Abstract
The internet of medical things (IoMT) is a relatively new territory for the internet of things (IoT) platforms where we can obtain a significant amount of potential benefits with the combination of cognitive computing. Effective utilization of the healthcare data is the critical factor in achieving such potential, which can be a significant challenge as the medical data is extraordinarily heterogeneous and spread across different devices with different degrees of importance and authority. To address this issue, in this paper, we introduce a cognitive internet of medical things architecture with a use case of early sepsis detection using electronic health records. We discuss the various aspects of IoMT architecture. Based on the discussion, we posit that the proposed architecture could improve the overall performance and usability in the IoMT platforms in particular for different IoMT based services and applications. The use of an RNN-LSTM network for early prediction of sepsis according to Sepsis-3 criteria is evaluated with the empirical investigation using six different time window sizes. The best result is obtained from a model using a four-hour window with the assumption that data is missing-not-at-random. It is observed that when learning from heterogeneous sequences of sparse medical data for early prediction of sepsis, the size of the time window has a considerable impact on predictive performance.
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References
Afzal, A., et al.: The cognitive internet of things: a unified perspective. Mob. Netw. Appl. 20(1), 72–85 (2015)
Alam, M.U., Henriksson, A., Karlsson Valik, J., Ward, L., Naucler, P., Dalianis, H.: Deep learning from heterogeneous sequences of sparse medical data for early prediction of sepsis. In: 13th International Joint Conference on Biomedical Engineering Systems and Technologies, Valletta, Malta, 24–26 February 2020, vol. 5, pp. 45–55. SciTePress (2020)
Bahga, A., Madisetti, V.K.: Healthcare data integration and informatics in the cloud. Computer 48(2), 50–57 (2015)
Behera, R.K., Bala, P.K., Dhir, A.: The emerging role of cognitive computing in healthcare: a systematic literature review. Int. J. Med. Inform. 129, 154–166 (2019)
Coccoli, M., Maresca, P.: Adopting cognitive computing solutions in healthcare. J. e-Learn. Knowl. Soc. 14(1) (2018)
Delahanty, R.J., Alvarez, J., Flynn, L.M., Sherwin, R.L., Jones, S.S.: Development and evaluation of a machine learning model for the early identification of patients at risk for sepsis. Ann. Emerg. Med. 73, 334–344 (2019)
Dimitrov, D.V.: Medical internet of things and big data in healthcare. Healthcare Inform. Res. 22(3), 156–163 (2016)
Durga, S., Nag, R., Daniel, E.: Survey on machine learning and deep learning algorithms used in internet of things (IoT) healthcare. In: 2019 3rd International Conference on Computing Methodologies and Communication (ICCMC), pp. 1018–1022. IEEE (2019)
Estrela, V.V., Monteiro, A.C.B., França, R.P., Iano, Y., Khelassi, A., Razmjooy, N.: Health 4.0: applications, management, technologies and review. Med. Technol. J. 2(4), 262–276 (2018)
Ferrer, R., et al.: Empiric antibiotic treatment reduces mortality in severe sepsis and septic shock from the first hour: results from a guideline-based performance improvement program. Crit. Care Med. 42(8), 1749–1755 (2014)
Futoma, J., Hariharan, S., Heller, K.: Learning to detect sepsis with a multitask Gaussian process RNN classifier. In: Proceedings of the 34th International Conference on Machine Learning, vol. 70, pp. 1174–1182. JMLR.org (2017)
Futoma, J., et al.: An improved multi-output gaussian process RNN with real-time validation for early sepsis detection. In: Doshi-Velez, F., Fackler, J., Kale, D., Ranganath, R., Wallace, B., Wiens, J. (eds.) Proceedings of the 2nd Machine Learning for Healthcare Conference. Proceedings of Machine Learning Research, Boston, Massachusetts, vol. 68, pp. 243–254. PMLR, 18–19 August 2017. http://proceedings.mlr.press/v68/futoma17a.html
Gatouillat, A., Badr, Y., Massot, B., Sejdić, E.: Internet of medical things: a review of recent contributions dealing with cyber-physical systems in medicine. IEEE Internet of Things J. 5(5), 3810–3822 (2018)
Goodfellow, I., Bengio, Y., Courville, A.: Deep Learning. MIT Press, Cambridge (2016)
Goodfellow, I., et al.: Generative adversarial nets. In: Advances in Neural Information Processing Systems, pp. 2672–2680 (2014)
Habibzadeh, H., Dinesh, K., Shishvan, O.R., Boggio-Dandry, A., Sharma, G., Soyata, T.: A survey of healthcare internet-of-things (HIoT): a clinical perspective. IEEE Internet of Things J. 7, 53–71 (2019)
Hochreiter, S., Schmidhuber, J.: Long short-term memory. Neural Comput. 9(8), 1735–1780 (1997)
Irfan, M., Ahmad, N.: Internet of medical things: architectural model, motivational factors and impediments. In: 2018 15th Learning and Technology Conference (L&T), pp. 6–13. IEEE (2018)
Johnson, A.E., Stone, D.J., Celi, L.A., Pollard, T.J.: The mimic code repository: enabling reproducibility in critical care research. J. Am. Med. Inform. Assoc. 25(1), 32–39 (2018)
Jones, A.E., et al.: Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial. Jama 303(8), 739–746 (2010)
Kumar, A., et al.: Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit. Care Med. 34(6), 1589–1596 (2006)
Lipton, Z.C.: The doctor just won’t accept that! arXiv preprint arXiv:1711.08037 (2017)
Mishra, N., Lin, C.C., Chang, H.T.: A cognitive adopted framework for IoT big-data management and knowledge discovery prospective. Int. J. Distrib. Sens. Netw. 11(10), 718390 (2015)
Modha, D.S., Ananthanarayanan, R., Esser, S.K., Ndirango, A., Sherbondy, A.J., Singh, R.: Cognitive computing. Commun. ACM 54(8), 62–71 (2011)
Moor, M., Horn, M., Rieck, B., Roqueiro, D., Borgwardt, K.: Early recognition of sepsis with Gaussian process temporal convolutional networks and dynamic time warping. arXiv preprint arXiv:1902.01659 (2019)
Pagola-Lorz, I., et al.: Epidemiological study and genetic characterization of inherited muscle diseases in a northern Spanish region. Orphanet J. Rare Dis. 14(1), 276 (2019)
Seymour, C.W., et al.: Time to treatment and mortality during mandated emergency care for sepsis. N. Engl. J. Med. 376(23), 2235–2244 (2017)
Seymour, C.W., et al.: Assessment of clinical criteria for sepsis: for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 315(8), 762–774 (2016)
Shi, W., Dustdar, S.: The promise of edge computing. Computer 49(5), 78–81 (2016)
Singer, M., et al.: The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA 315(8), 801–810 (2016)
Steele, A.J., Denaxas, S.C., Shah, A.D., Hemingway, H., Luscombe, N.M.: Machine learning models in electronic health records can outperform conventional survival models for predicting patient mortality in coronary artery disease. PloS One 13(8), e0202344 (2018)
Vincent, J.L., et al.: The sofa (sepsis-related organ failure assessment) score to describe organ dysfunction/failure. Intensive Care Med. 22(7), 707–710 (1996)
Wu, Q., Ding, G., Xu, Y., Feng, S., Du, Z., Wang, J., Long, K.: Cognitive internet of things: a new paradigm beyond connection. IEEE Internet of Things J. 1(2), 129–143 (2014)
Xiao, C., Choi, E., Sun, J.: Opportunities and challenges in developing deep learning models using electronic health records data: a systematic review. J. Am. Med. Inform. Assoc. 25(10), 1419–1428 (2018)
Yoon, J., Jordon, J., Van Der Schaar, M.: Gain: missing data imputation using generative adversarial nets. arXiv preprint arXiv:1806.02920 (2018)
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Alam, M.U., Rahmani, R. (2021). Cognitive Internet of Medical Things Architecture for Decision Support Tool to Detect Early Sepsis Using Deep Learning. In: Ye, X., et al. Biomedical Engineering Systems and Technologies. BIOSTEC 2020. Communications in Computer and Information Science, vol 1400. Springer, Cham. https://doi.org/10.1007/978-3-030-72379-8_18
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DOI: https://doi.org/10.1007/978-3-030-72379-8_18
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