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<article xmlns:xlink="http://www.w3.org/1999/xlink">
  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>A Comparative Analysis of Soft Set Classifiers and a Fuzzy Classifier as Diagnostic Tools for Diabetes Prediction</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Kamil Giziński</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Bartosz Rolnik</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Dominik Sigulski</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, 44-100 Gliwice</addr-line>
          ,
          <country country="PL">Poland</country>
        </aff>
      </contrib-group>
      <abstract>
        <p>There are lots of diferent machine learning algorithms, and every one of them has its use. However, not every one of those algorithms will be a good choice for every scenario that we want to test - some are simply superior for one case, while others are more suitable for another. In this short paper, we compare the accuracy for predicting diabetes in Pima Indians patients of two soft set classifiers and one fuzzy classifier. SYSYEM 2022: 8th Scholar's Yearly Symposium of Technology, Engin"eekrianmgiagnizd35M9aptohlesml.palti(cKs., BGriuzinńeskk,iJ);ublyar2t3r,o2l005202polsl.pl (B. Rolnik); 2.1. Data normalization domisig095polsl.pl (D. Sigulski) © 2022 Copyright for this paper by its authors. Use permitted under Creative Commons License In select cases, data has been normalized using one of CPWrEooUrckReshdoinpgs IhStpN:/c1e6u1r3-w-0s.o7r3g ACttEribUutRion W4.0oInrtekrnsahtioonpal (PCCroBYce4.0e).dings (CEUR-WS.org) two types of normalization:</p>
      </abstract>
      <kwd-group>
        <kwd>eol&gt;Machine learning</kwd>
        <kwd>Disease detection</kwd>
        <kwd>Soft sets</kwd>
        <kwd>Fuzzy sets</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>1. Introduction</title>
      <p>
        between algorithms, two soft set classifiers and a fuzzy
classifier to be exact, to see how they perform - both in
One of the most important tools of artificial intelligence terms of their accuracy and the time required to produce
are neural networks [
        <xref ref-type="bibr" rid="ref1">1</xref>
        ]. They are an indispensable tool a result.
in identifying certain searched features in the examined Fuzzy sets [19, 20, 21, 22, 23] are sets whose elements
objects [
        <xref ref-type="bibr" rid="ref2 ref3 ref4">2, 3, 4</xref>
        ]. No less important role in modern com- have degrees of membership. They are an extension of
puter science is played by heuristic algorithms, which the classical set definition, where the membership of
are often inspired by the observation of the animal world an element to a set is described in a binary way - an
[
        <xref ref-type="bibr" rid="ref5 ref6">5, 6</xref>
        ]. They are used wherever an optimal solution is element either belongs to a set or it does not; there is no
sought when the functional describing the optimization "in between". The fuzzy set theory allows defining the
goal is dificult to define, we do not know about its math- membership of an element using a membership function
ematical properties. a very interesting application is the valued in the real unit interval [
        <xref ref-type="bibr" rid="ref1">0,1</xref>
        ]. One of the biggest
reduction of electricity consumption by optimizing the dificulties in the usage of fuzzy sets is the uncertainty
connection of [
        <xref ref-type="bibr" rid="ref7 ref8 ref9">7, 8, 9</xref>
        ] transformers. regarding the membership function: we can never really
      </p>
      <p>
        Disease detection is becoming a very important field know whether our choice of the membership function is
in machine learning [
        <xref ref-type="bibr" rid="ref10 ref11 ref12">10, 11, 12</xref>
        ]. Since we are becoming the optimal one. In our case, the membership functions
more and more dependent on the technology we have are, for the most part, based on medical norms.
developed, it is only natural we also implement new tech- Soft sets are a generalization of fuzzy sets, and they
nologies [
        <xref ref-type="bibr" rid="ref13 ref14 ref15">13, 14, 15</xref>
        ] in the process of diagnosing certain deal with the uncertainty in a parameterized way. On
diseases in patients; or at least marking those who we the contrary to fuzzy sets, they describe the reality more
suspect are sick, so that a healthcare [
        <xref ref-type="bibr" rid="ref16 ref17">16, 17</xref>
        ] professional extensively. As described in Khan and Herawan 2021,
can examine their cases more closely. The usage of ma- "Soft set describes fuzzy data in term of each parameter
chine learning algorithms can both improve the patients’ presence or absence while fuzzy set describe it in term of
outcomes and save valuable time of both doctors and all parameter’s accumulative weight only." This approach
patients. has its advantages and disadvantages, of course, as it
      </p>
      <p>
        Since not every machine learning algorithm is a good may be harder for a human to make a decision based on
ift for every problem, it is important to test diferent many parameters, while it is certainly much easier to
algorithms to see how they fit in our scenario. David make a choice based on a single, crisp value produced
H. Wolpert and William G. Macready have themselves by a classifier using a fuzzy set. However, it also means
indicated that the first theorem in their paper "state[s] that a decision made based on a soft set reasoning can be
that any two algorithms are equivalent when their per- much more complete, with more parameters available.
formance is averaged across all possible problems"[
        <xref ref-type="bibr" rid="ref18 ref7">18, 7</xref>
        ].
      </p>
      <p>That is why we have decided to focus on the comparison</p>
    </sec>
    <sec id="sec-2">
      <title>2. Mathematical model</title>
      <p>Standard deviation normalization
 − ¯</p>
      <p>− 
 − 
•  - sample value
•  - column standard deviation
• ¯ - mean column value
Min-max normalization
•  - sample value
•  - minimum column value
•  - maximum column value
where:
where:
where:
where:
•  - the beginning of the lower base of the
trapezoid, membership takes the value 0
Triangular membership function
 (; , , ) =
⎧ 0,
⎪⎪⎨ −  ,
− 
−</p>
      <p>,
− 
⎪ 
⎪⎩ 0,
if  ≤ .
if  &lt;  ≤ .
if  &lt;  ≤ .
if  &lt; .
•  - the beginning of the base of the triangle,
membership takes the value 0
the value 1
takes the value 0
•  - the center of the triangle, membership takes
•  - the end of the base of the triangle, membership</p>
      <sec id="sec-2-1">
        <title>Trapezoidal membership function</title>
        <sec id="sec-2-1-1">
          <title>2.2. Fuzzy classifier</title>
          <p>We have also used a handful of equations in our fuzzy
where:
classifier.
(3)
where:
 (; , , , ) =
⎧ 0,
⎪
⎪
⎨
⎪⎪ 
−  ,
− 
1,
⎪ −  ,
⎪⎪ 
⎪⎩ 0,
− 
if  ≤ .
if  &lt;  ≤ .
if  &lt;  ≤ .
if  &lt;  ≤ .
if  &lt; .</p>
          <p>•  - the end of the lower base of the trapezoid,
membership takes the value 0</p>
        </sec>
      </sec>
      <sec id="sec-2-2">
        <title>Antecedent fulfillment degree</title>
        <p>= { }</p>
      </sec>
      <sec id="sec-2-3">
        <title>Rule fulfillment degree for all antecedents</title>
        <p>() = { 1,  2, ...,  }
•   - antecedent fulfillment degree
Center of gravity of a triangle
• afd - antecedent fulfillment degrees (i.e.: afd=(0.6,</p>
      </sec>
    </sec>
    <sec id="sec-3">
      <title>3. Dataset</title>
      <p>The dataset used for this project was the Pima Indians
Diabetes Database [24]. According to the source, "This
dataset is originally from the National Institute of
Diabetes and Digestive and Kidney Diseases. [. . . ] In
particular, all patients here are females at least 21 years old
of Pima Indian heritage." The dataset consists of several
medical predictor variables and one target variable.
(4)</p>
      <p>Here is a short description of each column.</p>
      <p>1. Pregnancies — number of times pregnant;
2. Glucose — plasma glucose concentration after 2
hours in an oral glucose tolerance test;
zoid, membership takes the value 1
membership takes the value 1
•  - the beginning of the upper base of the
trape3. BloodPressure — diastolic blood pressure (mm
•  - the end of the upper base of the trapezoid,
4. SkinThickness — triceps skin fold thickness</p>
      <p>Hg);
(mm);
5. Insulin — 2-Hour serum insulin ( IU/ml);
6. BMI — Body mass index (weight in kg/(height in
m)ˆ2);
7. DiabetesPedigreeFunction — a function that
describes the likelihood of diabetes based on
family history;
8. Age — age in years;
9. Outcome — class variable (0 or 1). 268 of 768 are
1 and 500 are 0;</p>
      <sec id="sec-3-1">
        <title>3.1. Statistical analysis</title>
        <p>However, we had to clean the data first - as seen in
Tables 2, 3 and 4, there were many incomplete records which
in turn would result in the classifiers producing incorrect
predictions. Which is why we removed all zero values
outside the Pregnancies and Outcome columns. The
column statistics after removing the incomplete records can
be seen in Tables 5, 6 and 7.</p>
        <p>We have also shufled the dataset, normalized it in
select cases (either min-max or standard deviation
normalization) and divided it into a training set and a validation
set (70:30 split).</p>
        <p>The values for both sick (marked with yellow) and
healthy patients (marked with red) are not too distinct,
apart from the glucose column - as seen in Figure 1. As
shown in Figure 2, the correlation between the outcome
values and other columns is not particularly strong either
- only the glucose column shows a correlation above 0.5,
with almost all other correlations not even exceeding 0.3.</p>
      </sec>
      <sec id="sec-3-2">
        <title>3.2. Medical terms and norms</title>
        <p>In this subsection, we are going to describe the columns
in the database from the medical point of view.</p>
        <p>Glucose is a simple sugar, which is the basic source of
energy in the human body. Measuring blood glucose
levels on an empty stomach can help determine if a person
has diabetes.</p>
        <p>The approximate norm of blood glucose concentration
is:
which suggests that there was an error in the dataset - or
perhaps a diferent testing method was used.</p>
        <p>Diabetes pedigree function
Family history of diabetes was shown to be a significant
predictor of diabetes prevalence.There is no additional
information about this function in the dataset, apart from
the short explanation that it is "a function that describes
the likelihood of diabetes based on family history", so we
can only assume that the higher the value, the higher the
risk is for a patient.</p>
        <p>BMI is the body mass index. It is calculated by
comparing height with weight. Its value is helpful in assessing
the risk of overweight-related diseases such as
atherosclerosis, diabetes or ischemic heart disease. The lower the
BMI value, the lower the risk of disease development.</p>
        <p>Norms for BMI:</p>
        <p>Age
According to the American CDC agency, patients are at
risk if they are 45 years or older.</p>
      </sec>
    </sec>
    <sec id="sec-4">
      <title>4. Implementation</title>
      <p>The next column is blood pressure. Blood pressure is
the amount of pressure that flowing blood exerts against
the walls of your arteries. The measurement is made
with a pressure gauge and the obtained values are given
in mm Hg, i.e., millimeters of mercury.</p>
      <p>Blood pressure in terms of the norms is divided into:
• 70-99 mg/dL — correct values;
• 100-125 mg/dL — abnormal values, oral glucose
tolerance test is required;</p>
      <sec id="sec-4-1">
        <title>4.1. Soft set classifier - mean</title>
        <p>• above 126 mg/dL — abnormal values, repeating
the test is required, patient is diagnosed with dia- The first soft set classifier uses a mean column value to
betes after getting such a result twice. create the weights table.</p>
        <p>Firstly it gets the mean value, then it counts how many
values in the column were below and above the mean.</p>
        <p>
          If there were more values above the mean, the program
adds a pair [
          <xref ref-type="bibr" rid="ref1">0, 1</xref>
          ] to the table, otherwise it adds a pair
[
          <xref ref-type="bibr" rid="ref1">1, 0</xref>
          ]. If there is a draw, we randomly pick one of the
pairs and append it to the weights table.
        </p>
        <p>All the algorithms were written and executed in Python
3.9.5 using Jupyter Notebooks.
• normal: &lt;80 mm Hg;
• elevated phase 1: 80–89 mm Hg;
• elevated phase 2: &gt;90 mm Hg.</p>
        <p>The thickness of the skin fold on the triceps is
one of the determinants of body fat level. We have not
managed to nfid any information regarding the accepted
norms.</p>
        <p>Insulin is a hormone responsible for regulating blood
sugar (glucose) in the body. The norm 2 hours after a
meal is up to 30 mIU/ml.However, in our dataset the
median for insulin was 125.5  IU/ml - 4 times over the
norm, if we assume the units are the same exact ones</p>
      </sec>
      <sec id="sec-4-2">
        <title>4.2. Soft set classifier - percentage</title>
        <p>The second soft set classifier uses minimum and
maximum column values to calculate how a sample value
compares to the minimum and maximum values, to then
create the weights table.</p>
        <p>
          Firstly it gets the minimum and maximum values, then
it calculates how far they are from minimum to maximum
in percentage - i.e. if a sample value is equal to minimum,
the algorithm appends [
          <xref ref-type="bibr" rid="ref1">0, 1</xref>
          ] to the weights table and if a
value is right in the middle, it appends [0.5, 0.5].
        </p>
      </sec>
      <sec id="sec-4-3">
        <title>4.3. Fuzzy classifier</title>
        <p>Firstly, we need to explain how we chose the membership
functions for the antecedents and the consequent.</p>
        <p>There is no clear-cut threshold for the number of
pregnancies, so we have decided to pick 2 as our middle
threshold and with the rest of the domain divided based on the
middle triangle, as seen in Figure 3.</p>
        <p>We have decided to divide the glucose column domain
according to the glucose norms. with the middle being
at 112, since this is the middle of the abnormal range of
values that do not yet warrant a diabetes of diagnosis.
The chart of its membership function can be seen in
Figure 4.
BMI has quite clear norms, so we used them to divide
the values in the BMI column - as seen in Figure 8.</p>
        <p>As seen in Figure 9, the diabetes pedigree function
values were divided using its median, since no medical
norms were available.</p>
        <p>As seen in Figure 10, age values were divided according
to CDC’s norm that people who are 45 years or older are
at risk of developing type 2 of diabetes.</p>
        <p>Finally, the outcome consequent was divided in half,
with values that fall in the middle being marked as ’sick’,
which can be seen in Figure 11.</p>
        <p>After creating the membership functions, we wrote the
rules connecting all the antecedents to the consequent.
An example of such a rule can be seen in Table 8</p>
        <p>The algorithm starts by getting the membership
degrees for each column and then fuzzifying the sample
values based on these degrees. Once we have all the fuzzy
values, we can calculate the rule fulfillment and then pick
the highest fulfillment degrees for each consequent label.
Then out of these labels we pick the one with the highest
degree - if there is a "draw", i.e., the degrees are equal,
we pick the worst case - so in our dataset we mark the
patient as sick, since it is obviously better to mark one
too many, than one too few.</p>
      </sec>
    </sec>
    <sec id="sec-5">
      <title>5. Performance</title>
      <p>As seen in Figure 12, the time performance of the
classiifers varied quite a lot, with the soft set classifier using
percentages being more than three times slower than the
soft set classifier using mean values and almost twice as
slow as the fuzzy classifier. The time performance is an
average of 50 timed runs to average out any abnormal
situations.</p>
    </sec>
    <sec id="sec-6">
      <title>6. Results</title>
      <p>The soft set classifier using mean values was the worst
performing one, with less than 50% accuracy for data
normalized with standard deviation and around 50%
accuracy for data normalized with percentages and
unnormalized data. Table 11</p>
      <p>The soft set classifier using percentages did not per- Fuzzy Classifier accuracy summary (20 samples) - mean and
form much better, either, with its accuracy slightly ex- standard devitation
ceeding 50%. As seen in Table 9, the results were quite in
all cases. On the contrary to the mean soft set classifier, Value
it performed best with data normalized using standard mean 63.43%
deviation - but the diference was not stark at all. std dev 4.19</p>
      <p>The fuzzy classifier came out on top, with its
accuracy averaging out at more than 60%. As seen in Table
11 and Figure 13, its accuracy did not drop below 55%
- so in almost all cases it performed better than other
classifiers did on average. Even taking the standard
deviation into account, ass seen in Table 11, the results were
significantly better.</p>
    </sec>
    <sec id="sec-7">
      <title>7. Conclusion</title>
      <p>In conclusion, the soft set classifiers were not a good
choice for this problem and dataset. They probably would
have worked better with a more uniform outcome
distribution - but with more samples being marked as ’sick’,
the results were skewed.</p>
      <p>The fuzzy classifier produced superior results, and
with improved, more fine-tuned rules it could achieve
an even better accuracy. Similarly to the other soft set
classifier, it would have benefitted from a more uniform
data distribution.</p>
      <p>As seen in Figure 14, the fuzzy classifier did evidently
better, but the results can definitely be improved further.</p>
    </sec>
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