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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.

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.

In this chapter, a mathematical model explaining generically the propagation of a pandemic is proposed, helping in this way to identify the fundamental parameters related to the outbreak in general. Three free parameters for the pandemic are identified, which can be finally reduced to only two independent parameters. The model is inspired in the concept of spontaneous symmetry breaking, used normally in quantum field theory, and it provides the possibility of analyzing the complex data of the pandemic in a compact way. Data from 12 different countries are considered and the results presented. The application of nonlinear quantum physics equations to model epidemiologic time series is an innovative and promising approach.

A significant number of people infected by COVID19 do not get sick immediately but become carriers of the disease. These patients might have a certain incubation period. However, the classical compartmental model, SEIR, was not originally designed for COVID19. We used the simple, commonly used SEIR model to retrospectively analyse the initial pandemic data from Singapore. Here, the SEIR model was combined with the actual published Singapore pandemic data, and the key parameters were determined by maximizing the nonlinear goodness of fit R2 and minimizing the root mean square error. These parameters served for the fast and directional convergence of the parameters of an improved model. To cover the quarantine and asymptomatic variables, the existing SEIR model was extended to an infectious disease model with a greater number of population compartments, and with parameter values that were tuned adaptively by solving the nonlinear dynamics equations over the available pandemic data, as well as referring to previous experience with SARS. The contribution presented in this paper is a new model called the adaptive SEAIRD model; it considers the new characteristics of COVID19 and is therefore applicable to a population including asymptomatic carriers. The predictive value is enhanced by tuning of the optimal parameters, whose values better reflect the current pandemic.

The COVID-19 pandemic spread generated an urgent need for computational systems to model its behavior and support governments and healthcare teams to make proper decisions. There are not many cases of global pandemics in history, and the most recent one has unique characteristics, which are tightly connected to the current society’s lifestyle and beliefs, creating an environment of uncertainty. Because of that, the development of mathematical/computational models to forecast the pandemic behavior since its beginning, i.e., with a restricted amount of data collected, is necessary. This chapter focuses on the analysis of different data mining techniques to allow the pandemic prediction with a small amount of data. A case study is presented considering the data from Wuhan, the Chinese city where the virus was first detected, and the place where the major outbreak occurred. The PNN + CF method (Polynomial Neural Network with Corrective Feedback) is presented as the technique with the best prediction performance. This is a promising method that might be considered in future eventual waves of the current pandemic or event to have a suitable model for future epidemic outbreaks around the world.

There are several techniques to support simulation of time series behavior. In this chapter, the approach will be based on the Composite Monte Carlo (CMC) simulation method. This method is able to model future outcomes of time series under analysis from the available data. The establishment of multiple correlations and causality between the data allows modeling the variables and probabilistic distributions and subsequently obtaining also probabilistic results for time series forecasting. To improve the predictor efficiency, computational intelligence techniques are proposed, including a fuzzy inference system and an Artificial Neural Network architecture. This type of model is suitable to be considered not only for the disease monitoring and compartmental classes, but also for managerial data such as clinical resources, medical and health team allocation, and bed management, which are data related to complex decision-making challenges.

The application of different tools for predicting COVID19 cases spreading has been widely considered during the pandemic. Comparing different approaches is essential to analyze performance and the practical support they can provide for the current pandemic management. This work proposes using the susceptible-exposed-asymptomatic but infectious-symptomatic and infectious-recovered-deceased (SEAIRD) model for different learning models. The first analysis considers an unsupervised prediction, based directly on the epidemiologic compartmental model. After that, two supervised learning models are considered integrating computational intelligence techniques and control engineering: the fuzzy-PID and the wavelet-ANN-PID models. The purpose is to compare different predictor strategies to validate a viable predictive control system for the COVID19 relevant epidemiologic time series. For each model, after setting the initial conditions for each parameter, the prediction performance is calculated based on the presented data. The use of PID controllers is justified to avoid divergence in the system when the learning process is conducted. The wavelet neural network solution is considered here because of its rapid convergence rate. The proposed solutions are dynamic and can be adjusted and corrected in real time, according to the output error. The results are presented in each subsection of the chapter.

At the beginning of 2020, the World Health Organization (WHO) started a coordinated global effort to counterattack the potential exponential spread of the SARS-Cov2 virus, responsible for the coronavirus disease, officially named COVID-19. This comprehensive initiative included a research roadmap published in March 2020, including nine dimensions, from epidemiological research to diagnostic tools and vaccine development. With an unprecedented case, the areas of study related to the pandemic received funds and strong attention from different research communities (universities, government, industry, etc.), resulting in an exponential increase in the number of publications and results achieved in such a small window of time. Outstanding research cooperation projects were implemented during the outbreak, and innovative technologies were developed and improved significantly. Clinical and laboratory processes were improved, while managerial personnel were supported by a countless number of models and computational tools for the decision-making process. This chapter aims to introduce an overview of this favorable scenario and highlight a necessary discussion about ethical issues in research related to the COVID-19 and the challenge of low-quality research, focusing only on the publication of techniques and approaches with limited scientific evidence or even practical application. A legacy of lessons learned from this unique period of human history should influence and guide the scientific and industrial communities for the future.