Intelligent Health Vessel ABC-DE: An Electrocardiogram Cloud Computing Service

The severe challenges of the fast aging population and the prevalence of cardiovascular diseases highlight the needs for effective solutions supporting more accurate and affordable medical diagnosis and treatment. Recent advances in cloud computing have inspired numerous designs of cloud-based health care services. In this paper, we developed a cloud-computing platform monitored by physicians, which can receive 12-lead ECG records and send back diagnostic reports to users. Aiming to lessen the physicians’ workload, we implemented an analysis algorithm that can identify abnormal heart rate, irregular heartbeat, abnormal amplitude, atrial fibrillation and abnormal ECG in it. A large number of testing samples were used to evaluate performance. Our algorithm achieved a TPR95 (specificity under the condition of negative predictive value being equal to 95 percent) of 68.5 percent and 0.9317 AUC (area under the ROC curve) for classification of normal and abnormal ECG records and a sensitivity of 98.51 percent and specificity of 98.26 percent for atrial fibrillation classification, comparable to the state-of-the-art results for each subject. The proposed ECG cloud computing service has been applied in Hunan Jinshengda Aerial Hospital Network and it now can receive and analyze ECG records in real time.

[1]  Xia Liu,et al.  Ccdd: an Enhanced Standard ECG Database with its Management and Annotation Tools , 2012, Int. J. Artif. Intell. Tools.

[2]  Jun Dong,et al.  An R-peak detection method based on peaks of Shannon energy envelope , 2013, Biomed. Signal Process. Control..

[3]  Shantanu Sarkar,et al.  A Detector for a Chronic Implantable Atrial Tachyarrhythmia Monitor , 2008, IEEE Transactions on Biomedical Engineering.

[4]  Chao Huang,et al.  A Novel Method for Detection of the Transition Between Atrial Fibrillation and Sinus Rhythm , 2011, IEEE Transactions on Biomedical Engineering.

[5]  Jun Dong,et al.  Premature ventricular contraction detection combining deep neural networks and rules inference , 2017, Artif. Intell. Medicine.

[6]  Jun Dong,et al.  Classification of normal and abnormal ECG records using lead convolutional neural network and rule inference , 2016, Science China Information Sciences.

[7]  B. V. K. Vijaya Kumar,et al.  Heartbeat Classification Using Morphological and Dynamic Features of ECG Signals , 2012, IEEE Transactions on Biomedical Engineering.

[8]  A. Shah,et al.  Errors in the computerized electrocardiogram interpretation of cardiac rhythm. , 2007, Journal of electrocardiology.

[9]  G. Moody,et al.  The European ST-T database: standard for evaluating systems for the analysis of ST-T changes in ambulatory electrocardiography. , 1992, European heart journal.

[10]  Naixue Xiong,et al.  Comparative analysis of quality of service and memory usage for adaptive failure detectors in healthcare systems , 2009, IEEE Journal on Selected Areas in Communications.

[11]  P M Rautaharju,et al.  NHLBI workshop on the utilization of ECG databases: preservation and use of existing ECG databases and development of future resources. , 1998, Journal of electrocardiology.

[12]  Jun Dong,et al.  Ensemble Deep Learning for Biomedical Time Series Classification , 2016, Comput. Intell. Neurosci..

[13]  Ki H. Chon,et al.  Time-Varying Coherence Function for Atrial Fibrillation Detection , 2013, IEEE Transactions on Biomedical Engineering.

[14]  Wan-Young Chung,et al.  Mobile Cloud-Computing-Based Healthcare Service by Noncontact ECG Monitoring , 2013, Sensors.

[15]  Juan Pablo Martínez,et al.  Heartbeat Classification Using Feature Selection Driven by Database Generalization Criteria , 2011, IEEE Transactions on Biomedical Engineering.

[16]  Behnaz Ghoraani,et al.  Rate-independent detection of atrial fibrillation by statistical modeling of atrial activity , 2015, Biomed. Signal Process. Control..

[17]  Philip de Chazal,et al.  Automatic classification of heartbeats using ECG morphology and heartbeat interval features , 2004, IEEE Transactions on Biomedical Engineering.

[18]  Vaidotas Marozas,et al.  Low-complexity detection of atrial fibrillation in continuous long-term monitoring , 2015, Comput. Biol. Medicine.

[19]  Dong Yu,et al.  Context-Dependent Pre-Trained Deep Neural Networks for Large-Vocabulary Speech Recognition , 2012, IEEE Transactions on Audio, Speech, and Language Processing.

[20]  F. A. Afsar,et al.  Robust Electrocardiogram Beat Classification using Discrete Wavelet Transform , 2008, 2008 2nd International Conference on Bioinformatics and Biomedical Engineering.

[21]  J H van Bemmel,et al.  A reference data base for multilead electrocardiographic computer measurement programs. , 1987, Journal of the American College of Cardiology.

[22]  A. Taddei,et al.  Long-term ST database: A reference for the development and evaluation of automated ischaemia detectors and for the study of the dynamics of myocardial ischaemia , 2003, Medical and Biological Engineering and Computing.

[23]  Charles Maynard,et al.  Computer-based rhythm diagnosis and its possible influence on nonexpert electrocardiogram readers. , 2012, Journal of electrocardiology.

[24]  Emma Pickwell-MacPherson,et al.  Automatic online detection of atrial fibrillation based on symbolic dynamics and Shannon entropy , 2014, BioMedical Engineering OnLine.

[25]  Chung-Chih Lin,et al.  Wireless Sensor-Based Smart-Clothing Platform for ECG Monitoring , 2015, Comput. Math. Methods Medicine.

[26]  Pablo Laguna,et al.  A database for evaluation of algorithms for measurement of QT and other waveform intervals in the ECG , 1997, Computers in Cardiology 1997.

[27]  John Salvatier,et al.  Theano: A Python framework for fast computation of mathematical expressions , 2016, ArXiv.

[28]  Wen Wang,et al.  Summary of report on cardiovascular diseases in China, 2012. , 2014, Biomedical and environmental sciences : BES.

[29]  National Cardiovascular Disease Database , 2022 .

[30]  Xiaopeng Zhao,et al.  Cloud-ECG for real time ECG monitoring and analysis , 2013, Comput. Methods Programs Biomed..

[31]  Upkar Varshney,et al.  Pervasive Healthcare , 2003, Computer.

[32]  Miss Amrita Singh Real Time ECG Parameter Identification and Monitoring , 2016 .

[33]  Athanasios V. Vasilakos,et al.  Cloud-assisted body area networks: state-of-the-art and future challenges , 2014, Wirel. Networks.

[34]  Chandan Chakraborty,et al.  A two-stage mechanism for registration and classification of ECG using Gaussian mixture model , 2009, Pattern Recognit..

[35]  Markus Jakobsson,et al.  Controlling data in the cloud: outsourcing computation without outsourcing control , 2009, CCSW '09.

[36]  Xiaolei Dong,et al.  4S: A secure and privacy-preserving key management scheme for cloud-assisted wireless body area network in m-healthcare social networks , 2015, Inf. Sci..

[37]  W. Richard Stevens,et al.  TCP/IP Illustrated, Volume 1: The Protocols , 1994 .

[38]  F. Minhas,et al.  Robust electrocardiogram (ECG) beat classification using discrete wavelet transform , 2008, Physiological measurement.

[39]  Rohita H. Jagdale,et al.  Remote Experts Help in Case of Emergency: A Cloud Computing Solution for Heart Disease Patients , 2013 .

[40]  Athanasios V. Vasilakos,et al.  Flexible Data Access Control Based on Trust and Reputation in Cloud Computing , 2017, IEEE Transactions on Cloud Computing.

[41]  Zhanpeng Jin,et al.  Enabling Smart Personalized Healthcare: A Hybrid Mobile-Cloud Approach for ECG Telemonitoring , 2014, IEEE Journal of Biomedical and Health Informatics.

[42]  Rajkumar Buyya,et al.  An autonomic cloud environment for hosting ECG data analysis services , 2012, Future Gener. Comput. Syst..

[43]  Geoffrey E. Hinton,et al.  ImageNet classification with deep convolutional neural networks , 2012, Commun. ACM.

[44]  Yoshua Bengio,et al.  Gradient-based learning applied to document recognition , 1998, Proc. IEEE.

[45]  Pallavi Dhade,et al.  ECG - Remote Patient Monitoring Using Cloud Computing , 2016 .

[46]  Xingming Sun,et al.  Enabling Semantic Search Based on Conceptual Graphs over Encrypted Outsourced Data , 2019, IEEE Transactions on Services Computing.

[47]  Jun Dong,et al.  Deep learning research on clinical electrocardiogram analysis , 2015 .

[48]  Meng-Wei Hsu,et al.  A cloud computing based 12-lead ECG telemedicine service , 2012, BMC Medical Informatics and Decision Making.

[49]  Athanasios V. Vasilakos,et al.  SeDaSC: Secure Data Sharing in Clouds , 2017, IEEE Systems Journal.

[50]  J. R. Moorman,et al.  Accurate estimation of entropy in very short physiological time series: the problem of atrial fibrillation detection in implanted ventricular devices. , 2011, American journal of physiology. Heart and circulatory physiology.

[51]  Ian S. Graham The HTML SourceBook , 1995 .

[52]  Sheng Lu,et al.  Automatic Real Time Detection of Atrial Fibrillation , 2009, Annals of Biomedical Engineering.

[53]  Ki H. Chon,et al.  A 290 mV Sub- $V_{\rm T}$ ASIC for Real-Time Atrial Fibrillation Detection , 2015, IEEE Transactions on Biomedical Circuits and Systems.

[54]  Athanasios V. Vasilakos,et al.  Neural networks for computer-aided diagnosis in medicine: A review , 2016, Neurocomputing.

[55]  Alireza Mehrnia,et al.  Automatic detection of atrial fibrillation using stationary wavelet transform and support vector machine , 2015, Comput. Biol. Medicine.

[56]  Jie Lian,et al.  A simple method to detect atrial fibrillation using RR intervals. , 2011, The American journal of cardiology.