA was detected in 47 of 77 specimens. Infection with HPV was present in 32 specimens [86.5%] among SCC patients and in 15 specimens [37.5%] among CINIII, CIN II patients. The most frequent HPV types in SCC patients were HPV 16 and 18 [59.38%] and then 33 [34.38%] and in CINIII, CIN II patients was 16 [53.33%] and 18 [40%]. the most frequent co-infection in both groups was HPV 16 and 18 which was present in 40.62% and 26.7% of cases respectively. The most frequent HPV types in patients with SCC and CINIII, CIN II was 16 and 18 that is identical to many other countries infection pattern