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The adoption of computer-aided diagnosis and treatment systems based on different types of artificial neural networks (ANNs) is already a reality in several hospital and ambulatory premises. This chapter aims to present a discussion focused on the challenges and trends of adopting these computerized systems, highlighting solutions based on different types and approaches of ANN, more specifically, feed-forward, recurrent, and deep convolutional architectures. One section is focused on the application of AI/ANN solutions to support cardiology in different applications, such as the classification of the heart structure and functional behavior based on echocardiography images; the automatic analysis of the heart electric activity based on ECG signals; and the diagnosis support of angiogram images during surgical interventions. Finally, a case study is presented based on the application of a deep learning convolutional network together with a recent technique called transfer learning to detect brain tumors using an MRI images data set. According to the findings, the model has a high degree of specificity (precision of 0.93 and recall of 0.94 for images with no brain tumor) and can be used as a screening tool for images that do not contain a brain tumor. The f1-score for images with brain tumor was 0.93. The results achieved are very promising and the proposed solution may be considered to be used as a computer-aided diagnosis tool based on deep learning convolutional neural networks. Future works will consider other techniques and compare them with the one presented here. With the comprehensive approach and overview of multiple applications, it is valid to conclude that computer-aided diagnosis and treatment systems are important tools to be considered today and will be an essential part of the trend of personalized medicine over the coming years.
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The area of clinical decision support systems (CDSS) is facing a boost in research and development with the increasing amount of data in clinical analysis together with new tools to support patient care. This creates a vibrant and challenging environment for the medical and technical staff. This chapter presents a discussion about the challenges and trends of CDSS considering big data and patient-centered constraints. Two case studies are presented in detail. The first presents the development of a big data and AI classification system for maternal and fetal ambulatory monitoring, composed by different solutions such as the implementation of an Internet of Things sensors and devices network, a fuzzy inference system for emergency alarms, a feature extraction model based on signal processing of the fetal and maternal data, and finally a deep learning classifier with six convolutional layers achieving an F1-score of 0.89 for the case of both maternal and fetal as harmful. The system was designed to support maternal–fetal ambulatory premises in developing countries, where the demand is extremely high and the number of medical specialists is very low. The second case study considered two artificial intelligence approaches to providing efficient prediction of infections for clinical decision support during the COVID-19 pandemic in Brazil. First, LSTM recurrent neural networks were considered with the model achieving R2=0.93 and MAE=40,604.4 in average, while the best, R2=0.9939, was achieved for the time series 3. Second, an open-source framework called H2O AutoML was considered with the “stacked ensemble” approach and presented the best performance followed by XGBoost. Brazil has been one of the most challenging environments during the pandemic and where efficient predictions may be the difference in saving lives. The presentation of such different approaches (ambulatory monitoring and epidemiology data) is important to illustrate the large spectrum of AI tools to support clinical decision-making.
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