Prediction of Cardiovascular Diseases with

2024 International Conference on Advances in Computing, Communication and Applied Informatics (ACCAI) | 979-8-3503-8944-9/24/$31.00 ©2024 IEEE | DOI: 10.1109/ACCAI61061.2024.10601761

Retinal Images Using Deep Learning

Tumu Vineetha1, Danda Rami Reddy2, Kandimalla Mahendra2 and Ballanki Dhana Lakshmi2
1
Assistant Professor, Computer Science and Engineering, Lakireddy Bali Reddy College of Engineering, Mylavaram, India
2
Student, Computer Science and Engineering, Lakireddy Bali Reddy College of Engineering, Mylavaram, India

E-mail : [email protected], [email protected], [email protected],

[email protected]

Abstract- cardiovascular diseases (CVDs) represent a networks (CNNs) with the MobileNet architecture.
formidable global health challenge, necessitating astute early MobileNet's design, optimized for resource-constrained
detection and intervention strategies. This study introduces a devices, ensures efficiency without compromising
sophisticated deep learning paradigm, seamlessly integrating accuracy. Through in-depth retinal image processing, the
the discriminative prowess of convolutional neural networks
(CNNs) with the computational efficiency intrinsic to
main objective is to improve early identification, risk
MobileNet architecture, aiming to discern CVDs from assessment, and economical diagnosis of CVDs. The
retinal images with unprecedented accuracy. The dataset, extensive dataset will be painstakingly categorized and
meticulously curated to encompass diverse clinical scenarios, annotated, including retinal scans from both healthy and
undergoes scrupulous preprocessing, augmenting the CVD-afflicted people. Preprocessing methods that
model's robustness. The amalgamation of CNN architecture improve dataset quality and diversity include scaling,
and streamlined MobileNet design culminates a discerning standardization, and data augmentation. The CNN model,
framework capable of intricate classification tasks related to featuring MobileNet architecture and depth-wise
CVD presence within retinal imagery. This paradigm shift separable convolutions, will be fine-tuned with additional
holds promise for expeditious CVD diagnosis, risk
stratification, and economically viable medical imaging and
layers for CVD prediction specificity. Training will be
envisions a transformative era wherein healthcare executed with optimization algorithms like stochastic
professionals are endowed with timely insights, facilitating gradient descent (SGD) or Adam, coupled with
judicious interventions and proactive healthcare strategies. continuous monitoring and hyperparameter adjustments to
Nevertheless, the imperatives of rigorous validation and avoid overfitting. Performance evaluation, emphasizing
seamless integration into clinical practice loom, their fruition accuracy and other standard metrics, ensures the model's
being pivotal to gauging the veritable clinical utility and reliability. Anticipated benefits encompass improved
transformative potential of this innovative synthesis of early detection, enabling timely interventions and
cutting-edge retinal imaging and deep learning technologies management strategies for enhanced patient outcomes and
in cardiovascular health.
reduced complications. Retinal imaging offers a non-
Keywords: Retinal images, Deep learning algorithms, invasive, economical option that is particularly helpful in
Performance evaluation. areas with low resources. By utilizing deep learning and
retinal imaging, this research hopes to make a substantial
I. INTRODUCTION contribution to preventive cardiology by promoting early
detection, risk assessment, and economical diagnosis to
The world's morbidity and death rates are greatly improve patient care and outcomes.
increased by cardiovascular diseases (CVDs), which pose
a serious threat to global health. Effective therapies and II.LITERATURE SURVEY
better patient outcomes are urgently needed, as
demonstrated by the vital requirement for early The paper likely focuses on the utilization of machine
identification and accurate diagnosis. However learning methodologies for the early prediction of
conventional diagnostic techniques frequently require cardiovascular diseases by leveraging information
expensive imaging or invasive procedures, which limits extracted from retinal images. Retinal images, being a
accessibility, especially in environments with limited non-invasive and potentially rich source of information,
resources. This study addresses this gap by proposing a can contribute to the development of predictive models.
non-invasive, cost-effective approach using retinal The authors may have explored various machine learning
imaging for CVD prediction. The retina, mirroring algorithms to analyze retinal features and assess their
vascular characteristics of the heart, offers a unique correlation with cardiovascular diseases.[1]
window into systemic vascular health. This study attempts
to create a model for precise CVD prediction by utilizing [4] Retinal flow patterns using structural optical
deep learning, more especially convolutional neural coherence tomography (OCT) data are likely the main

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 focus of the work, which applies artificial intelligence to involve accuracy, sensitivity, specificity, and other
this task. The anatomical intricacies of the retina may be relevant evaluation measures.[6]
seen with optical coherence tomography, a non-invasive
imaging method. The study's artificial intelligence [7] The study presumably focuses on comparing and
approaches, which can involve machine learning analyzing the effectiveness of several supervised
techniques or neural network design, are expected to be machine-learning algorithms for the prediction of
described in depth by the authors. To extract retinal flow cardiovascular illnesses.
information, the mechanism probably entails processing
structural OCT data. [8] The performance analysis findings, including the
efficiency of the base and meta classifiers as well as the
[3] The use of deep learning methods for the automated ensemble stacking approach's overall predictive power,
detection of diabetic retinopathy is probably the focus of are probably presented in the publication. There may be
this research. A serious eye consequence of diabetes that inclusion of evaluation measures like accuracy,
requires prompt identification to treat effectively is sensitivity, specificity, etc.
diabetic retinopathy. The authors may have automatically
detected signs of diabetic retinopathy by analyzing retinal [9] The effectiveness of hybrid optimization in predicting
pictures using deep learning techniques. cardiovascular disorders is probably demonstrated in the
study by the outcomes of its application using a deep
[2] Retinal imaging has been investigated more and more learning methodology. There may be inclusion of
as a non-invasive way to extract data about cardiovascular evaluation measures like accuracy, sensitivity, specificity,
health; the paper is likely to concentrate on the etc.
application of deep learning techniques for the detection The paper likely presents the results of the combined
of cardiovascular risk factors by analyzing retinal fundus approach, demonstrating its effectiveness in predicting
photographs. The authors may have used deep learning cardiovascular diseases. Evaluation metrics such as
algorithms to automatically identify and assess certain accuracy, sensitivity, specificity, etc., may be included.
features in retinal fundus images indicative of The authors are expected to describe the combined data
cardiovascular risk. science approach involving deep learning and machine
learning used in their study for predicting cardiovascular
[5] The study investigates the integration of electronic diseases. The methodology likely includes data
medical records (EMR) data to improve prediction preprocessing, feature engineering, model training,
accuracy and is most likely focused on the real-time validation, and testing.[10]
prediction of cardiovascular disorders utilizing reservoir
computing, a kind of machine learning. The table presents information about various research
papers, detailing authors, publication years, advantages,
The paper likely presents the results of the machine and disadvantages associated with each paper.
learning models, including their performance metrics in
predicting cardiovascular disease events. This could

Table 1: Literature Survey

Ref Author Year Advantages Disadvantages
1 R.Garg, P.K. Sarangi, 2023 This is based on supervised Learning methods Lack of working with those
A.K.Sahoo, J.Jh a Like Logistic Regression (LR) And Gaussian models gives less prediction
Naive Bayes (NB). and accuracy.
2 V.K.H.M., S. D.S 2023 This is based on supervised learning methods Lack of working with those
like Logistic Regression (LR) and Gaussian models gives less prediction
Naive Bayes (NB). and accuracy.
3 P.Sai Krishna 2023 Hybrid optimization with deep learning Limited information on
K.A.Basith approach. hybrid optimization.
4 S.Sadasivuni, 2022 Reservoir computing for real-time prediction. At the time of multiple ECG
V.Damodaran, Using AUROC of 0.91 with ECG and EMR signals gives less
Banerjee, A.Sanyal sensors with high predictions. configuration with low
accuracy.
5 A.A.Romalt, R.M. 2022 Using the advanced Combined Data science Lack of Performing the
SN.Kumar approach for the prediction methodology with less
scalability of patient
records.

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 III.EXISTING SYSTEM:
Creating a system that can evaluate retinal images and
recognize patterns or signals linked to cardiovascular risk
factors is the first step in utilizing machine learning to
predict cardiovascular illnesses.

The current system of predicting cardiovascular disease

by analyzing retinal images using machine learning has
several drawbacks. First, it lacks ease of use due to slow
data retrieval and inefficient data maintenance, which
affects the overall performance of the system. Second,
there are challenges in generating reports as large-scale
calculations are needed, resulting in reports being
generated only at the end of the session. Third, the system
relies heavily on paperwork, which makes it vulnerable to
complications and difficulties if any records or files are
lost. The manual nature of the process also contributes to
the system being time-consuming, preventing reports
from being generated in real-time or based on immediate
requirements. Addressing these shortcomings is critical to
improving the efficiency, accessibility, and user
experience of the system for cardiovascular disease
prediction using retinal image analysis. Fig.1: Proposed model flow

IV.PROPOSED SYSTEM:
The proposed system provides a comprehensive
methodology for deep learning-based acquisition,
preprocessing, annotation, and analysis of retinal images
for cardiovascular disease prediction. The process begins
with the careful collection of retinal images, which are
then subjected to extensive pre-processing techniques to
improve data quality. These images are carefully
annotated with cardiovascular risk factors, providing
valuable contextual information for further analysis. The
methodology's core involves designing and implementing
a convolutional neural network (CNN)-based deep
Fig.2: Training samples of Retinal Images
learning model, known for its prowess in image analysis.
To facilitate effective training and evaluation of models,
Dataset Description: 5.1 Data Collection
different sets of training and validation data are selected.
The dataset, a collection of 2722 retinal images, has been
The model undergoes a rigorous training process, learning
sourced from Kaggle, a trusted platform known for its
complex patterns and correlations from annotated data.
diverse datasets. To ensure effective training and
After training, the system evaluates its performance
validation, we have thoughtfully split the dataset, with
across validation datasets, ensuring its robustness and
preventing overfitting.
7030 retinal images into two distinct categories:
cardiovascular and no cardiovascular images. Each record
This meticulous curation is particularly significant for
in the dataset provides detailed information about these
proposed deep learning model, utilizing CNNs and
features, making it a crucial resource for training and
MobileNet architecture, aimed at predicting
evaluating machine learning models.
cardiovascular diseases. By leveraging this well-
organized dataset, we aim to enhance the accuracy and
reliability of the model, contributing to advancements in
preventive cardiology and ultimately improving patient
outcomes.

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 which consists of 32 filters with (3,3) kernel sizes and the
same padding to maintain spatial dimensions, is essential
for identifying important characteristics in the input data.
The Rectified Linear Unit, often known as Relook, will be
used in this procedure's second part. We will talk about
relook layers and explore the function of linearity in
convolutional neural networks.
Fig.3: Cardiovascular Fig.4: No_Cardiovascular
6.1.2 Pooling Layer
V.DATA PREPROCESSING: In the following stage, we investigate pooling, mainly
concentrating on max pooling. We also discuss several
a) ImageDataGenerator Creation: alternatives, such as mean pooling, and attempt to clarify
An Image Data Generator objectis created with Rescale = how this particular pooling type operates. After the first
1 / 255 for pixel normalization and validation_split = 0.3 convolutional layer, an important max-pooling layer is
to split data into training and validation sets. It can be added, which reduces spatial dimensions by taking the
stored in Train_datagenterator maximum values inside predefined groupings of pixels.
To further reduce spatial dimensions, we extend this
The technique of adding more picture training data to the method by adding more convolutional layers with larger
available image data by applying various transformations filters. Convolutional neural network performs very well
to it, such as random rotations, shear transforms, shifts, in this project because of its strategic integration and
zooms, and flips, is known as image augmentation. When interactive visual interface, which offer a thorough grasp
we don't have enough training data to fully train the of pooling procedures.
model, we resort to image augmentation. By applying
alterations to the current photos, we can produce new 6.1.3 Flattening
images in such circumstances. CNN (Convolutional In the continuation, we focus on the transition from
Neural Network) views these photos as completely fresh pooled layers to flattened layers inside Convolutional
even if they appear identical. This will make it easier for Neural Networks (CNNs). This involves a brief dissection
us to produce a bigger training dataset, which will help of the flattening procedure, explaining how the change
the model converge more quickly. takes place. Adding a layer that has been flattened and
positioned carefully is the crucial step in converting the
Flow from Directories: 2D matrix data into a vector. This conversion is necessary
Train generator is created using to get the data ready for a smooth interaction with the
Train.datagenerator.flow_from_directory(), next fully linked layers in CNN architecture. The project's
specifying: overall capability for complex pattern recognition and
 Data_directory: The main directory containing classification is improved by this methodical transition,
images (e.g., Train) which guarantees the efficient integration of feature-rich
 Target_size: The desired image size (224x224 in this data retrieved through pooling layers.
case)
 Batch_size: The number of images to process in each 6.1.4 Full Connection
batch (20 here) By combining the elements in this part, we can see
 Blass_mode: The type of labels ('categorical' for convolutional neural networks (CNNs) in their whole. We
multiple classes) begin with the convolutional layers, which include max
 Subset: The subset to use ('training' for training data) pooling and filters for pattern recognition and spatial
 Test generator is created similarly, but with reduction, and then go on to the flattening procedure.
subset='validation' to access the validation set. ReLU activation and 512 neurons in a dense layer
indicate the shift to completely linked layers. CNN learns
complex picture classifications, culminating in a final
VI.METHODOLOGY: dense layer with two neurons and softmax activation
(perfect for binary classification). The project's photos can
6.1 Convolutional Neural Network: be effectively identified and categorized by the network's
6.1.1 convolutional operation neurons thanks to its thorough design, which guarantees
We begin by exploring the fundamental convolution efficient feature extraction.
process, which is a crucial component of neural network
architecture. Feature detectors, which are similar to filters,
are used in this operation, and they direct learning, pattern
recognition, and the tiered approach for thorough feature
extraction. We incorporate the first convolutional layer
into the model to implement these ideas. This layer,

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 reduces dimensionality by using a limited number of
1x1 filters.
 Mixing and transforming information from several
channels is made easier with pointwise convolution.

By dividing the convolution process into these two stages,

MobileNet considerably minimizes the amount of
parameters and computations while maintaining a
reasonable level of accuracy. Through depthwise
Fig.5: CNN Architecture separable convolutions, the network can learn efficient
and compact representations of the input data.
6.2 MobileNet Architecture:
MobileNet will offer a way to operate deep neural VII.MATHEMATICAL EVALUATION
networks on devices with limited resources, such as
embedded systems, cell phones, and other low-power 7.1 Accuracy:
devices. The main concept of MobileNet is to lower the The model's prediction accuracy is a measure of how well
computational complexity and model size by using the true labels match the model. This is calculated by
depthwise separable convolutions rather than taking the total number of forecasts and dividing it by the
conventional convolutions. The conventional convolution proportion of correct predictions.
process is divided into two distinct operations by = ℎ
depthwise separable convolutions ℎ
If there are T in overall retinal images and C properly
categorized retinal pictures, the accuracy is expressed as

Accuracy = C/T

The accuracy of both models is represented in a table

format, that is
Table 2: Accuracy
S. Model Number Training Validation
No Name of Epochs Accuracy Accuracy
CNN
1 20 91.34 60.49
Mobile
Net
2 (base 20 99.58 68.34
Model)

7.2 Convolutional Layer:

The mathematical equation for a convolutional operation
at a specific spatial location (i, j) for a single filter is as
Fig.6: MobileNet Architecture follows:
( , , )
Table 1 Depthwise Convolution: = (Σ =0 −1Σ =0 −1input( + ,
Using a single filter for each input channel, the depthwise + , channel). filter( ,, channel, filter )) + bias
convolution operates on each one separately. In
comparison to normal convolutions, this minimizes the Where:
number of parameters and calculations.  σ is the ReLU activation function.
 It uses a batch normalization and ReLU activation  U and V are the dimensions of the filter.
function after applying a 3x3 depthwise convolution  Input (i+u, j+v, channel) represents the input value at
with a stride of 1. the specified location and channel.
 Capturing spatial information inside each channel is  Filter (u, v, channel, filter) represents the weight of
aided by depthwise convolution. the filter at the specified position and channel.
 bias(filter) is the bias term associated with the
Pointwise Convolution: specific filter.
 To aggregate information across channels, the
pointwise convolution performs a 1x1 convolution This operation is applied to each location in the input
on the result of the depthwise convolution. image, and the resulting output forms the feature map for
 It combines features from several channels and that specific filter.

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 7.3 Max-Pooling Layer: two neurons in the output layer, the softmax activation
The Max-Pooling operation takes the maximum value will provide probabilities for the two classes.
within each pooling window. The mathematical operation
for Max-Pooling at a specific spatial location (i, j) for a VIII. RESULT & ANALYSIS:
single channel is as follows:
The MobileNet architecture will serve as the foundational
output( , , filter) network for the CNN model's construction. Depth-wise
max , (input(2 + , 2 + , filter)) separable convolutions, which are used by MobileNet,
dramatically lower computation costs without sacrificing
Where: accuracy.
 Input (2i+u,2j+v, channel) represents the input value
at the specified location and channel. The study's conclusions have several possible advantages.
 The max , operation finds the maximum value First off, the deep learning model that has been suggested
within the 2×2 pooling window. can help with CVD early detection and diagnosis.

The effect of Max-Pooling is to down-sample the spatial Ultimately, enhancing a deep learning model for CVD
dimensions of the input. It helps in capturing the most expectancies using CNNs and MobileNet architecture
important features while reducing the computational load employing retinal images can significantly advance the
and preventing overfitting. field of preventive cardiology. We aim to work on early
detection, risk assessment, and financially astute analysis
7.4 Fully Connected (Dense) Layer: of CVDs by using profound learning and retinal imaging,
The mathematical operation for a single neuron in a dense which will ultimately drive work on comprehending
layer is as follows: consideration and outcomes. The method provides a set of
output = activation(Σ =1input ⋅ weight + bias) images that are either healthy or sick.

Where: 8.1Graphical Representation:

 activation is the ReLU activation function. After the data has been fitted to the model, it is possible to
 N denotes the number of neurons in the layer above. calculate the training accuracy, validation accuracy,
 input is the output from the jth neuron in the previous training loss, and validation loss. The training accuracy,
layer. validation accuracy, training loss, and validation loss are
 weight is the weight associated with the connection plotted against the CNN model to produce the following
between the jth neuron in the previous layer and the graphs.
ith neuron in the dense layer
 bias is the bias term associated with the ith neuron in
the dense layer.

The last layers of a neural network, which translate the

learnt characteristics to the output classes, frequently
utilize fully connected layers. Activation functions are
included after them to add non-linearity to the model.
7.5 Softmax Activation:

The mathematical operation for the softmax activation in

a neural network is as follows:
Fig.7: CNN accuracy loss representation
_
( )=
Σ_
The CNN model exhibits promising performance with a
training accuracy peaking at 91.34%, while the validation
Where:
accuracy surpasses 60.49%. A noticeable gap between
 ( ) is the probability assigned to training and validation accuracy suggests potential
 _is the raw output score for from the previous layer. overfitting. Further analysis of loss curves is
 The sum is taken over all classes. recommended to ensure the model’s stability and
effective generalization to unseen data.
The softmax function essentially converts the raw scores
(logits) into a probability distribution over multiple The following graphs are obtained by charting the training
classes, making it suitable for multi-class classification and validation accuracy as well as the training and
problems. The class with the highest probability is validation losses against the MobleNet (Base model).
predicted as the final output. In this case, since we have

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 disease. The bottom row of the matrix shows that 350
patients were diagnosed as not having cardiovascular
disease. Of these, the model correctly predicted that 300
did not have cardiovascular disease, but it incorrectly
predicted that 50 did have cardiovascular disease. Overall,
the confusion matrix indicates that the model is
performing admirably in categorizing patients with
cardiovascular disease, but it is not as good at classifying
patients who do not have cardiovascular disease. This is
because there are more false negatives (patients who are
Fig.8: MobileNet Architecture accuracy loss sick but are predicted to be healthy) than false positives
representation (patients who are healthy but are predicted to be sick).
The MobileNet architecture shows superior training
Here are some additional details that can be gleaned from
accuracy at 98.58%, surpassing the CNN model, while
the confusion matrix:
maintaining a commendable validation accuracy close to
 The accuracy of the model is 81.4%, which is
68.34%. This model demonstrates effective learning on
calculated by dividing the number of correctly
the training data, but a significant accuracy gap indicates
classified instances (643) by the total number of
potential overfitting, warranting further investigation for
instances (715).
improved generalization.
 The sensitivity of the model is 77.8%, which is
calculated by dividing the number of correctly
8.2Evaluating the model performance:
The confusion heatmap is a helpful representation of a classified positive instances (283) by the total
classification model’s performance across multiple number of positive instances (365).
classes. Key elements of the heatmap include the axis  The specificity of the model is 85.7%, which is
labels, cell values, color intensity, annotations, diagonal calculated by dividing the number of properly
elements, and off-diagonal elements. Understanding these categorized negative examples (300) by the total
components can provide insights into the model’s number of negative instances (350).
accuracy and misclassifications. Interpreting the
confusion matrix involves considering diagonal 8.3 Implementation And Results Screen:
dominance, off-diagonal patterns, class imbalances, and 8.3.1System:
the model’s overall performance. Additionally, the 1.Create Dataset:
decision threshold impacts the trade-offs between true Using a test size of 30–20%, the dataset of images used to
positives and false positives. By utilizing the confusion forecast diseases is divided into training and testing
matrix heatmap, one can assess the strengths and datasets.
weaknesses of the model’s predictions and gain a 2. Pre-processing:
comprehensive view of its performance across different To train the model, then resize and reshape the images
classes. into the proper format.
3.Training:
Train the model using the pre-processed training dataset.
4.Classification:
This approach yields a display of pictures that are either
normal or diseased.

8.3.2User:
1. Home Page: Home page of a cardiovascular
disease prediction system.

Fig.9: Confusion Matrix

The specific confusion matrix in the image is for a model

that is trying to classify patients as having cardiovascular
disease or not having cardiovascular disease. The top row
of the matrix shows that 365 patients were diagnosed with
cardiovascular disease. Of these, the model correctly
predicted that 283 had cardiovascular disease, but it
incorrectly predicted that 82 did not have cardiovascular Fig.10: Home page

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 The homepage of the Cardiovascular Disease Prediction picture analysis, the system can recognize patterns and
System features an introduction, providing an overview of markers associated with variables that raise the likelihood
the system. Users can navigate to the ‖About‖ section for of problems. Healthcare practitioners may find new
detailed information. Additionally, the ―Upload‖ tab perspectives from this invaluable knowledge. Through
allows users to input relevant data for disease prediction, procedures for testing, validation, and training, the
enhancing the platform’s user-friendly functionality and system's accuracy and dependability are thoroughly
informative content. assessed. If this technology proves to be effective, it has
the potential to completely transform the way we
2. Upload Image: An image that must be categorized anticipate illnesses by providing a non-invasive, easily
must be uploaded by the user. available option to supplement existing diagnostic
techniques. To enhance and improve this system and
produce better patient care and results, more investigation
and validation are needed.

X.FUTURE ENHANCEMENT:
10.1Enhanced Deep Learning Models:
To boost the precision and resilience of the prediction
models, researchers might investigate more sophisticated
deep learning architectures and methodologies. One
Fig.11: Upload page
possible approach to this would be to look at more recent
models, including attention processes, recurrent neural
On the Upload page, users can provide relevant input data
networks (RNNs), or hybrid models that incorporate
for cardiovascular disease prediction. This includes
several modalities.
entering the necessary details for analysis. Additionally,
users can choose between two different model
10.2Larger and Diverse Datasets:
architectures, namely CNN and MobileNet, allowing
Enhancing the models' performance and generalizability
them to customize the prediction approach based on their
may require obtaining larger and more varied datasets. To
preferences. Once the input and model selections are
obtain comprehensive datasets that cover a variety of
made, users can then submit the information for
demographic characteristics, illness subtypes, and risk
processing and obtain predictions regarding
factors, collaboration across healthcare institutions and
cardiovascular health. This user-friendly interface
data-sharing programs might be beneficial.
enhances the accessibility and versatility of the system.
10.3Multi-Modal Approaches:
3. View Results: The user views the classified image
Combining retinal images with other medical data
results.
sources, such as genetic information, electronic health
records, or clinical measurements, can enhance the
prediction accuracy and provide a more comprehensive
risk assessment. Integration of multi-modal data can be
explored using fusion techniques or joint learning
frameworks.

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