P-values and confidence intervals for weighted log-rank tests under truncated binomial design based on clustered medical data.

The randomization design employed to gather the data is the basis for the exact distributions of the permutation tests. One of the designs that is frequently used in clinical trials to force balance and remove experimental bias is the truncated binomial design. The exact distribution of the weighted log-rank class of tests for censored cluster medical data under the truncated binomial design is examined in this paper. For p-values in this class, a double saddlepoint approximation is developed using the truncated binomial design. With the right censored cluster data, the saddlepoint approximation's speed and accuracy over the normal asymptotic make it easier to invert the weighted log-rank tests and find nominal 95% confidence intervals for the treatment effect.

Redefining Health Care Data Interoperability: Empirical Exploration of Large Language Models in Information Exchange.

BACKGROUND: Efficient data exchange and health care interoperability are impeded by medical records often being in nonstandardized or unstructured natural language format. Advanced language models, such as large language models (LLMs), may help overcome current challenges in information exchange. OBJECTIVE: This study aims to evaluate the capability of LLMs in transforming and transferring health care data to support interoperability. METHODS: Using data from the Medical Information Mart for Intensive Care III and UK Biobank, the study conducted 3 experiments. Experiment 1 assessed the accuracy of transforming structured laboratory results into unstructured format. Experiment 2 explored the conversion of diagnostic codes between the coding frameworks of the ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification), and Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT) using a traditional mapping table and a text-based approach facilitated by the LLM ChatGPT. Experiment 3 focused on extracting targeted information from unstructured records that included comprehensive clinical information (discharge notes). RESULTS: The text-based approach showed a high conversion accuracy in transforming laboratory results (experiment 1) and an enhanced consistency in diagnostic code conversion, particularly for frequently used diagnostic names, compared with the traditional mapping approach (experiment 2). In experiment 3, the LLM showed a positive predictive value of 87.2% in extracting generic drug names. CONCLUSIONS: This study highlighted the potential role of LLMs in significantly improving health care data interoperability, demonstrated by their high accuracy and efficiency in data transformation and exchange. The LLMs hold vast potential for enhancing medical data exchange without complex standardization for medical terms and data structure.

[Development of competencies in the Medical Informatics Initiative (MII)-educational offers for a competent and secure handling of medical data]. / Kompetenzentwicklung in der Medizininformatik-Initiative (MII) ­ Lehrangebote für einen souveränen und sicheren Umgang mit medizinischen Daten.

In order to achieve the goals of the Medical Informatics Initiative (MII), staff with skills in the field of medical informatics and data science are required. Each consortium has established training activities. Further, cross-consortium activities have emerged. This article describes the concepts, implemented programs, and experiences in the consortia. Fifty-one new professorships have been established and 10 new study programs have been created: 1 bachelor's degree and 6 consecutive and 3 part-time master's degree programs. Further, learning and training opportunities can be used by all MII partners. Certification and recognition opportunities have been created.The educational offers are aimed at target groups with a background in computer science, medicine, nursing, bioinformatics, biology, natural science, and data science. Additional qualifications for physicians in computer science and computer scientists in medicine seem to be particularly important. They can lead to higher quality in software development and better support for treatment processes by application systems.Digital learning methods were important in all consortia. They offer flexibility for cross-location and interprofessional training. This enables learning at an individual pace and an exchange between professional groups.The success of the MII depends largely on society's acceptance of the multiple use of medical data in both healthcare and research. The information required for this is provided by the MII's public relations work. There is also an enormous need in society for medical and digital literacy.

[Research progress on electronic health records multimodal data fusion based on deep learning].

Currently, the development of deep learning-based multimodal learning is advancing rapidly, and is widely used in the field of artificial intelligence-generated content, such as image-text conversion and image-text generation. Electronic health records are digital information such as numbers, charts, and texts generated by medical staff using information systems in the process of medical activities. The multimodal fusion method of electronic health records based on deep learning can assist medical staff in the medical field to comprehensively analyze a large number of medical multimodal data generated in the process of diagnosis and treatment, thereby achieving accurate diagnosis and timely intervention for patients. In this article, we firstly introduce the methods and development trends of deep learning-based multimodal data fusion. Secondly, we summarize and compare the fusion of structured electronic medical records with other medical data such as images and texts, focusing on the clinical application types, sample sizes, and the fusion methods involved in the research. Through the analysis and summary of the literature, the deep learning methods for fusion of different medical modal data are as follows: first, selecting the appropriate pre-trained model according to the data modality for feature representation and post-fusion, and secondly, fusing based on the attention mechanism. Lastly, the difficulties encountered in multimodal medical data fusion and its developmental directions, including modeling methods, evaluation and application of models, are discussed. Through this review article, we expect to provide reference information for the establishment of models that can comprehensively utilize various modal medical data.

Sharing Data With Shared Benefits: Artificial Intelligence Perspective.

Artificial intelligence (AI) and data sharing go hand in hand. In order to develop powerful AI models for medical and health applications, data need to be collected and brought together over multiple centers. However, due to various reasons, including data privacy, not all data can be made publicly available or shared with other parties. Federated and swarm learning can help in these scenarios. However, in the private sector, such as between companies, the incentive is limited, as the resulting AI models would be available for all partners irrespective of their individual contribution, including the amount of data provided by each party. Here, we explore a potential solution to this challenge as a viewpoint, aiming to establish a fairer approach that encourages companies to engage in collaborative data analysis and AI modeling. Within the proposed approach, each individual participant could gain a model commensurate with their respective data contribution, ultimately leading to better diagnostic tools for all participants in a fair manner.

FAIRness through automation: development of an automated medical data integration infrastructure for FAIR health data in a maximum care university hospital.

BACKGROUND: Secondary use of routine medical data is key to large-scale clinical and health services research. In a maximum care hospital, the volume of data generated exceeds the limits of big data on a daily basis. This so-called "real world data" are essential to complement knowledge and results from clinical trials. Furthermore, big data may help in establishing precision medicine. However, manual data extraction and annotation workflows to transfer routine data into research data would be complex and inefficient. Generally, best practices for managing research data focus on data output rather than the entire data journey from primary sources to analysis. To eventually make routinely collected data usable and available for research, many hurdles have to be overcome. In this work, we present the implementation of an automated framework for timely processing of clinical care data including free texts and genetic data (non-structured data) and centralized storage as Findable, Accessible, Interoperable, Reusable (FAIR) research data in a maximum care university hospital. METHODS: We identify data processing workflows necessary to operate a medical research data service unit in a maximum care hospital. We decompose structurally equal tasks into elementary sub-processes and propose a framework for general data processing. We base our processes on open-source software-components and, where necessary, custom-built generic tools. RESULTS: We demonstrate the application of our proposed framework in practice by describing its use in our Medical Data Integration Center (MeDIC). Our microservices-based and fully open-source data processing automation framework incorporates a complete recording of data management and manipulation activities. The prototype implementation also includes a metadata schema for data provenance and a process validation concept. All requirements of a MeDIC are orchestrated within the proposed framework: Data input from many heterogeneous sources, pseudonymization and harmonization, integration in a data warehouse and finally possibilities for extraction or aggregation of data for research purposes according to data protection requirements. CONCLUSION: Though the framework is not a panacea for bringing routine-based research data into compliance with FAIR principles, it provides a much-needed possibility to process data in a fully automated, traceable, and reproducible manner.

Flexible cloglog links for binomial regression models as an alternative for imbalanced medical data.

The complementary log-log link was originally introduced in 1922 to R. A. Fisher, long before the logit and probit links. While the last two links are symmetric, the complementary log-log link is an asymmetrical link without a parameter associated with it. Several asymmetrical links with an extra parameter were proposed in the literature over last few years to deal with imbalanced data in binomial regression (when one of the classes is much smaller than the other); however, these do not necessarily have the cloglog link as a special case, with the exception of the link based on the generalized extreme value distribution. In this paper, we introduce flexible cloglog links for modeling binomial regression models that include an extra parameter associated with the link that explains some unbalancing for binomial outcomes. For all cases, the cloglog is a special case or the reciprocal version loglog link is obtained. A Bayesian Markov chain Monte Carlo inference approach is developed. Simulations study to evaluate the performance of the proposed algorithm is conducted and prior sensitivity analysis for the extra parameter shows that a uniform prior is the most convenient for all models. Additionally, two applications in medical data (age at menarche and pulmonary infection) illustrate the advantages of the proposed models.

Dibenzo[b,f]oxepine Molecules Used in Biological Systems and Medicine.

In this short review, including 113 references, issues related to dibenzo[b,f]oxepine derivatives are presented. Dibenzo[b,f]oxepine scaffold is an important framework in medicinal chemistry, and its derivatives occur in several medicinally relevant plants. At the same time, the structure, production, and therapeutic effects of dibenzo[b,f]oxepines have not been extensively discussed thus far and are presented in this review. This manuscript addresses the following issues: extracting dibenzo[b,f]oxepines from plants and its significance in medicine, the biosynthesis of dibenzo[b,f]oxepines, the active synthetic dibenzo[b,f]oxepine derivatives, the potential of dibenzo[b,f]oxepines as microtubule inhibitors, and perspective for applications of dibenzo[b,f]oxepine derivatives. In conclusion, this review describes studies on various structural features and pharmacological actions of dibenzo[b,f]oxepine derivatives.

Generative AI in Medical Imaging: Applications, Challenges, and Ethics.

Medical imaging is playing an important role in diagnosis and treatment of diseases. Generative artificial intelligence (AI) have shown great potential in enhancing medical imaging tasks such as data augmentation, image synthesis, image-to-image translation, and radiology report generation. This commentary aims to provide an overview of generative AI in medical imaging, discussing applications, challenges, and ethical considerations, while highlighting future research directions in this rapidly evolving field.

Identifying health related occupations of Twitter users through word embedding and deep neural networks.

BACKGROUND: Twitter is a popular social networking site where short messages or "tweets" of users have been used extensively for research purposes. However, not much research has been done in mining the medical professions, such as detecting the occupations of users from their biographical contents. Mining such professions can be used to build efficient recommender systems for cost-effective targeted advertisements. Moreover, it is highly important to develop effective methods to identify the occupation of users since conventional classification methods rely on features developed by human intelligence. Although, the result may be favorable for the classification problem. However, it is still extremely challenging for traditional classifiers to predict the medical occupations accurately since it involves predicting multiple occupations. Hence this study emphasizes predicting the medical occupational class of users through their public biographical ("Bio") content. We have conducted our analysis by annotating the bio content of Twitter users. In this paper, we propose a method of combining word embedding with state-of-art neural network models that include: Long Short Term Memory (LSTM), Bidirectional LSTM, Gated Recurrent Unit, Bidirectional Encoder Representations from Transformers, and A lite BERT. Moreover, we have also observed that by composing the word embedding with the neural network models there is no need to construct any particular attribute or feature. By using word embedding, the bio contents are formatted as dense vectors which are fed as input into the neural network models as a sequence of vectors. RESULT: Performance metrics that include accuracy, precision, recall, and F1-score have shown a significant difference between our method of combining word embedding with neural network models than with the traditional methods. The scores have proved that our proposed approach has outperformed the traditional machine learning techniques for detecting medical occupations among users. ALBERT has performed the best among the deep learning networks with an F1 score of 0.90. CONCLUSION: In this study, we have presented a novel method of detecting the occupations of Twitter users engaged in the medical domain by merging word embedding with state-of-art neural networks. The outcomes of our approach have demonstrated that our method can further advance the process of analyzing corpora of social media without going through the trouble of developing computationally expensive features.

A novel multiple kernel fuzzy topic modeling technique for biomedical data.

BACKGROUND: Text mining in the biomedical field has received much attention and regarded as the important research area since a lot of biomedical data is in text format. Topic modeling is one of the popular methods among text mining techniques used to discover hidden semantic structures, so called topics. However, discovering topics from biomedical data is a challenging task due to the sparsity, redundancy, and unstructured format. METHODS: In this paper, we proposed a novel multiple kernel fuzzy topic modeling (MKFTM) technique using fusion probabilistic inverse document frequency and multiple kernel fuzzy c-means clustering algorithm for biomedical text mining. In detail, the proposed fusion probabilistic inverse document frequency method is used to estimate the weights of global terms while MKFTM generates frequencies of local and global terms with bag-of-words. In addition, the principal component analysis is applied to eliminate higher-order negative effects for term weights. RESULTS: Extensive experiments are conducted on six biomedical datasets. MKFTM achieved the highest classification accuracy 99.04%, 99.62%, 99.69%, 99.61% in the Muchmore Springer dataset and 94.10%, 89.45%, 92.91%, 90.35% in the Ohsumed dataset. The CH index value of MKFTM is higher, which shows that its clustering performance is better than state-of-the-art topic models. CONCLUSION: We have confirmed from results that proposed MKFTM approach is very efficient to handles to sparsity and redundancy problem in biomedical text documents. MKFTM discovers semantically relevant topics with high accuracy for biomedical documents. Its gives better results for classification and clustering in biomedical documents. MKFTM is a new approach to topic modeling, which has the flexibility to work with a variety of clustering methods.

A distribution-free procedure for testing versatile alternative in medical multisample comparison studies.

We propose a test for multisample comparison studies that can be applied without strict assumptions, especially when the underlying population distributions are far from normal. The new test can detect differences not only in location or scale but also in shape parameters among parent population distributions. We are motivated by numerous medical studies, where the variables are not normally distributed and may present in the various groups more complex differences than simple differences in a particular aspect of underlying distributions, such as location or scale. In these situations, traditional ANOVA and Kruskal-Wallis tests are unreliable since the underlying assumptions are not valid. The proposed procedure also allows the researcher to determine which aspects are more responsible for a significant result. This is an important practical advantage over procedures that test for general differences among the distribution functions but cannot identify which aspects lead to significant results. The asymptotic distribution of the test statistic is analyzed along with its small sample behavior against several competing tests. The practical advantages of the proposed procedure are illustrated with a multisample comparison study of a biomarker for liver damage in patients with hepatitis C.

Energy Efficiency of Inference Algorithms for Clinical Laboratory Data Sets: Green Artificial Intelligence Study.

BACKGROUND: The use of artificial intelligence (AI) in the medical domain has attracted considerable research interest. Inference applications in the medical domain require energy-efficient AI models. In contrast to other types of data in visual AI, data from medical laboratories usually comprise features with strong signals. Numerous energy optimization techniques have been developed to relieve the burden on the hardware required to deploy a complex learning model. However, the energy efficiency levels of different AI models used for medical applications have not been studied. OBJECTIVE: The aim of this study was to explore and compare the energy efficiency levels of commonly used machine learning algorithms-logistic regression (LR), k-nearest neighbor, support vector machine, random forest (RF), and extreme gradient boosting (XGB) algorithms, as well as four different variants of neural network (NN) algorithms-when applied to clinical laboratory datasets. METHODS: We applied the aforementioned algorithms to two distinct clinical laboratory data sets: a mass spectrometry data set regarding Staphylococcus aureus for predicting methicillin resistance (3338 cases; 268 features) and a urinalysis data set for predicting Trichomonas vaginalis infection (839,164 cases; 9 features). We compared the performance of the nine inference algorithms in terms of accuracy, area under the receiver operating characteristic curve (AUROC), time consumption, and power consumption. The time and power consumption levels were determined using performance counter data from Intel Power Gadget 3.5. RESULTS: The experimental results indicated that the RF and XGB algorithms achieved the two highest AUROC values for both data sets (84.7% and 83.9%, respectively, for the mass spectrometry data set; 91.1% and 91.4%, respectively, for the urinalysis data set). The XGB and LR algorithms exhibited the shortest inference time for both data sets (0.47 milliseconds for both in the mass spectrometry data set; 0.39 and 0.47 milliseconds, respectively, for the urinalysis data set). Compared with the RF algorithm, the XGB and LR algorithms exhibited a 45% and 53%-60% reduction in inference time for the mass spectrometry and urinalysis data sets, respectively. In terms of energy efficiency, the XGB algorithm exhibited the lowest power consumption for the mass spectrometry data set (9.42 Watts) and the LR algorithm exhibited the lowest power consumption for the urinalysis data set (9.98 Watts). Compared with a five-hidden-layer NN, the XGB and LR algorithms achieved 16%-24% and 9%-13% lower power consumption levels for the mass spectrometry and urinalysis data sets, respectively. In all experiments, the XGB algorithm exhibited the best performance in terms of accuracy, run time, and energy efficiency. CONCLUSIONS: The XGB algorithm achieved balanced performance levels in terms of AUROC, run time, and energy efficiency for the two clinical laboratory data sets. Considering the energy constraints in real-world scenarios, the XGB algorithm is ideal for medical AI applications.

Privacy Preservation in Patient Information Exchange Systems Based on Blockchain: System Design Study.

BACKGROUND: With the increasing sophistication of the medical industry, various advanced medical services such as medical artificial intelligence, telemedicine, and personalized health care services have emerged. The demand for medical data is also rapidly increasing today because advanced medical services use medical data such as user data and electronic medical records (EMRs) to provide services. As a result, health care institutions and medical practitioners are researching various mechanisms and tools to feed medical data into their systems seamlessly. However, medical data contain sensitive personal information of patients. Therefore, ensuring security while meeting the demand for medical data is a very important problem in the information age for which a solution is required. OBJECTIVE: Our goal is to design a blockchain-based decentralized patient information exchange (PIE) system that can safely and efficiently share EMRs. The proposed system preserves patients' privacy in the EMRs through a medical information exchange process that includes data encryption and access control. METHODS: We propose a blockchain-based EMR-sharing system that allows patients to manage their EMRs scattered across multiple hospitals and share them with other users. Our PIE system protects the patient's EMR from security threats such as counterfeiting and privacy attacks during data sharing. In addition, it provides scalability by using distributed data-sharing methods to quickly share an EMR, regardless of its size or type. We implemented simulation models using Hyperledger Fabric, an open source blockchain framework. RESULTS: We performed a simulation of the EMR-sharing process and compared it with previous works on blockchain-based medical systems to check the proposed system's performance. During the simulation, we found that it takes an average of 0.01014 (SD 0.0028) seconds to download 1 MB of EMR in our proposed PIE system. Moreover, it has been confirmed that data can be freely shared with other users regardless of the size or format of the data to be transmitted through the distributed data-sharing technique using the InterPlanetary File System. We conducted a security analysis to check whether the proposed security mechanism can effectively protect users of the EMR-sharing system from security threats such as data forgery or unauthorized access, and we found that the distributed ledger structure and re-encryption-based data encryption method can effectively protect users' EMRs from forgery and privacy leak threats and provide data integrity. CONCLUSIONS: Blockchain is a distributed ledger technology that provides data integrity to enable patient-centered health information exchange and access control. PIE systems integrate and manage fragmented patient EMRs through blockchain and protect users from security threats during the data exchange process among users. To increase safety and efficiency in the EMR-sharing process, we used access control using security levels, data encryption based on re-encryption, and a distributed data-sharing scheme.

A FHIR has been lit on gICS: facilitating the standardised exchange of informed consent in a large network of university medicine.

BACKGROUND: The Federal Ministry of Education and Research of Germany (BMBF) funds a network of university medicines (NUM) to support COVID-19 and pandemic research at national level. The "COVID-19 Data Exchange Platform" (CODEX) as part of NUM establishes a harmonised infrastructure that supports research use of COVID-19 datasets. The broad consent (BC) of the Medical Informatics Initiative (MII) is agreed by all German federal states and forms the legal base for data processing. All 34 participating university hospitals (NUM sites) work upon a harmonised infrastructural as well as legal basis for their data protection-compliant collection and transfer of their research dataset to the central CODEX platform. Each NUM site ensures that the exchanged consent information conforms to the already-balloted HL7 FHIR consent profiles and the interoperability concept of the MII Task Force "Consent Implementation" (TFCI). The Independent Trusted Third-Party (TTP) of the University Medicine Greifswald supports data protection-compliant data processing and provides the consent management solutions gICS. METHODS: Based on a stakeholder dialogue a required set of FHIR-functionalities was identified and technically specified supported by official FHIR experts. Next, a "TTP-FHIR Gateway" for the HL7 FHIR-compliant exchange of consent information using gICS was implemented. A last step included external integration tests and the development of a pre-configured consent template for the BC for the NUM sites. RESULTS: A FHIR-compliant gICS-release and a corresponding consent template for the BC were provided to all NUM sites in June 2021. All FHIR functionalities comply with the already-balloted FHIR consent profiles of the HL7 Working Group Consent Management. The consent template simplifies the technical BC rollout and the corresponding implementation of the TFCI interoperability concept at the NUM sites. CONCLUSIONS: This article shows that a HL7 FHIR-compliant and interoperable nationwide exchange of consent information could be built using of the consent management software gICS and the provided TTP-FHIR Gateway. The initial functional scope of the solution covers the requirements identified in the NUM-CODEX setting. The semantic correctness of these functionalities was validated by project-partners from the Ludwig-Maximilian University in Munich. The production rollout of the solution package to all NUM sites has started successfully.

A hybrid sampling algorithm combining synthetic minority over-sampling technique and edited nearest neighbor for missed abortion diagnosis.

BACKGROUND: Clinical diagnosis based on machine learning usually uses case samples as training samples, and uses machine learning to construct disease prediction models characterized by descriptive texts of clinical manifestations. However, the problem of sample imbalance often exists in the medical field, which leads to a decrease in classification performance of the machine learning. METHODS: To solve the problem of sample imbalance in medical dataset, we propose a hybrid sampling algorithm combining synthetic minority over-sampling technique (SMOTE) and edited nearest neighbor (ENN). Firstly, the SMOTE is used to over-sampling missed abortion and diabetes datasets, so that the number of samples of the two classes is balanced. Then, ENN is used to under-sampling the over-sampled dataset to delete the "noisy sample" in the majority. Finally, Random forest is used to model and predict the sampled missed abortion and diabetes datasets to achieve an accurate clinical diagnosis. RESULTS: Experimental results show that Random forest has the best classification performance on missed abortion and diabetes datasets after SMOTE-ENN sampled, and the MCC index is 95.6% and 90.0%, respectively. In addition, the results of pairwise comparison and multiple comparisons show that the SMOTE-ENN is significantly better than other sampling algorithms. CONCLUSION: Random forest has significantly improved all indexes on the missed abortion dataset after SMOTE-ENN sampled.

Unsupervised Clustering of Heartbeat Dynamics Allows for Real Time and Personalized Improvement in Cardiovascular Fitness.

VO2max index has a significant impact on overall health. Its estimation through wearables notifies the user of his level of fitness but cannot provide a detailed analysis of the time intervals in which heartbeat dynamics are changed and/or fatigue is emerging. Here, we developed a multiple modality biosignal processing method to investigate running sessions to characterize in real time heartbeat dynamics in response to external energy demand. We isolated dynamic regimes whose fraction increases with the VO2max and with the emergence of neuromuscular fatigue. This analysis can be extremely valuable by providing personalized feedback about the user's fitness level improvement that can be realized by developing personalized exercise plans aimed to target a contextual increase in the dynamic regime fraction related to VO2max increase, at the expense of the dynamic regime fraction related to the emergence of fatigue. These strategies can ultimately result in the reduction in cardiovascular risk.

Current state of dental informatics in the field of health information systems: a scoping review.

BACKGROUND: Over the past 50 years, dental informatics has developed significantly in the field of health information systems. Accordingly, several studies have been conducted on standardized clinical coding systems, data capture, and clinical data reuse in dentistry. METHODS: Based on the definition of health information systems, the literature search was divided into three specific sub-searches: "standardized clinical coding systems," "data capture," and "reuse of routine patient care data." PubMed and Web of Science were searched for peer-reviewed articles. The review was conducted following the PRISMA-ScR protocol. RESULTS: A total of 44 articles were identified for inclusion in the review. Of these, 15 were related to "standardized clinical coding systems," 15 to "data capture," and 14 to "reuse of routine patient care data." Articles related to standardized clinical coding systems focused on the design and/or development of proposed systems, on their evaluation and validation, on their adoption in academic settings, and on user perception. Articles related to data capture addressed the issue of data completeness, evaluated user interfaces and workflow integration, and proposed technical solutions. Finally, articles related to reuse of routine patient care data focused on clinical decision support systems centered on patient care, institutional or population-based health monitoring support systems, and clinical research. CONCLUSIONS: While the development of health information systems, and especially standardized clinical coding systems, has led to significant progress in research and quality measures, most reviewed articles were published in the US. Clinical decision support systems that reuse EDR data have been little studied. Likewise, few studies have examined the working environment of dental practitioners or the pedagogical value of using health information systems in dentistry.

A holistic overview of deep learning approach in medical imaging.

Medical images are a rich source of invaluable necessary information used by clinicians. Recent technologies have introduced many advancements for exploiting the most of this information and use it to generate better analysis. Deep learning (DL) techniques have been empowered in medical images analysis using computer-assisted imaging contexts and presenting a lot of solutions and improvements while analyzing these images by radiologists and other specialists. In this paper, we present a survey of DL techniques used for variety of tasks along with the different medical image's modalities to provide critical review of the recent developments in this direction. We have organized our paper to provide significant contribution of deep leaning traits and learn its concepts, which is in turn helpful for non-expert in medical society. Then, we present several applications of deep learning (e.g., segmentation, classification, detection, etc.) which are commonly used for clinical purposes for different anatomical site, and we also present the main key terms for DL attributes like basic architecture, data augmentation, transfer learning, and feature selection methods. Medical images as inputs to deep learning architectures will be the mainstream in the coming years, and novel DL techniques are predicted to be the core of medical images analysis. We conclude our paper by addressing some research challenges and the suggested solutions for them found in literature, and also future promises and directions for further developments.

Multi-Class Classification of Medical Data Based on Neural Network Pruning and Information-Entropy Measures.

Medical data includes clinical trials and clinical data such as patient-generated health data, laboratory results, medical imaging, and different signals coming from continuous health monitoring. Some commonly used data analysis techniques are text mining, big data analytics, and data mining. These techniques can be used for classification, clustering, and machine learning tasks. Machine learning could be described as an automatic learning process derived from concepts and knowledge without deliberate system coding. However, finding a suitable machine learning architecture for a specific task is still an open problem. In this work, we propose a machine learning model for the multi-class classification of medical data. This model is comprised of two components-a restricted Boltzmann machine and a classifier system. It uses a discriminant pruning method to select the most salient neurons in the hidden layer of the neural network, which implicitly leads to a selection of features for the input patterns that feed the classifier system. This study aims to investigate whether information-entropy measures may provide evidence for guiding discriminative pruning in a neural network for medical data processing, particularly cancer research, by using three cancer databases: Breast Cancer, Cervical Cancer, and Primary Tumour. Our proposal aimed to investigate the post-training neuronal pruning methodology using dissimilarity measures inspired by the information-entropy theory; the results obtained after pruning the neural network were favourable. Specifically, for the Breast Cancer dataset, the reported results indicate a 10.68% error rate, while our error rates range from 10% to 15%; for the Cervical Cancer dataset, the reported best error rate is 31%, while our proposal error rates are in the range of 4% to 6%; lastly, for the Primary Tumour dataset, the reported error rate is 20.35%, and our best error rate is 31%.