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  <front>
    <journal-meta>
      <journal-title-group>
        <journal-title>Journal of Maternal</journal-title>
      </journal-title-group>
    </journal-meta>
    <article-meta>
      <title-group>
        <article-title>Comparison of AI Systems in Fetal Health Classification</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Krzysztof Brzoza</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Kamila Gendasz</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Michał Dzumla</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Faculty of Applied Mathematics, Silesian University of Technology</institution>
          ,
          <addr-line>Kaszubska 23, 44100 Gliwice</addr-line>
          ,
          <country country="PL">POLAND</country>
        </aff>
      </contrib-group>
      <pub-date>
        <year>2014</year>
      </pub-date>
      <volume>1260</volume>
      <fpage>1615</fpage>
      <lpage>1619</lpage>
      <abstract>
        <p>Fetal health is a very important aspect in this day and age. The ability to predict the health status based on preliminary examinations could help a lot in saving lives, especially if it is done by an artificial intelligence system, which would streamline the whole process. The issue is complicated by the multitude of diferent algorithms that vary in accuracy and execution time that can be used for such predictions. This project compares three popular artificial intelligence systems: k-nearest neighbor algorithm, naive Bayes classifier, soft sets to show which one of them will prove to be the best. The final results are shown in comparison graphs. In this article, the mathematical issues related to these algorithms and examples of their application in this task are presented.</p>
      </abstract>
      <kwd-group>
        <kwd>eol&gt;soft sets</kwd>
        <kwd>knn</kwd>
        <kwd>naive Bayes</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>1. Introduction</title>
      <p>
        care problems. All mentioned solutions use diferent
approaches but the incoming data are analyzed mainly in
The reduction of child mortality is one of the key indi- two ways - taking the data, or only the extracted features.
cators of human progress. It is expected that by 2030, Such solutions were analyzed and discussed in terms of
countries end preventable deaths of newborns and chil- data analysis in [
        <xref ref-type="bibr" rid="ref11">11, 12, 13, 14, 15</xref>
        ].
dren under 5 years of age, with all countries aiming to This work will be compared artificial intelligence
sysreduce under-5 mortality. Parallel to the notion of child tems, their performance, and accuracy in predicting fetal
mortality is of course maternal mortality, during and fol- health.
lowing pregnancy and childbirth. The vast majority of For this purpose, 3 artificial intelligence systems were
these deaths occurred in low-resource settings, and most used:
could have been prevented.
      </p>
      <p>Cardiotocographs (CTGs) is a simple and cost-accessible
option to assess fetal health, allowing healthcare
professionals to take action in order to prevent child and
maternal mortality. The equipment itself works by sending
ultrasound pulses and reading its response, thus shedding to check which one of them will obtain the highest
light on fetal heart rate (FHR), fetal movements, uterine accuracy.
contractions, and more.</p>
      <p>
        Artificial intelligence is very important in all in all the
aspects of modern life [
        <xref ref-type="bibr" rid="ref1 ref2 ref3">1, 2, 3</xref>
        ]. In medical areas it is used 2. The mathematical part of the
for the prognosis of some diseases, classification, and selected tool
even clustering. It can be seen in the research in this area.
      </p>
      <p>
        In [
        <xref ref-type="bibr" rid="ref4 ref5">4, 5</xref>
        ], the neural network were used for prediction • The k-nearest-neighbor clustering algorithm,to
covid-19 virus spread. Similar research was the analysis maximize the probability of finding the most
suitof mortality [
        <xref ref-type="bibr" rid="ref6">6</xref>
        ]. Again in [
        <xref ref-type="bibr" rid="ref7 ref8">7, 8</xref>
        ], the deep learning solu- able solution, searches for it among k most similar
tions were analyzed and discussed in terms of application solutions, and then chooses the most popular one
in medical image analysis tasks. Image analysis was also by voting.
used in the skin evaluation mechanism [
        <xref ref-type="bibr" rid="ref9">9</xref>
        ]. In medical The easiest way to determine the similarity is to
systems not only neural networks are used but also fuzzy use the distance, the smaller it is, the greater the
logic and computational intelligence. In [
        <xref ref-type="bibr" rid="ref10">10</xref>
        ], the fuzzy similarity is. In this case, was used Minkowski
sets approach was used in the evaluation of the health- metric [19].
• The k-nearest neighbours clustering algorithm [16].
• Naive Bayes classifier [17].
• Softsets [18].
where
︃( 
∑︁ | − |
=1
)︃1/
      </p>
      <p>(1)
 is the value from the sample vector.
id
1
baseline value
120.0
· · ·
· · ·
hist._tend</p>
      <p>1.0
7–11
(3)
(4)
2.1. A calculation example for our base
Assuming that our sample vector is shown in Tab. 2.</p>
      <p>And having a training set, the Minkowski metric was
used to calculate the distance between the sample vector
and the analyzed vectors of the training set:
2(, ) =
︃( 21
∑︁ | − |2
=1</p>
      <p>)︃1/2
where  is the value from the column of the sample
vector, and  is the value of the column of the currently
analyzed vector from the training set. In project was
assumed the value m = 2. After analyzing the entire
training set, the distances between the sample vector and
the training set vectors are sorted. Next, a neighborhood
is selected for the specified k nearest neighbors based
on the previously calculated distances, and the most
frequent label is selected.</p>
      <p>A naive Bayes classifier based on Bayes’ theorem:
 (|) =
 (|) ()</p>
      <p>()
is particularly suitable for problems with very many
dimensions in the input. Despite the simplicity of the
method, it often performs better than other very complex
classifier methods. The classifier learns by analyzing a set
of learning data for which the correct classes are given.</p>
      <p>The model includes  (| )-the probability of
observations for diferent class labels and  ( )-a prior
probability, which is the probability calculated before
the random experiment is performed. This is the
classical probability calculated in the same way as the overall
probability. Bayes’ rule is used to determine  ( |)-the
conditional probability of a class for a given observation.</p>
      <p>The label for which the probability is highest is chosen.</p>
      <p>The model is called naive because it assumes a very strong
simplification that says that for a fixed class label all are
features are independent of each other.
2.1.1. A calculation example for this base
Classify the object X = (133.0, ..., 0.0) for this table
(decision means 1.0 - Normal, 2.0 - Suspect, 3.0 - Pathological)
what is shown in Tab. 2.</p>
      <p>After assigning a column to a 1.0/2.0/3.0 group, it is
needed to determine which probability is higher.</p>
      <p>•  ( = 1|) e.g. P(decision = 1.0| base. val. =</p>
      <p>133.0, ..., hist._tend .= 0.0),
•  ( = 2|) e.g. P(decision = 2.0| base. val. =</p>
      <p>133.0, ..., hist._tend .= 0.0),
•  ( = 3|) e.g. P(decision = 3.0| base. val. =
133.0, ..., hist._tend .= 0.0)</p>
      <p>So there is the need to calculate  ( = 1) ·  ( =
1|),  ( = 2) ·  ( = 2|) and  ( = 3) ·
 ( = 3|) and compare the results.</p>
      <p>1.  ( =  ) = 13
2.  ( = []| =  ) = [] where
under i insert the number of the next column,
under [] the value of that column, and
under [probability] the calculated probability value,
 ∈ {1, 2, 3}.</p>
      <p>Then it is needed to substitute the calculated values
into the formula:</p>
      <p>21
 ( =  · ∏︁  ( = | =  )) = [ ] (5)</p>
      <p>=1</p>
      <p>It is checked which result (probability value) is greater
which determines which class the object X should be
classified in.</p>
      <p>• Soft sets are defined by a set of properties which,
however, are not completely precise (e.g. instead
of saying that it is 15∘ C outside one can say that
it is warm). The general theory of soft sets is very
similar to that of fuzzy sets but much simplified.</p>
      <p>Thanks to the fact that there are no restrictions
on the approximate description of the object, it is
very easy to apply this method in practice.</p>
      <p>Mathematical assumptions: U - the class of all
elements considered. E - parameter class P(U)
- set of all subsets of U  ⊆  - components
considered
So the pair (F,A) is called a soft set, where F is an
assignment:
 :  →  ( )</p>
      <p>(6)</p>
      <sec id="sec-1-1">
        <title>Calculation example:</title>
        <p>−
−</p>
      </sec>
      <sec id="sec-1-2">
        <title>U - fetal health class</title>
        <p>E - a set of parameters that determine the
health of the fetus</p>
        <p>A = {baseline value, ..., hist._tend.}
−
The class consists of three health states.
U = {Normal, Suspect, Pathological}
E = {1, · · · , 21 }
What follows is the definition of subsets
specifying the characteristics that health states satisfy
given assumptions , where  ∈ 1 : 21:
F(1) = {Normal}
F(2) = {Normal, Suspect}
...</p>
        <p>F(20) = {Pathological}
F(21) = {Normal}
Based on this, a soft set table can be created (see
Tab. 3).</p>
        <p>Due to the simplicity of this system, subsets of
a soft set can be determined very easily. E.g. (F,
A) is a subset of(G,B)if  ⊂  and ∀∈ ∈ 1 and
 (∈) and (∈) are the same. Two soft sets will
be equal when the previous poset condition is
satisfied and when ( G,B) is also a poset of (F, A).</p>
      </sec>
    </sec>
    <sec id="sec-2">
      <title>3. Description of the database</title>
      <p>The project was used a ready-made database, which can
be downloaded at [20].</p>
      <p>The database consists of one table with 22 columns. 21
columns are numerical data defining the CTG study and
the last text column defines the fetal status.</p>
      <p>Description of the columns:
• ’baseline value’- FHR baseline (beats per minute).
• ’accelerations’ - Number of accelerations per
second.
• ’fetal_movement’- Number of fetal movements
per second.
• ’uterine_contractions’ - Number of uterine
contractions per second.
• ’light_decelerations’- Number of light
decelerations per second.
• ’severe_decelerations’ - Number of severe
decelerations per second.
• ’prolongued_decelerations’- Number of prolonged
decelerations per second.
• ’abnormal_short_term_variability’- Percentage
of time with abnormal short term variability.
• ’mean_value_of_short_term_variability’ - Mean
value of short term variability.
• ’percentage_of_time_with_abnormal_long_term_
variability’ - Percentage of time with abnormal
long term variability.
• ’mean_value_of_long_term_variability’- Mean
value of long term variability.
• ’histogram_width’ - Width of FHR histogram
• ’histogram_min’- Minimum (low frequency) of</p>
      <p>FHR histogram.</p>
    </sec>
    <sec id="sec-3">
      <title>4. Tests</title>
      <p>10 tests were performed for each system and extracted
the average values, obtaining the following results:
• ’histogram_max’ - Maximum (high frequency) of For all k achieved average precision values were around</p>
      <p>FHR histogram. 90, which is considered to be a very good result, and it
• ’histogram_number_of_peaks’ - Number of his- is concluded that this algorithm performs very well for
togram peaks. the database. Unfortunately, a big disadvantage for this
• ’histogram_number_of_zeroes’ - Number of his- algorithm is the execution time against a large database.</p>
      <p>togram zeros. In each iteration, for each validation sample, distances
• ’histogram_mode’ - Histogram mode. to nearest neighbors are recalculated and sorted anew,
hence the execution time for the database, for one
itera• ’histogram_mean’- Histogram mean. tion was about 173 seconds.
• ’histogram_median’- Histogram median. In the naive Bayes classifier algorithm, the final results
• ’histogram_variance’- Histogram variance. are not as satisfactory as in the k-nearest neighbor
clus• ’histogram_tendency’ - Histogram tendency. tering algorithm. The average precision obtained for 10
iterations was about 82%. This is not a bad result, but
compared to the previous algorithm, a significant
diference can be seen. It was also checked if the algorithm
would improve its final result when splitting the data
80:20 for training and validation data. Unfortunately,
the precision did not improve. The advantage of this
∙ A k-nearest neighbours clustering algorithm: algorithm is the speed of its execution, oscillating around
0.3 seconds.
− for  = 1 : 90.61% For classification using soft sets, an average obtained
− for  = 2 : 90.24% accuracy was oscillating 82%. The execution time of
− for  = 3 : 90.39% the algorithm for 1 iteration was about 4 seconds. In
− for  = 3 : 90.39% this method, quarterlies were used due to the strongly
∙∙ SNoafitvseeBtsa:y8es2-.n7e7a%rest-neighbour classifier: 82.43% oovfeGthrrleaappaplhgisnogrciotchmhmaprsaarucitsneegrdistihtniecosauocrfcputhrroeajcCeycTtaGanrdseuesrxhveoecywusntaioinnnalFytiizgme.de1.
and 2.</p>
    </sec>
    <sec id="sec-4">
      <title>5. Experiments</title>
      <p>For each of them, a certain number of tests were
performed and extracted average values to better specify the
ifnal result.</p>
      <p>In the k-nearest neighbor clustering algorithm using
the Minkowski metric, 10 tests were performed each for
diferent k, where k was assumed to be 1, 2, 3, and 4.</p>
    </sec>
    <sec id="sec-5">
      <title>6. Conclusions</title>
      <p>After an accuracy comparison, the k-nearest-neighbor
clustering algorithm proved to be the best. However,
its execution time was incomparably longer than in the
other cases. So if we look at the overall optimality of the
performance, the Bayes algorithm with a slightly worse</p>
    </sec>
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