Soumya Jana

Dhruv Srikanth, Jayang Gurung, N Satya Deepika et al.

Blindness and other eye diseases are a global health concern, particularly in low- and middle-income countries like India. In this regard, during the COVID-19 pandemic, teleophthalmology became a lifeline, and the Grabi attachment for smartphone-based eye imaging gained in use. However, quality of user-captured image often remained inadequate, requiring clinician vetting and delays. In this backdrop, we propose an AI-based quality assessment system with instant feedback mimicking clinicians' judgments and tested on patient-captured images. Dividing the complex problem hierarchically, here we tackle a nontrivial part, and demonstrate a proof of the concept.

Shanmukh Reddy Manne, Kiran Kumar Vupparaboina, Gowtham Chowdary Gudapati et al.

A variety of vision ailments are associated with geographic atrophy (GA) in the foveal region of the eye. In current clinical practice, the ophthalmologist manually detects potential presence of such GA based on fundus autofluorescence (FAF) images, and hence diagnoses the disease, when relevant. However, in view of the general scarcity of ophthalmologists relative to the large number of subjects seeking eyecare, especially in remote regions, it becomes imperative to develop methods to direct expert time and effort to medically significant cases. Further, subjects from either disadvantaged background or remote localities, who face considerable economic/physical barrier in consulting trained ophthalmologists, tend to seek medical attention only after being reasonably certain that an adverse condition exists. To serve the interest of both the ophthalmologist and the potential patient, we plan a screening step, where healthy and diseased eyes are algorithmically differentiated with limited input from only optometrists who are relatively more abundant in number. Specifically, an early treatment diabetic retinopathy study (ETDRS) grid is placed by an optometrist on each FAF image, based on which sectoral statistics are automatically collected. Using such statistics as features, healthy and diseased eyes are proposed to be classified by training an algorithm using available medical records. In this connection, we demonstrate the efficacy of support vector machines (SVM). Specifically, we consider SVM with linear as well as radial basis function (RBF) kernel, and observe satisfactory performance of both variants. Among those, we recommend the latter in view of its slight superiority in terms of classification accuracy (90.55% at a standard training-to-test ratio of 80:20), and practical class-conditional costs.

B S Chandra, C S Sastry, S Jana

Objective: Heartbeat detection remains central to cardiac disease diagnosis and management, and is traditionally performed based on electrocardiogram (ECG). To improve robustness and accuracy of detection, especially, in certain critical-care scenarios, the use of additional physiological signals such as arterial blood pressure (BP) has recently been suggested. There, estimation of heartbeat location requires information fusion from multiple signals. However, reported efforts in this direction often obtain multimodal estimates somewhat indirectly, by voting among separately obtained signal-specific intermediate estimates. In contrast, we propose to directly fuse information from multiple signals without requiring intermediate estimates, and thence estimate heartbeat location in a robust manner. Method: We propose as a heartbeat detector, a convolutional neural network (CNN) that learns fused features from multiple physiological signals. This method eliminates the need for hand-picked signal-specific features and ad hoc fusion schemes. Further, being data-driven, the same algorithm learns suitable features from arbitrary set of signals. Results: Using ECG and BP signals of PhysioNet 2014 Challenge database, we obtained a score of 94%. Further, using two ECG channels of MIT-BIH arrhythmia database, we scored 99.92\%. Both those scores compare favourably with previously reported database-specific results. Also, our detector achieved high accuracy in a variety of clinical conditions. Conclusion: The proposed CNN-based information fusion (CIF) algorithm is generalizable, robust and efficient in detecting heartbeat location from multiple signals. Significance: In medical signal monitoring systems, our technique would accurately estimate heartbeat locations even when only a subset of channels are reliable.

Bollepalli S. Chandra, Challa S. Sastry, Laxminarayana Anumandla et al.

While cardiovascular diseases (CVDs) are prevalent across economic strata, the economically disadvantaged population is disproportionately affected due to the high cost of traditional CVD management. Accordingly, developing an ultra-low-cost alternative, affordable even to groups at the bottom of the economic pyramid, has emerged as a societal imperative. Against this backdrop, we propose an inexpensive yet accurate home-based electrocardiogram(ECG) monitoring service. Specifically, we seek to provide point-of-care monitoring of premature ventricular contractions (PVCs), high frequency of which could indicate the onset of potentially fatal arrhythmia. Note that a traditional telecardiology system acquires the ECG, transmits it to a professional diagnostic centre without processing, and nearly achieves the diagnostic accuracy of a bedside setup, albeit at high bandwidth cost. In this context, we aim at reducing cost without significantly sacrificing reliability. To this end, we develop a dictionary-based algorithm that detects with high sensitivity the anomalous beats only which are then transmitted. We further compress those transmitted beats using class-specific dictionaries subject to suitable reconstruction/diagnostic fidelity. Such a scheme would not only reduce the overall bandwidth requirement, but also localising anomalous beats, thereby reducing physicians' burden. Finally, using Monte Carlo cross validation on MIT/BIH arrhythmia database, we evaluate the performance of the proposed system. In particular, with a sensitivity target of at most one undetected PVC in one hundred beats, and a percentage root mean squared difference less than 9% (a clinically acceptable level of fidelity), we achieved about 99.15% reduction in bandwidth cost, equivalent to 118-fold savings over traditional telecardiology.