APJCP 18(10): 2775
5. Concluding remarks
International Journal of Medical Informatics 149 (2021) 104420
10
compatibility within the solution. Consideration of these characteristics in solution design, development, and evaluation (validation) is therefore significant. As
Table A1(see appendix) shows, evaluation of several solutions is still in progress. It is expected that the contributors will consider the discussed needs in their evaluation process to deliver a sustainable solution for a prospective predictive universal digital healthcare ecosystem.
4.2. Identification of trends and gaps
In this review, 58 out of 69 studies are confirmatory. This not only
ensures the academic recognition of these data modelling and analytics
technologies but also highlights their prospects for the desired predic-
tive universal digital healthcare ecosystem. Throughout the review
process, detailed knowledge of these technologies been acquired, along
with different proposing concepts. Moreover, it is realized that the
foundation for a predictive universal digital healthcare ecosystem de-
mands advanced technological implementation for data connectivity,
data storage and security. To the best of our knowledge, none of the
existing academic reviews has explored the discussed theme, which is
significant for the desired sustainable healthcare. This research gap
needs to be addressed as a priority.
Table A1
Coding Table of reviewed research.
Sl No. Study
Reference Publication
Year Title Objective(s) Approach
(Conceptual/
Methodological/
Experimental)
Evaluation information and Findings
1 [58] 2015 A System Architecture for Smart
Health Services and Applications Remote support for home and
primary healthcare Conceptual The proposed application scheme was test with dataset (8 specific attributes) of 19,000 doctor importations from 1500 hospitals. The scheme found efficient in performance.
2 [100] 2016 Cloud enabled data analytics and visualization framework for health-shocks prediction
Health-shocks prediction Conceptual The framework was test with dataset of 1000 households and resulted with efficiency (89 % success in performance). A useful health informatics tool for government and healthcare professionals to construct healthcare policies and healthcare reforms.
3 [52] 2015 An Interactive Healthcare System with Personalized Diet and Exercise Guideline Recommendation
Assisting patients with chronic diseases to understand health conditions, followed by self- management
Conceptual Evaluation of the system is in progress.
The system is able to:
•Analyse result of regular physical examination to evaluate health risk.
•Provides personalized healthcare services: dietary, exercise guideline recommendations.
4 [54] 2016 ConfidentCare: A Clinical Decision Support System for Personalized Breast Cancer Screening
Providing personalized screening policies for breast cancer screening.
Conceptual The system was test with sample dataset (theoretical evaluation). Result shows that it outperforms existing clinical practice guidelines (CPGs) in cost efficiency and false positive rates (31 % reduction in false positive rate).
5 [22] 2016 A Proposed Serious Game
Architecture to Self-Management HealthCare for Older Adults
Kinesiology exercises Conceptual The system simulates kinesiology exercises, responds to quizzes and sends feedback. Evaluation information not found.
6 [98] 2016 Computational Health Informatics
in the Big Data Age: A Survey Decision support system for
practitioners Conceptual Structured analysis of historical and state-of-the-art methods (170 papers and web Papers). The framework provides a systematic data processing pipeline for big data health informatics.
7 [101] 2016 Healthcare big data voice
pathology assessment framework Voice pathology assessment
(VPA) Conceptual The system was test and resulted with
accuracy (95 %). The system:
•Implies ranking criterion between ML, SVM, ELM for classifying signals (normal or pathological).
•Extendable for other healthcare assessments
8 [59] 2016 Machine Learning in Cardiac
Health Monitoring and Decision Support
To identify cardiac health risks
and estimate severity Conceptual The proposed method was evaluated (case study) and found efficient in performance. The method is extendable for other healthcare purposes.
9 [65] 2016 Medic: An Artificially Intelligent System to Provide Healthcare Services to Society and Medical Assistance to Doctors
To perform disease diagnosis with accuracy using contemporary ICT devices
Conceptual The system was test with sample dataset and resulted efficient in performance. It allows user to input health related problem and provide prescription on reply. In case of visit to physicians, the system provides basic information, medical history and previous prescriptions of the patient to the physicians.
10 [99] 2016 Towards a Comprehensive Data
Analytics Framework for Smart Healthcare Services
Enhancing healthcare services by integrating sensor technologies, cloud-computing and big data analytics
Methodological The proposed Framework collects patient data from different sources (Hospital Information System, Radiology and laboratory information systems) to deliver healthcare services. However, evaluation of the system not discussed.
11 [53] 2016 Medical Sieve: A Cognitive Assistant for Radiologists and Cardiologists
To assist Radiologists and cardiologists in clinical decision- making
Conceptual The system was test with dataset of 250 coronary angiography studies (each contained over 3000 images). Resulted with efficiency (average chart browsing time reduced from 0.5 h (paper chart) to 7 min), without changing the overall diagnosis.
12 [60] 2017 Wearable-Based Human Activity
Recognition Using an IoT Approach
To determine the activities
conducted within 4 pre- Conceptual The system was test with sample dataset and resulted with success (95.83 % accuracy in classification).
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International Journal of Medical Informatics 149 (2021) 104420
12 Table A1 (continued)
Sl No. Study
Reference Publication
Year Title Objective(s) Approach
(Conceptual/
Methodological/
Experimental)
Evaluation information and Findings
established categories (lie, sit, walk and jog)
13 [103] 2017 Towards Energy-Aware Cloud- Oriented Cyber-Physical Therapy System
To provide energy-efficient
affordable therapeutic services Conceptual The framework was test with real subjects (performing several therapists) and found effective.
14 [23] 2017 Serious Game Based Personalized Healthcare System for Dysphonia Rehabilitation
Dysphonia rehabilitation Conceptual The tool was test through clinical treatment (3 patients) and resulted efficient. The tool:
•Facilitates simultaneous voice training without any interruption and assists in rehabilitation exercise independently at home.
•Facilitate the evaluation of long-time rehabilitation results (followed by prediction) by analysing recorded voice of patients.
•Applies the most suitable pitch estimation algorithm (by evaluating and comparing seven algorithms).
15 [104] 2017 Smart Health: Big Data Enabled Health Paradigm within Smart Cities
Connecting healthcare knowledge discovery mechanism with smart service infrastructure
Conceptual The framework theoretically offers an intra and inter organizational business model for healthcare setting. Evaluation detail not discussed.
16 [105] 2017 PopHR: a knowledge-based
platform to support integration, analysis, and visualization of population health data
To facilitate evidence-based decision making related to population health
Conceptual Tested with a sample population data of the greater Montr´eal area. The system trial was determined with a small group of test users from public health and health service agencies in the province of Qu´ebee. Result in progress.
17 [102] 2017 Health-CPS: Healthcare Cyber- Physical System Assisted by Cloud and Big Data
To provide service convenience and technological environment of healthcare
Conceptual The system includes a data collection layer (maintains unified standard), a data management layer (for parallel computing and distributed storage), and a data-oriented service layer. On demonstration, the system performed well with efficiency and can be adopted into numerous patient centric smart healthcare services and applications.
18 [61] 2018 A Personalized Healthcare
Monitoring System for Diabetic Patients by Utilizing BLE-Based Sensors and Real-Time Data Processing
To provide assistance in self- management for diabetic patients with chronic condition
Conceptual The proposed system was test with sample dataset from PIMA Indian Women and resulted with efficiency (comparing to other commercially available solutions).
19 [55] 2018 A Personalized Risk Stratification Platform for Population Lifetime Healthcare
Empowering patients with chronical conditions for self- management, self-monitor and self-risk assessment
Methodological (Healthcare Knowledge Management)
The platform was test through survey questionnaire (participants: 40) and resulted satisfactory (publication in progress). Technical evaluation is in progress. The platform provides:
•Informative and interactive tools for assessing cumulative chronic disease risk.
•Provides suggestion in lifestyle changes through personalized behavioural interventions to mitigate potential risks.
20 [24] 2018 Augmented Reality Visualization of Joint Movements for Physical Examination and Rehabilitation
In situ visualization of joint
movement Conceptual Evaluation of the tool is in progress. The
tool is able to provide assistance in:
•Physical examination (visualization of abnormal joint behaviour and functions).
•Physical rehabilitation (with review sessions).
21 [25] 2018 Augmented Reality Visualization of Joint Movements for Rehabilitation and Sports Medicine
In situ visualization of joint movements, analysing sports injury and rehabilitation
Conceptual Evaluation of the tool is in progress. The tool is able to provide:
•Precision in overlapping of personalized functional joint structures.
•Provides a calibration method to adjust the physical centre of projection
•Supports a few orthopaedic activities (e.g. sports injury evaluation and
(continued on next page) A. Zahid et al.
Table A1 (continued) Sl No. Study
Reference Publication
Year Title Objective(s) Approach
(Conceptual/
Methodological/
Experimental)
Evaluation information and Findings
prevention, clinical trial, rehabilitation) 22 [56] 2018 Machine learning to support social
media empowered patients in cancer care and cancer treatment decisions
Intelligent analysis and automated aggregation of patient information and interaction lines in online support groups
Conceptual The framework’s purpose is to investigate the effect of online social influences on patients in terms of selecting a treatment type, recovery after treatment, side effects and emotions expressed from time to time. To conduct the research, researchers used prostate cancer as model. The framework was test with live dataset from OSG (online support groups), contributed by 22,233 patients. It resulted effective in investigation, analysis and knowledge discovery on patient-reported information. The platform is extendable and can be used for any other health condition.
23 [62] 2018 A Data-analytical System to Predict Therapy Success for Obese Children
To determine prediction on future BMI changes before approaching a therapy
Conceptual The system was test with RCT data and data (from trained ML models) and resulted with efficiency (85 % of accuracy). It can be used as a personalized medicine tool.
24 [106] 2018 SLA based healthcare big data analysis and computing in cloud network
To process both batch and streaming patient data in Spark (a platform)
Conceptual The proposed model is able to deal both batch and streaming patient data, analysed in ID (Inter-cloud Data centre) and ED (External-cloud Data centre) environment. In experimental study, the method resulted in accuracy of 87.8 % (both batch and streaming data). The achieved result is 12% higher than the default Naive–Bayes (NB) algorithm and implementable in numerous patient monitoring applications.
25 [66] 2018 Deep Learning Based Medical
Diagnosis System Using Multiple Data Sources
To provide disease diagnosis for
authorized users Conceptual System was test with sample dataset.
Result was compared with real world and proved efficient. Efficient in data extraction from multiple sources with emerging information technologies.
Capable to provide diseases diagnosis, dealing with diverse sets of queries.
26 [64] 2019 Personalized health monitoring
using predictive analytics To determine risk prediction of
cardiovascular disease Conceptual The model was test with dataset from Framingham heart study cohort (participant 4240) and resulted efficient.
It determines advanced and personalized prognosis of cardiovascular problems by utilizing user’s lifestyle data, vital signs data, and medical history, derived from sensors.
27 [60] 2017 Context Mining based Mental
Health Model for Lifecare Platform
Providing personalized care to
depression patients Conceptual The model was test with health index and weather index data, facilitated by the Korea Meteorological
Administration. The model resulted effective.
28 [27] 2019 VR4NEUROPAIN: Interactive
Rehabilitation System Remote monitor and assistance in
therapy sessions Conceptual Platform evaluation is in progress. The platform:
•Allows two types of user access.
Clinicians (e.g. occupational therapist, physician) and Platform
Administrators.
•Records all the information about patients, rehabilitation session plans, physicians, VR games and related scenarios, and other related important information.
29 [107] 2019 HPCC based framework for COPD
readmission risk analysis To improve the operational capability of existing patient readmission analysis frameworks
Conceptual Tested with sample dataset. Result shows that the system is efficient to reduce the evaluation time significantly, while maintaining the performance.
30 [78] 2019 A Novel Cloud-Based Framework
for the Elderly Healthcare Services Using Digital Twin
Providing diagnosis, monitoring, and predicting aspects for older adults
Conceptual The proposed framework was test with 2 voluntary participants and resulted efficiency. It provides:
•Real-time supervision
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International Journal of Medical Informatics 149 (2021) 104420
14 Table A1 (continued)
Sl No. Study
Reference Publication
Year Title Objective(s) Approach
(Conceptual/
Methodological/
Experimental)
Evaluation information and Findings
•Accuracy in crisis warning for elderly care.
31 [108] 2019 BD2Decide: Big Data and Models for Personalized Head and Neck Cancer Decision Support
Providing necessary information for customized treatment and care delivery pathways to Head and Neck Cancer patients
Conceptual Tested with sample data of 1000 patients. Result showed efficiency.
32 [63] 2019 Anthropomorphic Virtual
Assistant to Support Self-care of Type 2 Diabetes in Older People: A Perspective on the Role of Artificial Intelligence
To provide assistance in self- management and self-care for diabetic patients (Type 2)
Conceptual Evaluation of the prototype not discussed in the paper. However, from study, the tool observed focusing on usability issues and user experience.
33 [81] 2019 Cardio Twin: A Digital Twin of the
human heart running on the edge IHD (Ischemic Heart Disease)
detection Conceptual The model was test with dataset of 200
patients from “PTB Diagnostic ECG Database” and resulted with satisfactory performance (accuracy: 85.77 %, processing time: 4.8 s).
34 [68] 2019 "Daily Stress and Mood Recognition System Using Deep Learning and Fuzzy Clustering for Promoting Better Well-Being"
To raise awareness among the users and encourage them to improve their health behaviour.
Conceptual The system helps the user to understand his or her own current health status. In demonstration, the model achieved higher accuracy (91 % for the personalized model and 83 % for the genetic model).
35 [26] 2019 Using Mobile Virtual Reality to Enhance Medical Comprehension and Satisfaction in Patients and their Families
Facilitate knowledge transfer
between physicians and patients Conceptual Tested with dataset from 17 participants (15 child patients and 2 clinicians).
Result was satisfactory. The designed tool (HealthVoyager GI) comprises 3 components:
•Clinician-focused front-end interface (to generate custom patient procedure reports)
•Patient-focused mobile application (uses individualized data for each patient
•Intermediary (for secure connectivity and web service)
36 [69] 2019 ARA: accurate, reliable and active histopathological image classification framework with Bayesian deep learning
To categorize histopathological
visuals of colorectal cancer Conceptual The system was test with dataset (5000 images). It outperformed in accuracy (0.89 % error rate). In addition, it surpassed the classification performance of other methods (18.78 %).
37 [82] 2019 Towards Continuous Monitoring
in Personalized Healthcare through Digital Twins
Visioning the potential of DT concept in personalized healthcare.
Conceptual Evaluation is prospective upon completion of the model development.
38 [67] 2019 DeepReco: Deep Learning Based Health
Recommender System Using Collaborative Filtering
To introduce an intelligent HRS system based on emerging information technologies like DL, BD, and others
Conceptual The system was test with dataset from 10,000 patients of 500 hospitals and found efficient in comparison with other existing approaches. Found capable to provide better quality recommendation for selecting hospital.
39 [70] 2019 Activity Recognition for Cognitive Assistance Using Body Sensors Data and Deep Convolutional Neural Network
To provide cognitive assistance in smart healthcare using body sensors (fall detection)
Conceptual In the experimental study, the proposed approach found to be robust and efficient in providing cognitive assistance compared to the other approaches.
40 [71] 2020 A smart healthcare monitoring system for heart disease prediction based on ensemble deep learning and feature fusion
To determine prediction on heart
disease base using DL. Methodological The proposed system was tested with sample dataset and compared with traditional classifiers based on feature fusion, feature selection, and weighting techniques. The system found efficient, ensuring 98.5 % accuracy.
41 [83] 2020 Digital Twins for Precision
Healthcare To investigate precision
healthcare goals for patient and healthcare system levels.
Conceptual In demonstration, the proposed frameworks performed effectively.
42 [109] 2020 Predictive Analytics Model Based on Multiclass Classification for Asthma Severity by Using Random Forest Algorithm
To improve decision making of Asthma disease treatment using predictive analytics.
Conceptual In experimental study, the model performed efficient (attained an accuracy of 98.80 %).
43 [84] 2020 A Proposal to Evolving Towards
Digital Twins in Healthcare To orchestrate a health ecosystem with digital twins for
personalized healthcare (specifically for lung cancer patients).
Conceptual Evaluation of the proposed architecture is not discussed.
44 [72] 2020 Methodological
(continued on next page) A. Zahid et al.
Table A1 (continued) Sl No. Study
Reference Publication
Year Title Objective(s) Approach
(Conceptual/
Methodological/
Experimental)
Evaluation information and Findings
Enhanced deep learning algorithm development to detect pain intensity from facial expression images
To sense pain intensity from facial
expression images In experimental study, the model is
found accurate and robust in pain intensity detection.
45 [28] 2020 Virtual Reality Integrated Multi- Depth-Camera-System for Real- Time Telepresence and Telemanipulation in Caregiving
To provide Tele-presence and Tele-manipulation for caregivers in real-time.
Conceptual In simulation test, the system performed with efficiency (resulted 97.1 % of the relevant cloud data below 1 cm error and 99.5 % below 1.6 cm error).
46 [29] 2020 Augmented Reality: Telehealth
Demonstration Application To support and track patient activities (as per the care plan) without any active supervision of physician.
Conceptual Evaluation is in progress.
47 [30] 2020 Real-time approach for gait analysis using the Kinect v2 sensor for clinical assessment purpose
To determine the efficiency of RGB-D sensor (built in Microsoft Kinect v2) in Gait analysis
Conceptual Tested with 75 different gait samples with real-time approach. Result showed efficiency (step length and stride length outcomes are found accurate and precise). However, feet angles are found non-reliable.
48 [127] 2020 A Model to Patient Abandonment Prediction in the Pulmonary Rehabilitation
To determine prediction of abandonment in pulmonary rehabilitation
Methodological In experimental study, the model performed efficiently (achieved 69.82 % of accuracy in prediction).
49 [85] 2020 Leveraging Digital Twin
Technology in the Healthcare Industry–A Machine Learning Based Approach
To improve personalized
diagnosis in healthcare domain. Conceptual In simulation test, the model performed efficiently.
50 [110] 2020 An application of big data mining and fuzzy prediction of total knee replacement surgery patients attributes-fuzzy TKR patients attributes prediction
To improve knee replacement surgery procedures using predictive analytics.
Methodological The application was test with datasets from two hospitals (clinical databases).
Result shows that the proposed application is robust in performance (Total 1644 patients’ attributes were extracted and predicted with high accuracy).
51 [31] 2020 Serious Virtual Reality Game for Isometric Eye Training of Strabismic Patients
To train strabismus patients with
VR. Conceptual Test was determined in presence of an
ophthalmologist. In demonstration, the games are found performing with expected efficiency.
52 [32] 2020 Virtual Reality Training System for Rehabilitation of Patients with Stroke Based on Compensatory Movement Detection
To develop a multi-disciplinary solution for providing assistance in homecare and related services.
Conceptual Evaluation of the system is not discussed in the paper. In the study, the developed system is observed functioning 3 occupational therapy, 2 mirror therapy, and 2 constraint-induced movement therapy activities.
53 [73] 2020 HiTANet: Hierarchical Time- Aware Attention Networks for Risk Prediction on Electronic Health Records
To leverage time information for
risk prediction Conceptual The proposed model was evaluated with 3 real world datasets and compared with existing solutions. The model is found efficient (achieved 7% higher in accuracy).
54 [33] 2020 Sensor-Based Virtual Reality for Clinical Decision Support in the Assessment of Mental Disorders
To improve the performance of clinical decision-support system (CDSS) for mental disorder diagnosis and assessment.
Conceptual Simulation test was conducted with 2 datasets consisting of 10 activities. The performance found satisfactory.
55 [34] 2020 A mobile clinical DSS based on augmented reality and deep learning for the home cares of patients afflicted by bedsores
To support filed operators in
dealing with bedsore. Conceptual For evaluation, a laboratory experiment was designed and conducted. In the experimental study, the solution performed with efficiency.
56 [35] 2020 Augmented and mixed reality for collaborative cardiac planning using 3D and 4D medical imaging data
To improve:
•Cardiology treatment planning and simulation
•Cardiology education and patient awareness
•Collaborative cardiac planning.
Methodological In the experimental study, the platform performed efficiently. it was able to generate proper visuals of medical images, collected from different devices.
57 [111] 2020 Ubiquitous Health Profile (UHPr):
a big data curation platform for supporting health data interoperability
To support health data
interoperability Conceptual In evaluation study, the proposed platform is found time efficient, accurate and scalable. It was able to retrieve error free comprehensive health profile of patients from a set of 116.5 million (approx) serialized medical fragments of 390,101 patients with moderate scalability.
58 [112] 2020 Innovative and efficient method of robotics for helping the Parkinson’s disease patient using IoT in big data analytics
Application of robotics in PD
treatment Methodological The proposed system was tested in
simulation and compared with existing solutions. The system is found efficient in performance.
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