Computers in Bio-Medical Instrumentation Introduction The ability of electronic computers to store very large quantities of data & to-have it readily accessible for further processing makes them extremely useful ina hospital set-up, Inadministration and management, their hospital set-up, Inadministration and management, their usefulness lies in that all patient data of interest can be quickly recorded and retrieved ita simple way. The heart ofa microcomputer is its microprocessing unit (MPU). The MPU of amicro computer isimplemented with a VLSI device known as Microprocessor, or just a processor for short, A Microprocessor — alsa known as a CPU or Central Processing Unit isa complete computation device that is fabricated on a single chip. ‘The best known application of computers in medical diagnosisis their use inanalyzing and evaluating ¢lectrocardiograms. The recorded elec trocardiogram which is analog in chatacter is digitized by taking several hundred samples per second. The analogue data are thus converted into digital form and displayed mostly by jJluminating type display system, Processing onthe ECG includes digital filteting, averaging of complexes and fully automated measurement of P,. QRS, T wave amplitudes and durations, ‘The alternative approach uses a statistical model with mutually exclusive diagnosis being listed in order of descending probability. ‘Thetechnology has gone into a Jot ofadvancements with the medical instrumentation field. Itis difficult for an active medical personnel ta know the spectrum of instruments available for variqus diagnosis and therapy. ARer the introduction of computers and microprocessors the medical instrumentation is improved furtherin all respects. Electronic computers store very large quantities of data that is extremely useful ina hospital set-up. Data processing system in hospital works in two ways diagnosis and therapy, The physician task is reduced, An additional advantage is that storage of clinical patient data for future study and. analysis. The computerised ECG can be obtained in an exact manner,Advancements in medical instrumentation helps the human society to improve their living standards right from the early human civilisation, On the otherhand the computer never gets tired, 9.2 Computers in Medicine Computers are tised in the medical equipment from 1970 onwards, Used in for signal processing, storage, data reduction and data presentation, Itas a device which can accept and supply information and is derived from the information accepted by logical processes. ‘Two types of computers I, Analogue - Quantites are represented and processed without the use ofa language. 2. Digital ~ Operates with information in the form of digits and are language is called adigital computer. Elements of a Computer Nconsists of a) Arithmeticunit = - b) Memoryunit — - ©} Tnputunit . 2) Output unit - ¢) Control unit - f) Programme - 2) Data processing - h) Datareduction — - i) Datahandling =~ Performs mathematical operation and decision making funetion, Store data and instructions, Accepts the data [rom outside. Delivers the result from the computer to outside, Used to control the operations of various blocks in the computer, A sel of instriictions in the proper sequence for the collection of a set of data or solution ofa mathematical problem is called programme, Operation performed on data is called data processing. Reducing the quantity of data, No. of bits may be stored at one time and may be fed tothe input, ftmay bein digital or binary and analogue ‘or position signals,i) Buses - Group of wires carrying datas k) Central processing Unit - Most complex chip consists of ALU, control unit. A) Memory - Consisisof millions ofmemory location, Each memory location has 8-bit register. tm) Address bus - Carries words from the CPU to the other units and Control bus carries digital data fram CPU to control the timing of their operations. n) Input unit - Consists of keyboard of alpha numerics, 0} Data bus - Corries digital data between all the units. p) Output unit - Consists of a set of cight terminal pins. The output is obtained. Main memory Control unit “— cpu Figure 9.1 Microprocessor ~ Itiswidely used to do-signal processing of blosignals from the recorders. Microprocessor based ECG analyser to compute P-R intervals and heart rates and EEG analysers'to do frequeney analysis of brain. Ttisalso called as microcomputer. Itconsists of two major chips, the CPU, heart of the computer (micro) and memory along with input and output, There chips and units are connected by cables called buses.[2uteue ‘unit Control Figure 9.2: Micropracessor In Medical Field a) Computer Analysis of ECG and EEG Computers are widely used to diagnose the state of the heart and brain, In ECG. analysis the heart duration of QRS complex, PR hnverval, ST interval, heartrate are computed inshorttime. In EEG the relative amplitude of given frequency can be evaluated (brain) using computers, by) Computer Aided Tomography Xray imaging, thermal imaging, nuclear imaging, magnetic resonance imaging, positron emission imaging and ultrasonic imaging techniquesare all done by computers, ©) Computers in Patient Monitoring Used in intensive care unit monitoring. Itdisplays body temperature, blood pressure heart rate are very useful in patient monitoring. Lotof patient records are stored and then the computer can provide more complete information, d) Computers in the Clinical Laboratories ‘To produce laboratory reports like analysis offblood, urine and PH, computers are used now-a-days, A number of clinical laboratories are computer systems for data requisition and processing, 9.3. Computer-Aided ECG Analysis ‘The best known application of computers in medical diagnosis is theiruse in analysing and evaluating electrocardiogram. Processing on the ECG includes digital filtering, removalof artefact, overaging of complexes and fully automated measurement of P.QRS, T wave amplitudes and durations. Vital parameters such as position, height, slope and interval between the individual waves relative to one another can be determined and written out as digital values, * Inthe process of computer-assisted ECG analysis following measurements are made: (i) Amplinudes, (ji) Durations, (iii) Intervals. ECG can be classified into following four groups to provide guidelines. Pri far Normal - Thisis favourable finding no possibility Low of heart disease, Agpical - Finding exceed normal limits but the Low association with heart disease is low. Borderline- This may ormay not be associated Intermediate with heart disease, Abnormal - Definite indication forevaluation of High the cardio vascular system. Normal heart may generate abnormal ECG. PR, T-Amptinuae Widthiduration) PA.RW Tete Intervals PO,PRST.OT Figure 9.3: PR, T-Amplitude Width (duration) PW, RW, TW etc... Intervals PR, PQ, ST, QTInopetation the patient may be connected to 3 channel ECG data acquisition system. CG from the patient site to the computer site can be transmitted in two ways. a) Real time on-line processing b) Computerised ECG with magnetic ape storage or off-line processing. a) On-line Processing By direct connection over telephone lines the system permits the operator to dial the computers centre directly from the bedside and the 12-lead ECG is transmitted in four groups of3 leads simultaneously in analog form te the computer cettre, At the bedside the operator may code the recording with information about the patients’s age, hospital, number ¢te and this information is also transmitted to the computer. The ECG is interpreted at the computer. The analysis ECG Signal =p-—— Data acauistios Prone | —> +O systam temmnal Telephone tink, Print out from data ECG Recorder transmitted back from computer site ‘Computer (ECS inter “pretatie system) Figure 9.4 b) Off-line Processing Computer {ECG inter are -pretatia system) recorder Ls Diaia aeauistion I T aysiem | Magnetic tao for EGG storage Figure 9.5By making a magnetic tape recording at the patient site and then taking it te the computersite, The computer can be used to establish minimum or maxiomm valueof these parameters. For each patient, based upon his own signal. Itcan be used to scan and identify P waves, QRs complexes, T waves, to derive such things as PR - intervals, P-P intervals and from this data to track the nature of rhythm, Eleven categories are covered in: the QRs interpretation. Five categories in ST and T waves. Thus in this way ECG hus been analysed. EEg, spirogram, phonocardiogram also have been chosen as an initial offer since each of these signals lends itself to automated measurement and interpretation. 94 Time and Frequency Domain Technique A periodic function f(t) with a period T has frequency components with angulare velocities 40,220, 230, ino, Where @ = 2 _ This spectrum of frequencies defines afunction. Every function has its own frequency spectrum which can be determined by using fourier seties. Alternatively A function may be defined asa finction of time in terms of relative magnitudes possessed by various frequency components of the spectrum. This is termed as time domain. Frequency domain comprises diserete frequencies 0, 2a, 3m etc and is not a continuous spectrum. A function may be represented in frequency domain with a series ofequally spaced vertical lines, their heights giving the magnitude of each frequency component. ‘Thus we may express a function in time-domain (plot of magnitude against time) or in frequency-domain (plot of magnitude against frequency). + ) i? file T | =WE Tz Ft aft ant Gites domain} Figure 9.6 Time domain representation specifies 3 function at each instant oftime. Frequency domain representation specifies the relative amplitude of the frequency components of the function.vt 2uT (Frequency domain} Figure 9.7 9.5 Basie of Signal Conversion ‘The trend for communication channel is the use of signals for transmission of messages. ‘These signals may be analogue or digital. Now digital signals are used for transmission of messages, Telecormunications involve the conversion of messaves which may be in the form of words or coded symbols into electrical voltage or current which varies with time andis used to catty information from one pointto another. Such electrical quantitics are termed assignals. These signals arc then transmitted aver communication systems to the receiver where they are converted back to the original form. Transmission —+[meitage] +] Encoder }-+[Tanemer} ~~" —- [Receiver] [Decmaer]—+[Raeseane] Noise Figure 9.8 ‘The encoder converts the message into electrical signals and feeds them to the transmitter, ‘The signals are processed at the transmitter and transmitted to the receiver. ‘The transmission path may be a telephone line or free space. Naw in the first case the system is commonly termed as line communication, the latter is termed as radio communication, Atthe receiver end, the receiver is made to select the desired signal, process it and deliver to the decoder an electrical signal which resembles in all respects to the signal produced by the encoder. The decoder converts them in the form of original message.Types of Signals 1. Analogue signal — Sinusoidal innature with or without harmonics and represent the variations ofa physical quantity likea sound wave, 2. Digital signal — Ttcomprisea series of pulses that occur at discreet intervals oftime, 9.6 Digital Filtering A digital filteris a numerical procedure, oralgorithm that transforms a given sequence ornumbers into a second sequence that has some more desirable properties such as noise or) distortion. UP Sequence Digital OP Sequenca flo} Me ce) Figure 9.9 A digital filter transforms the input sequence {x (n) into the output sequence {y{n)}}. ‘Digital filtering technique consists of three simple elements, adders, multiplexers and delays. The adder and multiplexerare simple components that are readily implemented in the arithmetic logic unit of the computer. Delays are components that allow access to future and past values in the sequences. x(n) vinx, (n}rxs{n) alt) Figure 9.10 afr} S Vipira xin) Figure 9.11 ‘MultiplexerDelay Positive delay-Delay’ Negative delay-‘Advance x(n) Yin)=x(n—1) x(o} [= [wee 5 poe -——+ Figure 9,12 9.7 Applications Figure 9.13 * Microphone - less background noise of interference, + Radar applications - used to improve the detection of airplanes. * Speech processing - to reduce the redundancy in the speech Signal $0 as to allow more efficient transmission and for speech recognition. Input sequences can be generated in several ways, such a5 continuous time-signal, Discrete Time Signal a (xa) | ey, je Time Figure 9.14 Example: Speech processing Letus consider the sequence {x, (n)} and (x, (n)}. feet} faint} Figure 9.15‘The first is the | a| sound in ‘Father’ and the second is the | i {sound as in ‘see’. ‘These two periodic signals are most easily differentiated by computing the magnitude spectrum of one period. We note that two spectra (x, |2”,| and x, |e [} consists of peaks that corresponds to the resonances of the local tract shape that was used to generate the sound. Q bxte"y]a8 a patel jaa 30 = —————— ~i0 a a) 2 wea} Figure 9.16 The sequence {x, (n)} consists of $12 samples of the speech sound | a| and {x,(n}} of |i]. The sample values are connected by straight lines. The corresponding spectra fx, (@)and (x, ((e!")))| given in logarithmic units of dB, exhibit peaks that can be used todifferentiate these souncls, 9.8 Data Reduction Technique Data reduction techniques can be applied to obtain a reduced representation of the data set that is much smaller in volume, Yetclosely maintains the integrity of the original data. i.e. mining on the reduced data set should be more efficient yet produce the same analytical results. Itincludes the following. i) Data Cube Aggregation Here Aggregation operation are applied to the data in the construction of a data cube. The data can be aggregated so that the resulting data summarize the total sales per ‘year, Each cell holds an aggregate data value, corresponding to the data paint in multidimensional space, Data cubes provide fast access to precomputed, summarized data, thereby benefiting on-line analytical processing well asdata mining.Year=1998 YYear= 1397 Home Quarter | Sales. entertainment, a, | s224.000 Computer| 759 ooo Os) Re Phone| 460 a, | $350,000 Q, $566,000 Sequrity| 50 Year 4s97 | 1998 Figure 9.17 The cuibe created at the lowest level of abstraction is referred toasthe base cuboid. ‘Acube forthe highest level ofabstraction is the apex cuboid. Each higher level of abstraction further reduces the resulling data size, ii) Dimension Reduetion In this the irrelevant, weakly relevant, or reduntant attributes (or) dimensions may bedetected or removed, Datasets for analysis may contain hundreds of antibutes, many of whieh may be irrelevant to the mining task or redundant. Tireduces the data set size by remaining such attributes (or dimensions) fronait. The three methods are employed. a) stepwise forward selection b) stepwise backward selection ¢) combination of forward selection and backward elimination Example: Initial attribute set {Ay Ars Ay Ay Ags Ag Reduced set FAY Ag Reduced attribute set EAL Ay Ag}Figure 9,18 iii) Data Compression Encoding mechanisms are used to reduce the data size. Ifthe original data can be reconstructed from the compressed data without any loss of information, the data compression technique used is called lossless, If instead, we can reconstruct only an approximation of the original data, then the data compression techniques called lossy. Example, 3-D data cube forsales with the dimensions item-type, branch and year mast first be reduced toa 2D cube, Such as with the dimensions item-type and branch x year, iv) Numerosity Reduction ‘The data are replaced or estimated by alternative, smaller data representation such as parametric models (which need store only the mode! parameters instead of the actual data) or non parametric methods such as clustering, sampling and the use of histograms, In clustering technique consider data tuplesas objects. They partition the object into groups or clusters, so that objects within a cluster are similar to one another and dissimilar to objects in other clusters, Histograms use binning to approximate data distributions and are popular form of data reduction. A histogram ‘for an attribute A partitions the data distribution of A into disjoint subsets, or buckets. y) Diseretization and Concept Hierarchy Generation ‘The data values forattributes are replaced by ranges or higher conceptual levels. Hierarchies allow the mining of data at multiple levels of abstraction and area powerful tool fordata mining, .Short Questions and Answers 1, Whatis meant by computer? What are the different components in it? Itis a device which can accept and supply information which is used for sigma processing, storage, data reduction and data presentation, The components in this== arithmetic / Logie Unit, Memory Unit, Inpat/ Qutput unit and control Unit. 2. What is microprocessor? What are the components in it and what is the use of it in medical field? Hisalso called as microcomputer, itconsistof two major chips, the CPU-heart ofthe computer and memery along with input and output unit, Its use in the medical field isto do signal processing of biosignals from the recorder. Microprocessor based ECG analysis is to compute P-Rt intervals and heart rates. ECG analysis is todo frequency analysis of brain 43. Define frequency and time domain technique? A function may be represented in frequency domain witha series of equally spaced vertical lines, Their height giving the magnitude of each frequency eaimponent. Frequency domain representation specifies the relative amplitude of the frequency components of the function, A function that may be defines asa function of time in terms of relative magnitude possessed by various frequency components of the spectrum is called time demain technique. Time domain representation specifies a function at cach instant of time. 4. What are the techniques to be applied for data reduction? ‘There are five types of technique which is applicable. a) Data cube aggregation b) Dimension reduction ¢)} Data compression d) Numosity reduction ¢) Discretization and concept hierarchy generation.10, Define digital filter and the techniques used behind that, Adigital filter isa numerical Procedure oralgorithm that ttarisforms.a given sequence of numbers into a second sequence thal has some more desirable Properties suchas house (or) distortion. Elements: a) Adders ch Multiplexers d) Delays. Name the types of signal fer basics of signal conversion. ‘The two types of signal are: a) Analogue signal b) Digital Signat The analogue signal is sinusoidal in nature with or without harmonies and represent the variations of a physical quantity like a sound wave Digital Signal Comprise a series of pulses that occur at discreet intervals of time. Write the various application af computer in medical field, The best application of computer in medical diagnosis is their use in analyzing and evaluating clectrocardiogram. The process of computer-assisted ECG analysis gives the measurement ofamplitude, durations, intervals, Define A/D converter, The process. of sampling a signal and converting each sample to a number code is accomplished by analog to digital converter, Define D/A converter, Itisthe reverse process ofA‘) converter, i obtain a continuous signal from diserete valuesis called digital to-analog conversion. Here the sampling interval must be short, Define sampling Process. The amplitude of the continuays ‘voltage ar currentto be transformed is firstsampled at regular intervals and the resultant samples are converted intoappropriate binary numbers corresponding to theiramplitude values is ealled as sampling process.