Estimating critical values from electrocardiogram using a deep ordinal convolutional neural network.

BACKGROUND: Critical values are commonly used in clinical laboratory tests to define health-related conditions of varying degrees. Knowing the values, people can quickly become aware of health risks, and the health professionals can take immediate actions and save lives. METHODS: In this paper, we propose a method that extends the concept of critical value to one of the most commonly used physiological signals in the clinical environment-Electrocardiogram (ECG). We first construct a mapping from common ECG diagnostic conclusions to critical values. After that, we build a 61-layer deep convolutional neural network named CardioV, which is characterized by an ordinal classifier. RESULTS: We conduct experiments on a large public ECG dataset, and demonstrate that CardioV achieves a mean absolute error of 0.4984 and a ROC-AUC score of 0.8735. In addition, we find that the model performs better for extreme critical values and the younger age group, while gender does not affect the performance. The ablation study confirms that the ordinal classification mechanism suits for estimating the critical values which contain ranking information. Moreover, model interpretation techniques help us discover that CardioV focuses on the characteristic ECG locations during the critical value estimation process. CONCLUSIONS: As an ordinal classifier, CardioV performs well in estimating ECG critical values that can help people quickly identify different heart conditions. We obtain ROC-AUC scores above 0.8 for all four critical value categories, and find that the extreme values (0 (no risk) and 3 (high risk)) have better model performance than the other two (1 (low risk) and 2 (medium risk)). Results also show that gender does not affect the performance, and the older age group has worse performance than the younger age group. In addition, visualization techniques reveal that the model pays more attention to characteristic ECG locations.

Artificial-Intelligence-Enhanced Mobile System for Cardiovascular Health Management.

The number of patients with cardiovascular diseases is rapidly increasing in the world. The workload of existing clinicians is consequently increasing. However, the number of cardiovascular clinicians is declining. In this paper, we aim to design a mobile and automatic system to improve the abilities of patients' cardiovascular health management while also reducing clinicians' workload. Our system includes both hardware and cloud software devices based on recent advances in Internet of Things (IoT) and Artificial Intelligence (AI) technologies. A small hardware device was designed to collect high-quality Electrocardiogram (ECG) data from the human body. A novel deep-learning-based cloud service was developed and deployed to achieve automatic and accurate cardiovascular disease detection. Twenty types of diagnostic items including sinus rhythm, tachyarrhythmia, and bradyarrhythmia are supported. Experimental results show the effectiveness of our system. Our hardware device can guarantee high-quality ECG data by removing high-/low-frequency distortion and reverse lead detection with 0.9011 Area Under the Receiver Operating Characteristic Curve (ROC-AUC) score. Our deep-learning-based cloud service supports 20 types of diagnostic items, 17 of them have more than 0.98 ROC-AUC score. For a real world application, the system has been used by around 20,000 users in twenty provinces throughout China. As a consequence, using this service, we could achieve both active and passive health management through a lightweight mobile application on the WeChat Mini Program platform. We believe that it can have a broader impact on cardiovascular health management in the world.

Gated temporal convolutional neural network and expert features for diagnosing and explaining physiological time series: A case study on heart rates.

BACKGROUND AND OBJECTIVE: Physiological time series are common data sources in many health applications. Mining data from physiological time series is crucial for promoting healthy living and reducing governmental medical expenditure. Recently, research and applications of deep learning methods on physiological time series have developed rapidly because such data can be continuously recorded by smart wristbands or smartwatches. However, existing deep learning methods suffer from excessive model complexity and a lack of explanation. This paper aims to handle these issues. METHODS: We propose TEG-net, which is a novel deep learning method for accurately diagnosing and explaining physiological time series. TEG-net constructs T-net (a multi-scale bi-directional temporal convolutional neural network) to model physiological time series directly, E-net (personalized linear model) to model expert features extracted from physiological time series, and G-net (gating neural network) to combine T-net and E-net for diagnosis. The combination of T-net and E-net through G-net improves diagnosis accuracy and E-net can be utilized for explanation. RESULTS: Experimental results demonstrate that TEG-net outperforms the second-best baseline by 13.68% in terms of area under the receiver operating characteristic curve and 11.49% in terms of area under the precision-recall curve. Additionally, intuitive justifications can be provided to explain model predictions. CONCLUSIONS: This paper develops an ensemble method to combine expert features and deep learning method for modeling physiological time series. Improvements in diagnostic accuracy and explanation make TEG-net applicable to many real-world health applications.