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Background The COVID-19 pandemic has limited daily activities and even contact between patients and primary care providers. This makes it more difficult to provide adequate primary care services, which include connecting patients to an appropriate medical specialist. A smartphone-compatible artificial intelligence (AI) chatbot that classifies patients’ symptoms and recommends the appropriate medical specialty could provide a valuable solution. Objective In order to establish a contactless method of recommending the appropriate medical specialty, this study aimed to construct a deep learning–based natural language processing (NLP) pipeline and to develop an AI chatbot that can be used on a smartphone. Methods We collected 118,008 sentences containing information on symptoms with labels (medical specialty), conducted data cleansing, and finally constructed a pipeline of 51,134 sentences for this study. Several deep learning models, including 4 different long short-term memory (LSTM) models with or without attention and with or without a pretrained FastText embedding layer, as well as bidirectional encoder representations from transformers for NLP, were trained and validated using a randomly selected test data set. The performance of the models was evaluated on the basis of the precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC). An AI chatbot was also designed to make it easy for patients to use this specialty recommendation system. We used an open-source framework called “Alpha” to develop our AI chatbot. This takes the form of a web-based app with a frontend chat interface capable of conversing in text and a backend cloud-based server application to handle data collection, process the data with a deep learning model, and offer the medical specialty recommendation in a responsive web that is compatible with both desktops and smartphones. Results The bidirectional encoder representations from transformers model yielded the best performance, with an AUC of 0.964 and F1-score of 0.768, followed by LSTM model with embedding vectors, with an AUC of 0.965 and F1-score of 0.739. Considering the limitations of computing resources and the wide availability of smartphones, the LSTM model with embedding vectors trained on our data set was adopted for our AI chatbot service. We also deployed an Alpha version of the AI chatbot to be executed on both desktops and smartphones. Conclusions With the increasing need for telemedicine during the current COVID-19 pandemic, an AI chatbot with a deep learning–based NLP model that can recommend a medical specialty to patients through their smartphones would be exceedingly useful. This chatbot allows patients to identify the proper medical specialist in a rapid and contactless manner, based on their symptoms, thus potentially supporting both patients and primary care providers.

Background: Early diagnosis of skin cancer lesions by dermoscopy, the gold standard in dermatological imaging, calls for a diagnostic upscale. The aim of the study was to improve the accuracy of dermoscopic skin cancer diagnosis through use of novel deep learning (DL) algorithms. An additional sonification-derived diagnostic layer was added to the visual classification to increase sensitivity. Methods: Two parallel studies were conducted: a laboratory retrospective study (LABS, n = 482 biopsies) and a non-interventional prospective observational study (OBS, n = 63 biopsies). A training data set of biopsy-verified reports, normal and cancerous skin lesions (n = 3954), were used to develop a DL classifier exploring visual features (System A). The outputs of the classifier were sonified, i.e. data conversion into sound (System B). Derived sound files were analyzed by a second machine learning classifier, either as raw audio (LABS, OBS) or following conversion into spectrograms (LABS) and by image analysis and human heuristics (OBS). The OBS criteria outcomes were System A specificity and System B sensitivity as raw sounds, spectrogram areas or heuristics. Findings: LABS employed dermoscopies, half benign half malignant, and compared the accuracy of Systems A and B. System A algorithm resulted in a ROC AUC of 0.976 (95% CI, 0.965–0.987). Secondary machine learning analysis of raw sound, FFT and Spectrogram ROC curves resulted in AUC's of 0.931 (95% CI 0.881–0.981), 0.90 (95% CI 0.838–0.963) and 0.988 (CI 95% 0.973–1.001), respectively. OBS analysis of raw sound dermoscopies by the secondary machine learning resulted in a ROC AUC of 0.819 (95% CI, 0.7956 to 0.8406). OBS image analysis of AUC for spectrograms displayed a ROC AUC of 0.808 (CI 95% 0.6945 To 0.9208). By applying a heuristic analysis of Systems A and B a sensitivity of 86% and specificity of 91% were derived in the clinical study. Interpretation: Adding a second stage of processing, which includes a deep learning algorithm of sonification and heuristic inspection with machine learning, significantly improves diagnostic accuracy. A combined two-stage system is expected to assist clinical decisions and de-escalate the current trend of over-diagnosis of skin cancer lesions as pathological. Fund: Bostel Technologies.Trial Registration clinicaltrials.gov Identifier: NCT03362138 Keywords: Skin cancer, Deep learning, Sonification, Artificial intelligence, Dermoscopy, Melanoma, Telemedicine

Gaining knowledge and actionable insights from complex, high-dimensional and heterogeneous biomedical data remains a key challenge in transforming health care. Various types of data have been emerging in modern biomedical research, including electronic health records, imaging, -omics, sensor data and text, which are complex, heterogeneous, poorly annotated and generally unstructured. Traditional data mining and statistical learning approaches typically need to first perform feature engineering to obtain effective and more robust features from those data, and then build prediction or clustering models on top of them. There are lots of challenges on both steps in a scenario of complicated data and lacking of sufficient domain knowledge. The latest advances in deep learning technologies provide new effective paradigms to obtain end-to-end learning models from complex data. In this article, we review the recent literature on applying deep learning technologies to advance the health care domain. Based on the analyzed work, we suggest that deep learning approaches could be the vehicle for translating big biomedical data into improved human health. However, we also note limitations and needs for improved methods development and applications, especially in terms of ease-of-understanding for domain experts and citizen scientists. We discuss such challenges and suggest developing holistic and meaningful interpretable architectures to bridge deep learning models and human interpretability.

Background Screening for influenza in primary care is challenging due to the low sensitivity of rapid antigen tests and the lack of proper screening tests. Objective The aim of this study was to develop a machine learning–based screening tool using patient-generated health data (PGHD) obtained from a mobile health (mHealth) app. Methods We trained a deep learning model based on a gated recurrent unit to screen influenza using PGHD, including each patient’s fever pattern and drug administration records. We used meteorological data and app-based surveillance of the weekly number of patients with influenza. We defined a single episode as the set of consecutive days, including the day the user was diagnosed with influenza or another disease. Any record a user entered 24 hours after his or her last record was considered to be the start of a new episode. Each episode contained data on the user’s age, gender, weight, and at least one body temperature record. The total number of episodes was 6657. Of these, there were 3326 episodes within which influenza was diagnosed. We divided these episodes into 80% training sets (2664/3330) and 20% test sets (666/3330). A 5-fold cross-validation was used on the training set. Results We achieved reliable performance with an accuracy of 82%, a sensitivity of 84%, and a specificity of 80% in the test set. After the effect of each input variable was evaluated, app-based surveillance was observed to be the most influential variable. The correlation between the duration of input data and performance was not statistically significant (P=.09). Conclusions These findings suggest that PGHD from an mHealth app could be a complementary tool for influenza screening. In addition, PGHD, along with traditional clinical data, could be used to improve health conditions.

Artificial intelligence (AI) is making computer systems capable of executing human brain tasks in many fields in all aspects of daily life. The enhancement in information and communications technology (ICT) has indisputably improved the quality of people’s lives around the globe. Especially, ICT has led to a very needy and tremendous improvement in the health sector which is commonly known as electronic health (eHealth) and medical health (mHealth). Deep machine learning and AI approaches are commonly presented in many applications using big data, which consists of all relevant data about the medical health and diseases which a model can access at the time of execution or diagnosis of diseases. For example, cardiovascular imaging has now accurate imaging combined with big data from the eHealth record and pathology to better characterize the disease and personalized therapy. In clinical work and imaging, cancer care is getting improved by knowing the tumor biology and helping in the implementation of precision medicine. The Markov model is used to extract new approaches for leveraging cancer. In this paper, we have reviewed existing research relevant to eHealth and mHealth where various models are discussed which uses big data for the diagnosis and healthcare system. This paper summarizes the recent promising applications of AI and big data in medical health and electronic health, which have potentially added value to diagnosis and patient care.

The purpose of current paper is to create a smart and effective tool for telemedicine to early detect and diagnose COVID-19 disease and therefore help to manage Pandemic Crisis (MCPC) in Sultanate of Oman, as a tool for future pandemic containment. In this paper, we used tools to create robust models in real-time to support Telemedicine, it is Machine Learning (ML), Deep Learning (DL), Convolutional Neural Networks using Tensorflow (CNN-TF), and CNN Deployment. These models will assist telemedicine, 1) developing Automated Medical Immediate Diagnosis service (AMID). 2) Analysis of Chest X-rays image (CXRs). 3) Simplifying Classification of confirmed cases according to its severity. 4) Overcoming the lack of experience, by improving the performance of medical diagnostics and providing recommendations to the medical staff. The results show that the best Regression among the five Regression models is Random Forest Regression. while the best classification among the eight classification models and Recurrent Neural Network using Tensorflow (RNNTF) is Random Forest classification, and the best Clustering model among two Clustering models is K-Means++. Furthermore, CNN-TF model was able to discriminate between those with positive cases Covid-19 and those with negative cases.

Nowadays people are mostly focused on their work while ignoring their health which in turn is creating a drastic effect on their health in the long run. Remote health monitoring through telemedicine can help people discover potential health threats in time. In the COVID-19 pandemic, remote health monitoring can help obtain and analyze biomedical signals including human body temperature without direct body contact. This technique is of great significance to achieve safe and efficient health monitoring in the COVID-19 pandemic. Existing remote biomedical signal monitoring methods cannot effectively analyze the time series data. This paper designs a remote biomedical signal monitoring framework combining the Internet of Things (IoT), 5G communication and artificial intelligence techniques. In the constructed framework, IoT devices are used to collect biomedical signals at the perception layer. Subsequently, the biomedical signals are transmitted through the 5G network to the cloud server where the GRU-AE deep learning model is deployed. It is noteworthy that the proposed GRU-AE model can analyze multi-dimensional biomedical signals in time series. Finally, this paper conducts a 24-week monitoring experiment for 2000 subjects of different ages to obtain real data. Compared with the traditional biomedical signal monitoring method based on the AutoEncoder model, the GRU-AE model has better performance. The research has an important role in promoting the development of biomedical signal monitoring techniques, which can be effectively applied to some kinds of remote health monitoring scenario.

In this paper, a novel medical knowledge graph in Chinese approach applied in smart healthcare based on IoT and WoT is presented, using deep neural networks combined with self-attention to generate medical knowledge graph to make it more convenient for performing disease diagnosis and providing treatment advisement. Although great success has been made in the medical knowledge graph in recent studies, the issue of comprehensive medical knowledge graph in Chinese appropriate for telemedicine or mobile devices have been ignored. In our study, it is a working theory which is based on semantic mobile computing and deep learning. When several experiments have been carried out, it is demonstrated that it has better performance in generating various types of medical knowledge graph in Chinese, which is similar to that of the state-of-the-art. Also, it works well in the accuracy and comprehensive, which is much higher and highly consisted with the predictions of the theoretical model. It proves to be inspiring and encouraging that our work involving studies of medical knowledge graph in Chinese, which can stimulate the smart healthcare development.

We are currently witnessing an immense proliferation of natural language processing (NLP) applications. Natural language generation (NLG) has emerged from NLP and is now commonly utilized in various applications, including chatting applications. The objective of this paper is to propose a deep learning-based language generation model that simplifies the process of writing medical recommendations for doctors in an Arabic context, to improve service satisfaction and patient-doctor interactions. The developed language generation model is a predictive text system intended for next word prediction in a telemedicine service. Altibbi—a digital platform for telemedicine and teleconsultations services in the Middle East and the North Africa (MENA) region—was utilized as a case study for the textual prediction process. The proposed model was trained using data obtained from Altibbi databases related to medical recommendations, particularly gynecology, dermatology, psychiatric diseases, urology, and internist diseases. Variants of deep learning models were implemented and optimized for next word prediction, based on the unidirectional and bidirectional long short-term memory (LSTM and BiLSTM), the one-dimensional convolutional neural network (CONV1D), and a combination of LSTM and CONV1D (LSTM-CONV1D). The algorithms were trained using two versions of the datasets (i.e., 3-gram and 4-gram representations) and evaluated in terms of their training accuracy and loss, validation accuracy and loss, and testing accuracy per their matching scores. The proposed models’ performances were comparable. CONV1D produced the most promising matching score.

Skin conditions affect an estimated 1.9 billion people worldwide. A shortage of dermatologists causes long wait times and leads patients to seek dermatologic care from general practitioners. However, the diagnostic accuracy of general practitioners has been reported to be only 0.24-0.70 (compared to 0.77-0.96 for dermatologists), resulting in referral errors, delays in care, and errors in diagnosis and treatment. In this paper, we developed a deep learning system (DLS) to provide a differential diagnosis of skin conditions for clinical cases (skin photographs and associated medical histories). The DLS distinguishes between 26 skin conditions that represent roughly 80% of the volume of skin conditions seen in primary care. The DLS was developed and validated using de-identified cases from a teledermatology practice serving 17 clinical sites via a temporal split: the first 14,021 cases for development and the last 3,756 cases for validation. On the validation set, where a panel of three board-certified dermatologists defined the reference standard for every case, the DLS achieved 0.71 and 0.93 top-1 and top-3 accuracies respectively. For a random subset of the validation set (n=963 cases), 18 clinicians reviewed the cases for comparison. On this subset, the DLS achieved a 0.67 top-1 accuracy, non-inferior to board-certified dermatologists (0.63, p

Intraoperative detection and tracking of minimally invasive instruments is a prerequisite for computer- and robotic-assisted surgery. Since additional hardware, such as tracking systems or the robot encoders, are cumbersome and lack accuracy, surgical vision is evolving as a promising technique to detect and track the instruments using only endoscopic images. The present paper presents a review of the literature regarding image-based laparoscopic tool detection and tracking using convolutional neural networks (CNNs) and consists of four primary parts: (1) fundamentals of CNN; (2) public datasets; (3) CNN-based methods for the detection and tracking of laparoscopic instruments; and (4) discussion and conclusion. To help researchers quickly understand the various existing CNN-based algorithms, some basic information and a quantitative estimation of several performances are analyzed and compared from the perspective of 'partial CNN approaches' and 'full CNN approaches'. Moreover, we highlight the challenges related to research of CNN-based detection algorithms and provide possible future developmental directions.

Maintaining a high quality of conversation between doctors and patients is essential in telehealth services, where efficient and competent communication is important to promote patient health. Assessing the quality of medical conversations is often handled based on a human auditory-perceptual evaluation. Typically, trained experts are needed for such tasks, as they follow systematic evaluation criteria. However, the daily rapid increase of consultations makes the evaluation process inefficient and impractical. This paper investigates the automation of the quality assessment process of patient–doctor voice-based conversations in a telehealth service using a deep-learning-based classification model. For this, the data consist of audio recordings obtained from Altibbi. Altibbi is a digital health platform that provides telemedicine and telehealth services in the Middle East and North Africa (MENA). The objective is to assist Altibbi’s operations team in the evaluation of the provided consultations in an automated manner. The proposed model is developed using three sets of features: features extracted from the signal level, the transcript level, and the signal and transcript levels. At the signal level, various statistical and spectral information is calculated to characterize the spectral envelope of the speech recordings. At the transcript level, a pre-trained embedding model is utilized to encompass the semantic and contextual features of the textual information. Additionally, the hybrid of the signal and transcript levels is explored and analyzed. The designed classification model relies on stacked layers of deep neural networks and convolutional neural networks. Evaluation results show that the model achieved a higher level of precision when compared with the manual evaluation approach followed by Altibbi’s operations team.

Cardiovascular diseases and heart failures in particular are the main cause of non-communicable disease mortality in the world. Constant patient monitoring enables better medical treatment as it allows practitioners to react on time and provide the appropriate treatment. Telemedicine can provide constant remote monitoring so patients can stay in their homes, only requiring medical sensing equipment and network connections. A limiting factor for telemedical centers is the amount of patients that can be monitored simultaneously. We aim to increase this amount by implementing a decision support system. This paper investigates a machine learning model to estimate a risk score based on patient vital parameters that allows sorting all cases every day to help practitioners focus their limited capacities on the most severe cases. The model we propose reaches an AUCROC of 0.84, whereas the baseline rule-based model reaches an AUCROC of 0.73. Our results indicate that the usage of deep learning to improve the efficiency of telemedical centers is feasible. This way more patients could benefit from better health-care through remote monitoring .

According to the World Health Organization, cardiovascular diseases contribute to 17.7 million deaths per year and are rising with a growing ageing population. In order to handle these challenges, the evolved countries are now evolving workable solutions based on new communication technologies such as ambient assisted living. In these solutions, the most well-known solutions are wearable devices for patient monitoring, telemedicine and mHealth systems. This systematic literature review presents the detailed literature on ambient assisted living solutions and helps to understand how ambient assisted living helps and motivates patients with cardiovascular diseases for self-management to reduce associated morbidity and mortalities. Preferred reporting items for systematic reviews and meta-analyses technique are used to answer the research questions. The paper is divided into four main themes, including self-monitoring wearable systems, ambient assisted living in aged populations, clinician management systems and deep learning-based systems for cardiovascular diagnosis. For each theme, a detailed investigation shows (1) how these new technologies are nowadays integrated into diagnostic systems and (2) how new technologies like IoT sensors, cloud models, machine and deep learning strategies can be used to improve the medical services. This study helps to identify the strengths and weaknesses of novel ambient assisted living environments for medical applications. Besides, this review assists in reducing the dependence on caregivers and the healthcare systems.

The massive increase in health-related digital data has revolutionized the power of machine learning algorithms to produce more salient information. Digital health data consists of various information, including diagnoses, treatments, and medications. Diagnosis is a fundamental service provided by healthcare agents for improving patient health. However, diagnosis errors result in treating the patient incorrectly or at an improper time causing harm to them. Computer-aided diagnosis systems are intelligent methods that help clinicians in making correct decisions by mitigating the potential of clinical cognitive errors. This paper proposes an intelligent diagnosis decision support system as part of a telemedicine 11 Telemedicine is defined by the World Health Organization by “healing at a distance, which signifies the use of information and communication technologies to improve patient outcomes by increasing access to care and medical information.” platform for serving the Middle East and North Africa (MENA) region. The proposed system utilizes a huge health-related dataset curated by the Altibbi company, which includes numerous unstructured patient questions written in different dialects of the Arabic language, and structured symptoms identified by general practitioners (GPs). The system encompasses a fusion of machine learning models trained based on two modalities: the symptoms and the medical questions of the patients. Various feature representation techniques (i.e., statistical and word embeddings) and machine learning classifiers, including Logistic Regression (LR), Random Forest (RF), Stochastic Gradient Descent Classifier (SGDClassifier), and variants of the Multilayer Perceptron (MLP) classifier have been used for experiments. The output of the combination of the two modalities has shown promising predictive ability in terms of the classification accuracy, which is 84.9%. The obtained results indicate the potential of the model in predicting the diagnosis of possible patient conditions based on the given symptoms and patients’ questions, which consequently can aid doctors in making the right decisions.

This paper proposes a teleophthalmology support system in which we use algorithms of object detection and semantic segmentation, such as faster region-based CNN (FR-CNN) and SegNet, based on several CNN architectures such as: Vgg16, MobileNet, AlexNet, etc. These are used to segment and analyze the principal anatomical elements, such as optic disc (OD), region of interest (ROI) composed by the macular region, real retinal region, and vessels. Unlike the conventional retinal image quality assessment system, the proposed system provides some possible reasons about the low-quality image to support the operator of an ophthalmoscope and patient to acquire and transmit a better-quality image to central eye hospital for its diagnosis. The proposed system consists of four steps: OD detection, OD quality analysis, obstruction detection of the region of interest (ROI), and vessel segmentation. For the OD detection, artefacts and vessel segmentation, the FR-CNN and SegNet are used, while for the OD quality analysis, we use transfer learning. The proposed system provides accuracies of 0.93 for the OD detection, 0.86 for OD image quality, 1.0 for artefact detection, and 0.98 for vessel segmentation. As the global performance metric, the kappa-based agreement score between ophthalmologist and the proposed system is calculated, which is higher than the score between ophthalmologist and general practitioner.