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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Adaptive Signal Filtering Algorithm in Telemedicine</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Natalia Konnova</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Andrey Konovalov</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Bauman Moscow State Technical University</institution>
          ,
          <addr-line>5/1 2nd Baymanskay st., Moscow, 105005</addr-line>
          ,
          <country country="RU">Russia</country>
        </aff>
      </contrib-group>
      <fpage>40</fpage>
      <lpage>50</lpage>
      <abstract>
        <p>The article presents the results of an experiment of filtering a mixture of electrocardiogram signal with superimposed noise, represented by a discrete time series. The work of the signalto-noise mixture filtering algorithm is considered for the cases of white, gaussian, pink and brown (Brownian) noises. The results of an experiment on finding the optimal filtering parameters in cases with normal and imperfect noise are presented. The algorithm uses wavelet filtering and filtering methods based on Kalman's algorithm. In the course of the work, the effectiveness of the filtering algorithm for medical signals was confirmed.</p>
      </abstract>
      <kwd-group>
        <kwd>1 Wavelet filtering</kwd>
        <kwd>Kalman algorithm</kwd>
        <kwd>SNR</kwd>
        <kwd>Electrocardiogram filtering</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>1. Introduction</title>
      <p>
        Nowadays, remote medical support gains more popularity, posing new challenges [
        <xref ref-type="bibr" rid="ref2 ref3">1, 2</xref>
        ]. One of
these cases is to provide the transmission accuracy of medical information for correct and early
diagnosis. In connection with the above, the task is to ensure a sufficient data transfer rate, as well as
to obtain a clean signal, without noise and interference. Filtering is an appropriate method for obtaining
a clean signal [
        <xref ref-type="bibr" rid="ref20">19</xref>
        ].
      </p>
      <p>This paper presents the results of a numerical experiment of filtering and sufficient information
transfer rate problem in the medical industry. This task is considered as part of the methodology for
secure data transmission, including signal compression and encryption algorithms in addition to
preprocessing. The goal is to conduct numerical experiment with an assessment of the results for the
selected metrics and errors obtained in process. It is necessary to understand that there are many
standards for the medical data transmission, as well as signal (such as ECG, SCG and flowmetry)
filtering techniques.</p>
      <p>First, the metrics for evaluating the type of noise and filtering success are considered, then the results
are presented.</p>
    </sec>
    <sec id="sec-2">
      <title>2. Metrics and Methods</title>
      <p>The experiment was carried out for ECG signals based on the Medical Signals Database of St.
Vincent University Hospital2.
2.1.</p>
    </sec>
    <sec id="sec-3">
      <title>Signal to noise ratio</title>
      <p>SNR, or Signal to Noise Ratio, (hereinafter SNR) metric will be considered as a metric of the
filtering success. Let's represent the noisy signal as the sum of the required signal and noise:
 ( ) – noise,
 ( ) – the required signal,
where  is the measurement number,
 ( ) – the signal-and-noise mixture is the time series with the number of measurements (nodes) N,
which is fed to the input of the filtering algorithm.</p>
      <p>To assess the effect of noise in the channel on signal transmission, the concept of "signal-to-noise
ratio", which is basically the power-of-signal to power-of-noise ratio, is introduced as:
 ( ) =  ( ) +  ( ),

=
 
   
.</p>
      <p>(1)
(2)
(3)
(4)
2 PhysioNet. St. Vincent's University Hospital / University College Dublin Sleep Apnea Database, 2021. URL:
https://physionet.org/content/ucddb/1.0.0/ (Accessed July 6, 2021)
If all the components are expressed in decibels, then the formula can be simplified to:


=  
_
−      
=  ( ) −  ( ).</p>
      <p>In all the above cases, P is the average power. Also, the signal-to-noise ratio can be obtained by
squaring the ratio of the root mean square values of the signal and noise amplitudes, respectively.
2.2.</p>
    </sec>
    <sec id="sec-4">
      <title>Allan Variance</title>
      <p>Variances are used to characterize fluctuations in frequency data. Allan variance is also known as

 =  0 +  ∗  and   +1 =  0 + ( + 1) ∗  , respectively (for M measurements):
the variance of the difference between the values of the relative readings   and   +1, measured at times
where 
=</p>
      <p>− 1,
  =

1
 + −1
 =


  ,
  2( ) =</p>
      <p>1
2(
− 1)
 −1
 =0
(  +1 −   ) ,
2
  =   +1−  and   is the i-th of M values of the particular frequency values averaged over the
 0
measurement (sample) interval (according IEEE Std 1554-20053).</p>
      <p>
        The applications of Allan variations in the problems of detecting noise and chaotic processes in
biomedical data give interesting results [
        <xref ref-type="bibr" rid="ref16 ref17 ref18 ref19">15-18</xref>
        ].
2.3.
      </p>
    </sec>
    <sec id="sec-5">
      <title>Hadamard variance</title>
      <p>The Hadamard variance is based on the Hadamard transform, which is suitable for measuring
frequency stability in the time domain and has a higher resolution than Allan variance. For the frequency
series, the Hadamard variation looks like this:
  2( ) =</p>
      <p>
        1
6(
− 2)
where   - i-th frequency value from M, averaged over time τ [
        <xref ref-type="bibr" rid="ref1 ref4">3</xref>
        ].
      </p>
      <p>Having calculated the variations of  ( ) for different τ and plotting their mutual dependence,
plotting an approximating curve from its slope, we could make an assumption about the type of noise
coming with the signal.</p>
    </sec>
    <sec id="sec-6">
      <title>3. Numerical experiment</title>
      <p>In this article, the following signal processing algorithm is used:
1. Evaluation of the signal-to-noise mixture using the Allan and Hadamard variances.
2. Determining the type of noise presented in the mixture based on these metrics.
3. Selection of the most suitable filtering method based on the type of noise (for white and
Gaussian noises in the mixture, approximation is performed using wavelet filtering, for pink
and brown noises, the Kalman algorithm with B-splines is selected).
4. Mixture time series direct approximation.</p>
      <p>In case of an ideal noise, it will be relevant to maximize the SNR metric by choosing an effective
threshold function with a suitable threshold λ. For the variant of other noises, it is important to find the
optimal value of the interval, taken for filtering at one moment in time, with the number of
measurements M.</p>
      <p>Let us impose restrictions on the sampling rate of the considered mixture of signal and noise and on
the length of the template:
(5)
(6)
  
  = 
≤   ≤   
.</p>
      <p>Sampling rate (ν). To create a template, we need to sample at a specific frequency. Let's take the
sampling rate ν = 100 Hz. This frequency is the most common among the sampling rates of signals in
medicine.</p>
      <p>Maximum and minimum template length (   and    ). It is assumed that the heart rate is in the
range of 40-120 beats per minute. Therefore, the maximum length of the template which includes at
least one complete cardiac cycle fell, we take    = 1.5s. The minimum template length will be   
= 0.5s.</p>
      <p>It is required to obtain the maximum increase in the SNR value after the approximation in
comparison with the SNR before the time series approximation:
approximated_signal − 
noisy_signal =  
_
− (    _
  

_   _ ) − ( 
_</p>
      <p>−     _ ) =  ( ) −     
( ( ) −      _ 
ℎ
( )) =&gt;     
format. Fig. 1 shows the 10-second interval of one of three ECG signals.
(The number of measurements is shown horizontally)</p>
      <p>An example of applying white noise to this signal can be seen in Figure 2. As a result of overlaying,
we get a signal and noise mixture. As a result of finding the variances of Allan and Hadamard (Fig.
35), we can determine the type of noise. By the slope of the approximating straight line, we determine
the type of the noise. After that, we start filtering.</p>
    </sec>
    <sec id="sec-7">
      <title>Wavelet filtering algorithm</title>
      <p>threshold, we use a garrote function:</p>
      <p>
        The wavelet filtering algorithm is based on the properties of the wavelet decomposition [
        <xref ref-type="bibr" rid="ref5 ref6 ref7 ref8">4-7</xref>
        ]. As a
   ̃, 
=
 2
 ̃
 ̃ −
      </p>
      <p>, если  ̃ ≥ 
0, если  ̃ &lt;</p>
    </sec>
    <sec id="sec-8">
      <title>Algorithm based on Kalman filtering</title>
      <p>
        The Kalman filter using B-spline functions is a bit like the sliding window method [
        <xref ref-type="bibr" rid="ref10 ref11 ref9">8-10</xref>
        ].
As a result of using the algorithm and taking into account the SNR metric:
    
_  
ℎ  ( ) −      ℎ
      </p>
      <p>( )
=  ∗  −      _  
ℎ  ( ) − ( ∗  −     
_  
ℎ  ( ))
=
−

 =1</p>
      <p>It is necessary to find the optimal width of the interval M in order to obtain the maximum increase
in the value of the signal-to-noise metric:
,
(10)
approximation errors,
where   – is the position of the i-th dimension,
 (  ) – control points, the position of which is determined depending on the values of the
M – total number of measurements based on sampling rate and pattern width, M ≤ 150,
  , ( ) – B-spline function of order k associated with measurements   ,…,  + .</p>
      <p>
        This type of processing of the signal-to-noise mixture consists in the sequential execution of the
Kalman filtering algorithm for intervals containing M measurements [
        <xref ref-type="bibr" rid="ref12">11</xref>
        ]. One can read more about the
intricacies of using the Kalman filter for processing biomedical data in publications [
        <xref ref-type="bibr" rid="ref13 ref14 ref15">12-14</xref>
        ].
      </p>
      <p>One can notice a general trend with a decrease in the difference between the signal-to-noise ratio
before and after filtering with an increase in the value of the threshold function. The value of the
threshold λ, which is in the vicinity of the value 5, can be considered optimal. Columns in Fig. 6 and 8
(that’s the results of developed software processing) one by one:
6. SNR of the mixture before filtering, 7. SNR of the mixture after filtering, 8. SNR difference.</p>
    </sec>
    <sec id="sec-9">
      <title>4. Results</title>
      <p>mixture (Fig. 3-5).</p>
      <p>As a result of determining the type of noise stage, it is possible to recognize the type of noise in the</p>
      <p>Research practically shows that the 3rd level of wavelet transform gives the largest number of high
smoothing results. The best values for white and Gaussian noise are shown in Fig. 8.</p>
      <p>Let's overlay the brown noise (Figure 9) and find the signal-to-noise ratio (Figure 10). D[x]=   2 =
1102−6, − 102−3 ≤  ( ) ≤ 102−3 is an optimal Brownian noise dispersion added to the signal. Under the
sampling rate in the table in Fig. 10 refers to the increase / decrease the ratio of the original sampling
rate. The most optimal coefficient is 1, with the value of covariance  = 10-4. Such conditions are most
acceptable for all values of the interval M, but such parameters give the greatest improvement in the
signal-to-noise ratio for M = 99. The results of the approximation are shown in Fig. 11.</p>
    </sec>
    <sec id="sec-10">
      <title>5. Conclusions</title>
    </sec>
    <sec id="sec-11">
      <title>6. References</title>
      <p>The article presents the results of two filtering algorithms performed depending on the type of noise
superimposed on the signal. An increase in the signal-to-noise ratio after filtering the data was
confirmed.</p>
      <p>The experiment carried out in this article makes it possible to filter the real signal in the form of an
ECG using wavelet transforms and threshold functions, as well as the Kalman filter.</p>
      <p>Thus, the three-step technique, which includes the preprocessing of the signal described in this
article, the compression algorithm and the encryption algorithm, can be considered as one of the
methods for safe and fast signal transmission in telemedicine.</p>
    </sec>
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