<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Archiving and Interchange DTD v1.0 20120330//EN" "JATS-archivearticle1.dtd">
<article xmlns:xlink="http://www.w3.org/1999/xlink">
  <front>
    <journal-meta>
      <journal-title-group>
        <journal-title>May</journal-title>
      </journal-title-group>
    </journal-meta>
    <article-meta>
      <title-group>
        <article-title>Artificial Intelligence in Decision Making System</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Saswati Chatterjee</string-name>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Suneeta Satpathy</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Sri Sri University</institution>
          ,
          <addr-line>Cuttack Odisha</addr-line>
        </aff>
        <aff id="aff1">
          <label>1</label>
          <institution>Sunstone Eduversity</institution>
          ,
          <country country="IN">India</country>
        </aff>
      </contrib-group>
      <pub-date>
        <year>2022</year>
      </pub-date>
      <volume>1</volume>
      <fpage>7</fpage>
      <lpage>19</lpage>
      <abstract>
        <p>There is a way to transmute in Medical Management by implementing Artificial Intelligence techniques. The latest techniques are being incorporated into the research technologies. It shows a way for the experts to deliver accurate, consistent, and knowledgeable results. It incorporates the liability as well as clarity reasoning utilized by AI-associated systems dynamically. The main issues to appear with these moderations include accountability as well as a clear concept made by AI-based systems. These are also been elevated from scientific bias. These can be well-adjusted and can be stable against the necessities of making community benefit in a systematic way. AI can be employed in numerous organized and unorganized data in medical analysis. The techniques include different methods like support vector machines and some other networks for those unorganized data. For this, some AI tools must be employed. It will be effective in medical analysis massively, in connection with detailed calculations, and meaningful analysis on the basis of the outcomes. The study enforces the corresponding approach for Big Data together with healthcare for exploration based on these complications (Xafis et al. 2019). The exploration spread over in terms of appropriate standards. Depending upon this the analyzer can interpret data for spreading and employing AI-based systems in medical analysis with the experimentation properly and accurately. However, Artificial Intelligence plays a significant role in acting as black boxes that is characteristics as well as the quantity, computation, and techniques would be moderated properly by the experts. Reaching out to this point of measure, black-box medicine will point out this. In this research paper, how the black box deals with the patient-centered medicine that needs to be executed.</p>
      </abstract>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>1. Introduction</title>
      <p>
        A large portion of healthcare is increasingly being transformed by artificial intelligence (AI).
Usually, these AI systems use automated systematic analysis. These algorithms are used to
filter, incorporate, look for patterns in massive data sets from multiple sources, and then
generate a probability analysis that may be used as the basis for choices by healthcare
practitioners. Most experts do not certify these techniques to be the ultimate resolution.
They used some screening tools alternatively for scrutiny. These learning tools along with
the data survey have been used predominantly in the study with patient electronic
wellbeing reports. These data can be endured on a reliable server. The growing analytical tool
of using hardware and the algorithm-based AI is empowering the platform outline linked
with EHRs with the various origin of data viz the exploration of biomedical data,
pathological data along with the information gathered from Internet of Things (IoT) devices
can also be mentioned.
The collection of these huge data can produce related information for clinical experts,
administrators of clinical professionals, and policymakers. Implementing the
techniques of machine learning with the concept of fuzzy logic, and artificial neural
networks,
        <xref ref-type="bibr" rid="ref2">(Wagholikar et al.2012)</xref>
        the Clinical Decision Support Systems (CDSS) were
also automated. In addition, CDSS with learning algorithms is at present underneath a
growth to support clinicians with their decision-making built upon past effective
diagnoses, treatment, and projection. Due to the rapid development of advanced
technology AI systems have consistency as well as flawless accuracy compared in
diagnosing ailments. It helps the physicians by letting them proper data from various
sources to provide beneficial guidance to the patient. To reduce errors and provide
valid information AI systems draws a vital role. For better results, it gives suitable data
considering a huge patient population.
      </p>
    </sec>
    <sec id="sec-2">
      <title>2. Literature Review</title>
      <p>
        To obtain the data in terms of medical terminology is command over the information
predominantly
        <xref ref-type="bibr" rid="ref3">(McGibbon et al. 2008; National Academies of Science 2017)</xref>
        . The
chances for CDSS to gain that data effectively on medical services.
      </p>
      <p>
        Appropriate Decision making, implementing previous experiences is important to
explore the possible steps and activities for making consequent actions over it. (Jain,
S., &amp; Patel, A. (2020))
Due to the rapid progress of data in the CDSS platform can be authenticated, and
circulated to others which is exterior to the doctor-patient relationship. For the
purpose of analysis, the investigators and authorities can choose to collect accurate
data.
        <xref ref-type="bibr" rid="ref6">(Lim 2017)</xref>
        .
      </p>
      <p>
        Doctors will increasingly play the main role in the One moral inference of the limit
        <xref ref-type="bibr" rid="ref7">(Kass et al. 2013)</xref>
        for both medical analyzers and experts interrelating with the CDSS.
There are some conflict possibilities that can appear when clinicians have the
realizations to record the data in EHR for exploring impedes the specializations for
the patient’s welfare (Goodman 2010).
      </p>
      <p>
        Information is produced on the basis of doctors based on the App in their
conversation with patients to explore or affect the patient-doctor relationship.
indication to recommend those patient results outlooks effects extreme use of
nonbeneficial actions
        <xref ref-type="bibr" rid="ref9">(Berge et al. 2005)</xref>
        .
      </p>
      <p>
        AI-aided predictive scoring systems help apparently in contradictory orders. Those are
comparable for prediction, for example, APACHE
        <xref ref-type="bibr" rid="ref10">(Niewinski et al. 2014)</xref>
        , as an extra
advantage, for further clarifications and substantial period for experts in incoming
information as this can be routinely recovered
For analyzing as well as evaluation purposes deep learning networks have been
implemented
        <xref ref-type="bibr" rid="ref11">(Jiang et al. 2017)</xref>
        . Certainly, categorizing those have on current
inclusive meta-analysis Liu et al. (2019)
Comparing the review, numerous orientations have been employed, which, rendering
the researchers, providing the explanations as well as the efficient analysis of
countless reviews roughly”
        <xref ref-type="bibr" rid="ref12">(Loh 2018, p. 59)</xref>
        .
      </p>
      <p>
        Obermeyer and Emanuel (2016) predicted theoretically the approaches that draw on
learning strategies for their upcoming study
        <xref ref-type="bibr" rid="ref13">(Obermeyer and Emanuel 2016, p. 1218)</xref>
        .
It has been permitted that the primary device which has been used for AI purposes
offers to screen and aided clarification b9y7 an expert
        <xref ref-type="bibr" rid="ref14">(US Food and Drug Administration
2018)</xref>
        .
      </p>
      <p>Recently explained by Ploug and Holm (2019), the patients have proper analysis to
pull out from AI-related diagnostics as well as treatment.</p>
      <p>
        Despite the exactness, the learning methodologies can be considered. Though the
Creators make out the planned architecture of the systems and the procedure to build
up the models used for cataloging, it itself is not readable
        <xref ref-type="bibr" rid="ref16">(London 2019, p. 17)</xref>
        Relatively, coming to the learning systems, the controlling way provides “far better for
presenting the chosen behavior related to it accordingly by anticipating the possible
outcomes with the probable values”
        <xref ref-type="bibr" rid="ref17">(Jordan and Mitchell 2015, p. 255)</xref>
        .
The procedure needs to compute input that is dissimilar [learning systems] are
identical, which can be categorically different
        <xref ref-type="bibr" rid="ref18">(Schubbach 2019, p. 15)</xref>
        Pointing some significant alterations depending upon the choice concentration faith
inpatient care. the eminent way of elucidations and belief of receiving proper
decisions”
        <xref ref-type="bibr" rid="ref19">(Binns et al. 2018, p. 377)</xref>
        .
      </p>
      <p>Spontaneously, supervisory analysis, enlightens the cause based on AI forecast,
according to the probabilistic belief and performance-based upon forecasting. Witness
Ribeiro et al. (2016):</p>
    </sec>
    <sec id="sec-3">
      <title>3. Black-Box Medicine</title>
      <p>Mostly in Medical management, Artificial Intelligence can be alienated that operates on
organized data and systems that function on unorganized data. The organized data
encompasses genetic as well as imaging data which contain Learning methodologies
along with deep learning networks.</p>
      <p>
        These kinds of networks have been executed in evaluating related with medical
images and for evaluation
        <xref ref-type="bibr" rid="ref21">(Esteva et al. 2017,)</xref>
        . Moreover, inventors of these learning
systems declare the correctness which is more advanced than skilled experts in ranges
from imaging (MRI) interpretation,
Operating on the unorganized data comparatively used in analyzing cause relatively as
a tool for clarifying the data from sources for example reports that are generated from
the clinical experts for supporting medical analysis. Due to the development of the
technology algorithms are considered to be enormous probable value comparable to
AI systems. These algorithms are perhaps applied to interpret data from numerous
sources.
      </p>
      <p>Utilizing automated image recognition leads to progress in recent years because of
qualitative data. Recently data can be employed for better upgrading purposes to
expand the quality. In this connection, the outline of the result doesn’t provide that
deep learning systems usually surpass experts as well as clinicians.</p>
      <p>According to De Fauw et al. (2018), deviations that present the technology as well as
experts, are significantly concentrated when experts can interpret the data—viz.
patient history as well as medical analysis—generally utilize the data for the
experiment. For assumptions considered to be the procedure
There is a correlation between the quantity of data that a clinician has and the
stepbased applications. In addition, experts can access the data with a skilled one the
previous one might be effective to in terms of the output. Considering that AI systems
can accumulate the data comparatively from the expert human practitioners.
However, the outcomes stating no such distinction can be made by measuring with the
data which trace the clinical data. for example, enlightened with the dissimilar data
augmented by amalgamating various distinct data After doing the experiment the
Researchers claimed that this kind of system validity is much more impact over the
areas where there is a concept of MRI. The idea behind this in the cases of radiation
necrosis out of frequent discrimination of brain tumors SVM has been implemented.</p>
    </sec>
    <sec id="sec-4">
      <title>3. Patient-Centered Medicine</title>
      <p>
        In medical analysis, the extended outside the thought can be considered as diseases:
“Current areas some contemporaries have defined as a pattern swing emphasis on
targeted- person-oriented wellbeing. Medicine was primarily spotlighted on the
eviction of (severe) symptoms According to the World Health Organisation (WHO) in
1946, the classification articulated as to highlight that health was defined
not only by the nonappearance of disease, moving towards “patient-centred care”
which was gradually forms the basis
        <xref ref-type="bibr" rid="ref23">(De Maeseneer et al. 2012, p. 602)</xref>
        . Subsequently
not even skilled data scientists, may be able to elucidate the cause of a specific
outcome is associated in terms of input. Through learning methodologies acting as
major examples, categorizing with other system there is a command on the inputs
and detect the consistent outcome, where there is no clarification of why the input is
interrelated with the output.
      </p>
      <p>Categorizing “Black-box medicine” the area of medical terminology It act as a vital
role in decision-making. Considering other groups, wherever “AI-informed medicine”
can be acknowledged, defines experimentations in terms of learning system—it may
be obscure or translucent—playing an crucial role.</p>
    </sec>
    <sec id="sec-5">
      <title>3.1 Turbidity in Medical Decision-Making</title>
      <p>Until now the complications included in the fundamental principles of comparing
with the applications related to both types of medicine. Though medicine is the
earliest creative one the information of basic is from the inception. As a consequence,
decisions that are theoretic, as well as obscure are commonly in medicine. Reviewing
an instance where experts applied a technique to analyze for a specific disease.
Although the experts are aware with the than previous ones. So far, the experts
underneath a specific function to trust on the methodology. It is obvious that specific
practitioners may often be even extremely undefined about how exact technological
assistances really operate.</p>
      <p>But there is often analyser who grab the appropriate information. Medical experts,
researchers, or extra types of specialists who could, if possible, interpret definite
scientific aids for example blood testing approaches work. Rather ambiguity on
specific data, experts decode accordingly. This varies with the usage of the previous
system. Dealing with previous systems, valuable clarifications not needed.
Considering the experts suggests a remedy for the betterment of the patient, and
assuming consequently. The experts provide other accessible procedures.
subsequently no individuals can enlighten the utility of these drug along with the
applied alterations imperviousness with the previous one. Approximately both types
of decision making in medicine provide purely correlational report
It looks, there are vital distinction. Though there is no such description of using a certain
given medicine probable and valuable data that can permit to obtain of knowledgeable data.
In a distinctive way, viz, the expert can access numerous elementary facts about the drug</p>
    </sec>
    <sec id="sec-6">
      <title>4. Machine Learning</title>
      <p>To extract features from data Machine Learning builds data analytical algorithms. In
Machine Learning algorithms the probable value contains reports based on the outputs.
Based upon those qualities usually comprise details of diseases as well as detailed data
related to diseases, for example, the reports generated from the examination results,
quantifiable signs, etc.</p>
      <p>Medical outputs, such as illness markers and quantifiable disease levels, are typically
included in clinical research analysis. Based on the integration of the results, ML
algorithms may be divided into two primary categories: unsupervised learning and
supervised learning. In contrast to supervised learning, which is suitable for analytical
modeling by creating relationships between the patient input and the result as an
output, unsupervised learning can be utilized for feature extraction. Semi-supervised
learning, which has recently been portrayed as a combination of unsupervised and
supervised learning, is suitable for situations in which the results for some subjects are
unknown.</p>
      <p>Two popular techniques are clustering as well as principal component analysis (PCA).
These are related with analogous inputs along with the clusters. These can be utilized
with the use of Clustering algorithms. Commonly it contains k-means clustering. For
dimension reduction technique, PCA can be used. specifically, when the input can be
generated in terms of huge analysis. Without losing the information PCA can be
projected. PCA which is used to decrease and routine clustering consequently.
Considering the outputs of the supervised learning, and undergo to evaluate the
finest outcome related with the nearby value which considers on regular basis.
Typically, these value inventions fluctuate. such as, considering these values there is a
probability to predict the value within the probable subsistence time.</p>
      <p>Obviously, associated with other learning technology provides appropriate results;
henceforth this learning is preferable in medical terminology.</p>
      <p>Regression analysis, discriminant analysis, support vector machines (SVM), and
neural networks are examples of related techniques. Obviously, contrasting with
other learning technology delivers further appropriate outcomes; henceforth AI
applications is applicable in healthcare with the use of supervised learning. (In
101
Unsupervised learning the phase to decrease and classify the results and provide an
extra efficient way.)
In medical applications, evidently depicts that SVM as well as a neural network are
the prevalent ones. As a result, when constraining the other types displayed in figure
4.</p>
    </sec>
    <sec id="sec-7">
      <title>5. Neural network</title>
      <p>Since a Neural network is an add-on comparing with the linear regression amid the
variables that can be employed with the result. The relations amongst the consequence
with the values are shown as a hidden layer summation of the predefined basis. The
objective is to evaluate the weights with the resulting information so as to the normal error
among the consequence and their estimates is minimized
for that seed has been depicted. It can be observed from Fig.4(c), that when the seed is around
5000 the mean square error is minimum. It increases both decreasing the seed value as well
as increasing the seed value. It is shown that before the feature selection of the most
important features, the mean square error was 37.13% which was reduced to 28.92%. Although
the number of generations taken for the average and best features in graphs Fig.4(a) and
Fig.4(b) to reduce the fitness score (lesser the score, better the generation) is a little lesser
compared to Fig.4(c)
i.e., on a seed value of 5008, it is compensated by the reduced mean square error. This score
hugely depends on the initial seed value. Fig.5a shows the time required by the neural network
to train at different Epoch values. Fig.5b depicts that when we increase the batch size the time
taken to train the neural network gets reduced. With the increase in batch size, the loss value
decreases up to a certain batch size which is shown in Fig.5c. We get the least loss value at a
batch size equal to 500 and after that increasing the batch size decrease the time takenby the
neural network to get trained but it also increases the loss value. After getting a trainedneural
network we run the test data set on the system and the observations made on the output are
mentioned below. Accuracy = 99.94% Loss Value = 0.561%
6. Support vector machine
A significant characteristic of SVM is the purpose to employ the problem in an optimization
technique. for this, the result is continuously evaluated. Moreover, numerous prevailing
optimization tools are voluntarily relevant for this kind of application. For example, it has
been broadly used in research analysis. Such as Orrù et al
To categorize with the other types of neurological reports. Sweilam et al revised the usage
for the experimental purpose. It has been measured as an extra statistical tool to detect the
disease. Khedher et al. To validate with this SVM an interface should be measured. . Farina
et al</p>
    </sec>
    <sec id="sec-8">
      <title>7.Deep learning:</title>
      <p>Deep learning is a modern improvement on the neural network technique. The deep
learning can be observed as this kind of network considering the various layers (as
shown in the figure). Speedy growth of modern technology allows this learning to
formulate this network measuring the huge layers, which is impracticable with other
networks. It analyses more complexion- patterns of information.</p>
      <p>Figure 7 depicts the area of explore closely. Further using the analysis, provides an
idea obviously. Unlike other network, it uses extra layers for this the methodology
can grasp complicated and numerous values. Depending on the medical technology, it
contains deep belief network associating with the further network.</p>
      <p>The CNN was created in response to the traditional ML algorithms' failure to handle
highly dimensional data with a large number of inputs. The data is investigated by the
ML algorithm outline.Though the data are certainly extent measured due to the
values individually that covers the inputs. The way to accomplish this technique:
primarily predetermine the features, next complete the techniques based upon
resultant features. Howsoever heuristic feature election measures can lose data.</p>
      <p>Deep learning uses additional hidden layers in contrast to the standard neural
network in order for the algorithms to switch complex input with many structures.
Convolution neural network (CNN), recurrent neural network, deep belief network,
and deep neural network are the typical deep learning methods based on medical
applications.</p>
      <p>Lecun et al. initially anticipated and supported CNN in order to measure extent. The
right values are being implemented for CNN. Instead, it transmits the values over
increment in the convolution layers as well as other layers. The ultimate outcome is a
measure depending upon some values. It is been reduce the normal fault among the
results with the calculations.</p>
      <p>Newly, it has been effectively executed in the medical field to support disease
diagnosis. It has been used by Long et al for the experimental purpose. It produces
correctness on experimental basis as well as medical proposal.</p>
    </sec>
    <sec id="sec-9">
      <title>8.Natural language processing</title>
      <p>The data which are machine-dependent for the algorithms can be achieved after
appropriate pre-processing and depending procedures. Though, huge data for
example physical inspection, laboratory reports as well as release synopses, that are
not in proper format and inexplicable for the computer program. Underneath, NLP
focus on fetching proper data to provide medical support.</p>
      <p>The chief components associated with NLP: (1) text processing and (2) classification.
With this it classifies the records building on the previous databases. Choosing a
proper code which can be chosen through exploratory as well as on different cases.
The authentication can be enlightening the organized data to implement clinical
decision making.</p>
    </sec>
    <sec id="sec-10">
      <title>9. Conclusion</title>
      <p>A comparison had been made with other medicine technology skirmishes with
patientcentered medicine. Though, the previous one is not favorable for providing information
built on data, among experts and patients. Through focus is on cantered medicine analysis.
But the previous medical method provides indication-based medicine. Originally, it
appears as if the previous medical method is the final indication.</p>
      <p>Obviously, experts continuously provide decisions based on indication, the analysis goes—
trusted on indication which was inaccurate based on, the consequences from randomized
measured inputs and numerous values evaluate that information. Based on these,
minimizing the effects of personal biases and views. As far as black-box systems can
provide references, can collect the indications into thought for—so previous medical
method tallies the appearance based upon those medicine technology. Measuring this fact,
both can be compared, and can analyze by viewing the evidence collates with the other
ones.</p>
      <p>This can be noteworthy, not reasonable on additional formulation depending upon the
evidence. It has been envisaged that those evidence-—classically grades evidence
implemented from randomized measured input evaluates the order that supports medical
decision-making in this paper, the discussion is based on one-dimensional black-box
medicine as it a vital in the research exploration. Though there are some factors which is a
backdoor to affect the scope. For example, in patient-centered medicine, there is a concept
105
of opacity Which consider a basis in medical analysis. It has been found that the history of
patients is quite huge but it takes place less in healthcare. Similarly, we haven’t pondered
the cases where the black box function as an autonomous system that maintain medical
references straight to patients without proper human interaction. So, there is a graph
where opacity glitches will rise in terms of the degree of human interaction declines. The
distinctions between autonomous checkers and chatbots are the muddling factors that can
have an explicit discussion for future work.</p>
    </sec>
  </body>
  <back>
    <ref-list>
      <ref id="ref1">
        <mixed-citation>
          [1]
          <string-name>
            <given-names>]</given-names>
            <surname>Xafis</surname>
          </string-name>
          , Vicki,
          <string-name>
            <given-names>G.</given-names>
            <surname>Owen</surname>
          </string-name>
          <string-name>
            <given-names>Schaefer</given-names>
            ,
            <surname>Markus K. Labude</surname>
          </string-name>
          , Iain Brassington, Angela Ballantyne, Hannah Yeefen Lim,Wendy Lipworth, Tamra Lysaght, Cameron Stewart, Shirley
          <string-name>
            <surname>Hsiao-Li</surname>
            <given-names>Sun</given-names>
          </string-name>
          , Graeme T. Laurie, and
          <string-name>
            <given-names>E. Shyong</given-names>
            <surname>Tai</surname>
          </string-name>
          .
          <year>2019</year>
          .
          <article-title>An Ethics Framework for Big Data in Health and Research</article-title>
          .
          <source>Asian Bioethics Review</source>
          <volume>11</volume>
          (
          <issue>3</issue>
          ). https://doi.org/10.1007/s41649-019-00099-xM. S.
          <string-name>
            <surname>Kumar</surname>
            ,
            <given-names>V.</given-names>
          </string-name>
          <string-name>
            <surname>Soundarya</surname>
            ,
            <given-names>S.</given-names>
          </string-name>
          <string-name>
            <surname>Kavitha</surname>
            ,
            <given-names>E.</given-names>
          </string-name>
          <string-name>
            <surname>Keerthika</surname>
          </string-name>
          , E. Aswini,
          <article-title>Credit card fraud detectionusing random forest algorithm</article-title>
          ,
          <source>2019 3rd International Conference on Computing and Communications Technologies (ICCCT)</source>
          (
          <year>2019</year>
          )
          <fpage>149</fpage>
          -
          <lpage>153</lpage>
          .
        </mixed-citation>
      </ref>
      <ref id="ref2">
        <mixed-citation>
          [2]
          <string-name>
            <surname>Wagholikar</surname>
            ,
            <given-names>Kavishwar B.</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Vijayraghavan</surname>
            <given-names>Sundararajan</given-names>
          </string-name>
          , and
          <string-name>
            <surname>Ashok</surname>
            <given-names>W.</given-names>
          </string-name>
          <string-name>
            <surname>Deshpande</surname>
          </string-name>
          .
          <year>2012</year>
          .
          <article-title>ModelingParadigms for Medical Diagnostic Decision Support: a Survey and Future Directions</article-title>
          .
          <source>Journal ofMedical Systems</source>
          <volume>36</volume>
          (
          <issue>5</issue>
          ):
          <fpage>3029</fpage>
          -
          <lpage>3049</lpage>
          . https://doi.org/10.1007/s10916-011-9780-4.
        </mixed-citation>
      </ref>
      <ref id="ref3">
        <mixed-citation>
          [3]
          <string-name>
            <surname>McGibbon</surname>
            ,
            <given-names>E.</given-names>
          </string-name>
          ,
          <string-name>
            <given-names>J.</given-names>
            <surname>Etowa</surname>
          </string-name>
          , and
          <string-name>
            <given-names>C.</given-names>
            <surname>McPherson</surname>
          </string-name>
          .
          <year>2008</year>
          .
          <article-title>Health-Care Access as a Social Determinant of Health</article-title>
          .
          <source>The Canadian Nurse</source>
          <volume>104</volume>
          (
          <issue>7</issue>
          ):
          <fpage>22</fpage>
          -
          <lpage>27</lpage>
          . National Academies of Science, Engineering, and Medicine.
          <year>2017</year>
          . Communities in Action: Pathways to Health Equity. Washington DC: The National Academies Press. https://doi.org/10.17226/24624
        </mixed-citation>
      </ref>
      <ref id="ref4">
        <mixed-citation>
          [4]
          <string-name>
            <surname>Farina</surname>
            <given-names>D</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Vujaklija</surname>
            <given-names>I</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Sartori</surname>
            <given-names>M</given-names>
          </string-name>
          , et al.
          <article-title>Man/machine interface based on the discharge timings of spinal motor neurons after targeted muscle reinnervation</article-title>
          .
          <source>Nat Biomed Eng</source>
          <year>2017</year>
          ;
          <volume>1</volume>
          :
          <fpage>0025</fpage>
          ..
        </mixed-citation>
      </ref>
      <ref id="ref5">
        <mixed-citation>
          [5]
          <string-name>
            <surname>Jain</surname>
            ,
            <given-names>S.</given-names>
          </string-name>
          , &amp;
          <string-name>
            <surname>Patel</surname>
            ,
            <given-names>A.</given-names>
          </string-name>
          (
          <year>2020</year>
          ).
          <article-title>Situation-aware decision-support during man-made emergencies</article-title>
          .
          <source>In Proceedings of ICETIT 2019</source>
          (pp.
          <fpage>532</fpage>
          -
          <lpage>542</lpage>
          ). Springer, Cham
        </mixed-citation>
      </ref>
      <ref id="ref6">
        <mixed-citation>
          [6]
          <string-name>
            <surname>Lim</surname>
            ,
            <given-names>Hannah</given-names>
          </string-name>
          <string-name>
            <surname>Yeefen</surname>
          </string-name>
          .
          <year>2017</year>
          .
          <article-title>Data Protection in the Practical Context - Strategies and Techniques</article-title>
          . Singapore: Academy Publishing Singapore.
        </mixed-citation>
      </ref>
      <ref id="ref7">
        <mixed-citation>
          [7]
          <string-name>
            <given-names>]</given-names>
            <surname>Kass</surname>
          </string-name>
          ,
          <string-name>
            <given-names>Nancy E.</given-names>
            ,
            <surname>Ruth</surname>
          </string-name>
          <string-name>
            <given-names>R.</given-names>
            <surname>Faden</surname>
          </string-name>
          ,
          <string-name>
            <given-names>Steven N.</given-names>
            <surname>Goodman</surname>
          </string-name>
          ,
          <string-name>
            <given-names>Peter</given-names>
            <surname>Pronovost</surname>
          </string-name>
          , Sean Tunis,
          <string-name>
            <given-names>and Tom L.</given-names>
            <surname>Beauchamp</surname>
          </string-name>
          .
          <year>2013</year>
          .
          <article-title>The Research-Treatment Distinction: A Problematic Approach for Determining Which Activities Should Have Ethical Oversight</article-title>
          .
          <source>Hastings Center Report</source>
          <volume>43</volume>
          (
          <year>s1</year>
          ):
          <fpage>S4</fpage>
          -
          <lpage>S15</lpage>
          . https://doi.org/10.1002/hast.133
        </mixed-citation>
      </ref>
      <ref id="ref8">
        <mixed-citation>
          [8]
          <string-name>
            <surname>Goodman</surname>
            ,
            <given-names>Kenneth W.</given-names>
          </string-name>
          <year>2015</year>
          . Ethics, Medicine, and Information Technology:
          <article-title>Intelligent Machines and the Transformation of Health Care</article-title>
          . Cambridge: Cambridge University Press.
        </mixed-citation>
      </ref>
      <ref id="ref9">
        <mixed-citation>
          [9]
          <string-name>
            <surname>Berge</surname>
            ,
            <given-names>Keith H.</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Deborah</surname>
            <given-names>R.</given-names>
          </string-name>
          <string-name>
            <surname>Maiers</surname>
            ,
            <given-names>David P.</given-names>
          </string-name>
          <string-name>
            <surname>Schreiner</surname>
          </string-name>
          ,
          <string-name>
            <surname>Stephen M. Jewell</surname>
          </string-name>
          , Perry S. Bechtle,
          <string-name>
            <surname>Darrell R.Schroeder</surname>
          </string-name>
          ,
          <string-name>
            <surname>Susanna R. Stevens</surname>
          </string-name>
          , and William L. Lanier.
          <year>2005</year>
          .
          <article-title>Resource Utilization and Outcome in Gravely Ill Intensive Care Unit Patients with Predicted In-Hospital Mortality Rates of 95% or Higher by APACHE III Scores: the Relationship with Physician and Family Expectations</article-title>
          .
          <source>Mayo Clinic Proceedings</source>
          <volume>80</volume>
          (
          <issue>2</issue>
          ):
          <fpage>166</fpage>
          -
          <lpage>173</lpage>
          . https://doi.org/10.4065/80.2.166.
        </mixed-citation>
      </ref>
      <ref id="ref10">
        <mixed-citation>
          [10]
          <string-name>
            <surname>Niewinski</surname>
            ,
            <given-names>G.</given-names>
          </string-name>
          ,
          <string-name>
            <given-names>M.</given-names>
            <surname>Starczewska</surname>
          </string-name>
          ,
          <article-title>and</article-title>
          <string-name>
            <given-names>A.</given-names>
            <surname>Kanski</surname>
          </string-name>
          .
          <year>2014</year>
          .
          <article-title>Prognostic Scoring Systems for Mortality in Intensive Care Units-the APACHE Model</article-title>
          .
          <source>Anaesthesiol Intensive Therapy</source>
          <volume>46</volume>
          (
          <issue>1</issue>
          ):
          <fpage>46</fpage>
          -
          <lpage>49</lpage>
          . https://doi.org/10.5603/ait.
          <year>2014</year>
          .0010J.
        </mixed-citation>
      </ref>
      <ref id="ref11">
        <mixed-citation>
          [11]] Jiang, Fei, Yong Jiang, Hui Zhi, Yi Dong,
          <string-name>
            <given-names>Hao</given-names>
            <surname>Li</surname>
          </string-name>
          , Sufeng Ma, YilongWang, Qiang Dong,
          <string-name>
            <given-names>Haipeng</given-names>
            <surname>Shen</surname>
          </string-name>
          ,
          <string-name>
            <given-names>and Yongjun</given-names>
            <surname>Wang</surname>
          </string-name>
          .
          <source>2017. Artificial Intelligence in Healthcare: Past, 106 Present and Future. Stroke and Vascular Neurology</source>
          <volume>2</volume>
          (
          <issue>4</issue>
          ):
          <fpage>230</fpage>
          -
          <lpage>243</lpage>
          . https://doi.org/10.1136/svn-2017-000101.
        </mixed-citation>
      </ref>
      <ref id="ref12">
        <mixed-citation>
          [12]
          <string-name>
            <surname>] Loh</surname>
            ,
            <given-names>E.</given-names>
          </string-name>
          (
          <year>2018</year>
          ).
          <article-title>Medicine and the rise of the robots: a qualitative review of recent advances of artificial intelligence in health</article-title>
          .
          <source>BMJ Leader</source>
          ,
          <volume>2</volume>
          ,
          <fpage>59</fpage>
          -
          <lpage>63</lpage>
          .
        </mixed-citation>
      </ref>
      <ref id="ref13">
        <mixed-citation>
          [13]
          <string-name>
            <surname>] Obermeyer</surname>
            ,
            <given-names>Z.</given-names>
          </string-name>
          , &amp;
          <string-name>
            <surname>Emanuel</surname>
            ,
            <given-names>E. J.</given-names>
          </string-name>
          (
          <year>2016</year>
          ).
          <article-title>Predicting the future-big data, machine learning, and clinical medicine</article-title>
          .
          <source>The New England journal of medicine</source>
          ,
          <volume>375</volume>
          (
          <issue>13</issue>
          ),
          <fpage>1216</fpage>
          -
          <lpage>1219</lpage>
          .
        </mixed-citation>
      </ref>
      <ref id="ref14">
        <mixed-citation>
          [14]
          <string-name>
            <given-names>US</given-names>
            <surname>Food and Drug Administration</surname>
          </string-name>
          . (
          <year>2018</year>
          ).
          <article-title>FDA permits marketing of artificial intelligence-based device to detect certain diabetes-related eye problems</article-title>
          . News Release,
          <source>April (retrieved online Accessed August</source>
          <volume>7</volume>
          ,
          <year>2018</year>
          ).
        </mixed-citation>
      </ref>
      <ref id="ref15">
        <mixed-citation>
          [15]
          <string-name>
            <surname>Ploug</surname>
            ,
            <given-names>T.</given-names>
          </string-name>
          , &amp;
          <string-name>
            <surname>Holm</surname>
            ,
            <given-names>S.</given-names>
          </string-name>
          (
          <year>2019</year>
          ).
          <article-title>The right to refuse diagnostics and treatment planning by artificial intelligence</article-title>
          .
          <source>Medicine</source>
          ,
          <string-name>
            <given-names>Health</given-names>
            <surname>Care</surname>
          </string-name>
          , and Philosophy. https://doi.org/10.1007/s11019-019-09912-8
        </mixed-citation>
      </ref>
      <ref id="ref16">
        <mixed-citation>
          [16]
          <string-name>
            <surname>London</surname>
            ,
            <given-names>A. J.</given-names>
          </string-name>
          (
          <year>2019</year>
          ).
          <article-title>Artificial intelligence and black-box medical decisions: accuracy versus explainability</article-title>
          .
          <source>Hastings Center Report</source>
          ,
          <volume>49</volume>
          (
          <issue>1</issue>
          ),
          <fpage>15</fpage>
          -
          <lpage>21</lpage>
          .
        </mixed-citation>
      </ref>
      <ref id="ref17">
        <mixed-citation>
          [17]
          <string-name>
            <surname>Jordan</surname>
            ,
            <given-names>M. I.</given-names>
          </string-name>
          , &amp; Mitchell,
          <string-name>
            <surname>T. M.</surname>
          </string-name>
          (
          <year>2015</year>
          ).
          <article-title>Machine learning: trends, perspectives, and prospects</article-title>
          .
          <source>Science</source>
          ,
          <volume>349</volume>
          (
          <issue>6245</issue>
          ),
          <fpage>255</fpage>
          -
          <lpage>260</lpage>
          .
        </mixed-citation>
      </ref>
      <ref id="ref18">
        <mixed-citation>
          [18]
          <string-name>
            <surname>Schubbach</surname>
            ,
            <given-names>A.</given-names>
          </string-name>
          (
          <year>2019</year>
          ).
          <article-title>Judging machines: philosophical aspects of deep learning</article-title>
          .
          <source>Synthese</source>
          , pp.
          <fpage>1</fpage>
          -
          <lpage>21</lpage>
          .
        </mixed-citation>
      </ref>
      <ref id="ref19">
        <mixed-citation>
          [19]
          <string-name>
            <surname>Binns</surname>
            ,
            <given-names>R.</given-names>
          </string-name>
          , Van Kleek,
          <string-name>
            <given-names>M.</given-names>
            ,
            <surname>Veale</surname>
          </string-name>
          ,
          <string-name>
            <given-names>M.</given-names>
            ,
            <surname>Lyngs</surname>
          </string-name>
          ,
          <string-name>
            <given-names>U.</given-names>
            ,
            <surname>Zhao</surname>
          </string-name>
          ,
          <string-name>
            <given-names>J.</given-names>
            ,
            <surname>Shadbolt</surname>
          </string-name>
          ,
          <string-name>
            <surname>N.</surname>
          </string-name>
          (
          <year>2018</year>
          ).
          <article-title>'It's reducing a human being to a percentage': perceptions of justice in algorithmic decisions</article-title>
          .
          <source>In Proceedings of the 2018 CHI Conference on Human Factors in Computing Systems</source>
          (p.
          <fpage>377</fpage>
          ). ACM.
        </mixed-citation>
      </ref>
      <ref id="ref20">
        <mixed-citation>
          [20]
          <string-name>
            <surname>Ribeiro</surname>
            ,
            <given-names>M. T.</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Singh</surname>
            ,
            <given-names>S.</given-names>
          </string-name>
          , &amp;
          <string-name>
            <surname>Guestrin</surname>
            ,
            <given-names>C.</given-names>
          </string-name>
          (
          <year>2016</year>
          ,
          <article-title>August)</article-title>
          .
          <article-title>Why should i trust you?: Explaining the predictions of any classifier</article-title>
          .
          <source>In Proceedings of the 22nd ACM SIGKDD international conference on knowledge discovery and data mining</source>
          (pp.
          <fpage>1135</fpage>
          -
          <lpage>1144</lpage>
          ). ACM.
        </mixed-citation>
      </ref>
      <ref id="ref21">
        <mixed-citation>
          [21]
          <string-name>
            <surname>Esteva</surname>
            <given-names>A</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Kuprel</surname>
            <given-names>B</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Novoa</surname>
            <given-names>RA</given-names>
          </string-name>
          , et al.
          <article-title>Dermatologist-level classification of skin Cancer with deep neural networks</article-title>
          .
          <source>Nature</source>
          <year>2017</year>
          ;
          <volume>542</volume>
          :
          <fpage>115</fpage>
          -
          <lpage>8</lpage>
          .
        </mixed-citation>
      </ref>
      <ref id="ref22">
        <mixed-citation>
          [22]
          <string-name>
            <surname>De Fauw</surname>
            ,
            <given-names>J.</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Ledsam</surname>
            ,
            <given-names>J. R.</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Romera-Paredes</surname>
            ,
            <given-names>B.</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Nikolov</surname>
            ,
            <given-names>S.</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Tomasev</surname>
            ,
            <given-names>N.</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Blackwell</surname>
            ,
            <given-names>S.</given-names>
          </string-name>
          , et al. (
          <year>2018</year>
          ).
          <article-title>Clinically applicable deep learning for diagnosis and referral in retinal disease</article-title>
          .
          <source>Nature medicine</source>
          ,
          <volume>24</volume>
          (
          <issue>9</issue>
          ),
          <fpage>1342</fpage>
          -
          <lpage>1350</lpage>
        </mixed-citation>
      </ref>
      <ref id="ref23">
        <mixed-citation>
          [23]
          <string-name>
            <surname>De Maeseneer</surname>
            , J., vanWeel,
            <given-names>C.</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Daeren</surname>
            ,
            <given-names>L.</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Leyns</surname>
            ,
            <given-names>C.</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Decat</surname>
            ,
            <given-names>P.</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Boeckxstaens</surname>
            ,
            <given-names>P.</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Avonts</surname>
            ,
            <given-names>D.</given-names>
          </string-name>
          , &amp;
          <string-name>
            <surname>Willems</surname>
            ,
            <given-names>S.</given-names>
          </string-name>
          (
          <year>2012</year>
          ).
          <article-title>From “patient” to “person” to “people”: the need for integrated, people-centered healthcare</article-title>
          .
          <source>The International Journal of Person Centered Medicine</source>
          ,
          <volume>2</volume>
          (
          <issue>3</issue>
          ),
          <fpage>601</fpage>
          -
          <lpage>614</lpage>
          .
        </mixed-citation>
      </ref>
      <ref id="ref24">
        <mixed-citation>
          [24]
          <string-name>
            <surname>Orrù</surname>
            <given-names>G</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Pettersson-Yeo</surname>
            <given-names>W</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Marquand</surname>
            <given-names>AF</given-names>
          </string-name>
          , et al.
          <article-title>Using support Vector Machine to identify imaging biomarkers of neurological and psychiatric disease: a critical review</article-title>
          .
          <source>Neurosci Biobehav Rev</source>
          <year>2012</year>
          ;
          <volume>36</volume>
          :
          <fpage>1140</fpage>
          -
          <lpage>52</lpage>
          .
        </mixed-citation>
      </ref>
      <ref id="ref25">
        <mixed-citation>
          [25]
          <string-name>
            <surname>Sweilam</surname>
            <given-names>NH</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Tharwat</surname>
            <given-names>AA</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Abdel Moniem</surname>
            <given-names>NK</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Moniem</surname>
            <given-names>NKA</given-names>
          </string-name>
          .
          <article-title>Support vector machine for diagnosis Cancer disease: a comparative study</article-title>
          .
          <source>Egyptian Informatics Journal</source>
          <year>2010</year>
          ;
          <volume>11</volume>
          :
          <fpage>81</fpage>
          -
          <lpage>92</lpage>
          .
        </mixed-citation>
      </ref>
      <ref id="ref26">
        <mixed-citation>
          [26]
          <string-name>
            <surname>Khedher</surname>
            <given-names>L</given-names>
          </string-name>
          , Ram?rez J, G?
          <string-name>
            <surname>rriz</surname>
            <given-names>JM</given-names>
          </string-name>
          , et al.
          <article-title>Early diagnosis of Alzheimer?s disease based on partial least squares, principal component analysis and support vector machine using segmented MRI images</article-title>
          .
          <source>Neurocomputing</source>
          <year>2015</year>
          ;
          <volume>151</volume>
          :
          <fpage>139</fpage>
          -
          <lpage>50</lpage>
          .
        </mixed-citation>
      </ref>
      <ref id="ref27">
        <mixed-citation>
          [27]
          <string-name>
            <surname>Lecun</surname>
            <given-names>Y</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Bottou</surname>
            <given-names>L</given-names>
          </string-name>
          ,
          <string-name>
            <surname>Bengio</surname>
            <given-names>Y</given-names>
          </string-name>
          , et al.
          <article-title>Gradient-based learning applied to document recognition</article-title>
          .
          <source>Proc IEEE Inst Electr Electron Eng</source>
          <year>1998</year>
          ;
          <volume>86</volume>
          :
          <fpage>2278</fpage>
          -
          <lpage>324</lpage>
          .
        </mixed-citation>
      </ref>
      <ref id="ref28">
        <mixed-citation>
          [28]
          <article-title>Comprehensive Claims of AI for Healthcare Applications-Coherence Towards COVID19 Suneeta Satpathy</article-title>
          , Sachi Nandan Mohanty, Jyotir Moy Chatterjee &amp; Anasuya Swain [
          <volume>29</volume>
          ]
          <string-name>
            <surname>Data-Driven Symptom</surname>
          </string-name>
          Analysis and
          <article-title>Location Prediction Model for Clinical Health Data Processing and Knowledgebase Development for COVID-19 Subhasish Mohapatra</article-title>
          , Suneeta Satpathy &amp; Debabrata Paul
        </mixed-citation>
      </ref>
      <ref id="ref29">
        <mixed-citation>
          [30]
          <string-name>
            <surname>Artificial</surname>
            <given-names>Intelligence:</given-names>
          </string-name>
          <article-title>The Strategies Used in COVID-19 for Diagnosis Saswati Chatterjee</article-title>
        </mixed-citation>
      </ref>
    </ref-list>
  </back>
</article>