Biomedical Signal Analysis for Connected Healthcare

332 Pages·2021·15.616 MB·English

by  Sridhar Krishnan

BIOMEDICAL SIGNAL
ANALYSIS FOR CONNECTED
HEALTHCARE
SRI KRISHNAN
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DedicatedtotheloveandinspirationprovidedbymywifeMahi,
and to our children, Sibi and Sarvi.
Grateful for the constant support and encouragement of my
parents, extended family, students, professors, and friends.
About the author
Sridhar (Sri) Krishnan received his B.E. degree in Electronics
and Communication Engineering from the College of Engineer-
ing, Guindy, Anna University, Chennai, India, in 1993 and M.Sc.
andPh.D.degrees(withstudentfellowshipfromAlbertaHeritage
Foundation for Medical Research) in Electrical and Computer
Engineering from The University of Calgary, Calgary, Alberta,
Canada, in 1996 and 1999, respectively. Sri Krishnan joined
RyersonUniversityinJuly1999andiscurrentlyaprofessorinthe
Department of Electrical, Computer, and Biomedical Engineer-
ing. From 2011 to2021, he wasanAssociate Dean(Research and
External Partnerships) for the Faculty of Engineering and Archi-
tectural Science. He is also the Founding Co-director of the
Institute for Biomedical Engineering, Science, and Technology
(iBEST) and an Affiliate Scientist at the Keenan Research Centre
in St. Michael’s Hospital, Toronto.
Sri Krishnan’s research interests include biomedical signal
processing, audio signal processing, wearable technology, and
machinelearning.From2007to2017,SriKrishnanheldaCanada
Research Chair position in Biomedical Signal Analysis. He has
published more than 340 papers in refereed journals and
conferences and has filed 15 invention disclosures/patents. He
has presented keynote/plenary/invited talks in more than 60
international conferences and workshops. Sri Krishnan serves in
the advisory boards of research institutes, innovation centers,
incubator zones, and biomedical tech start-up organizations. Sri
Krishnan is a registered Professional Engineer in the Province of
Ontario. He was the Founding Chair (2005e2015) of IEEE Signal
ProcessingSociety,TorontoSectionandRegion7(Canada),anda
Founding Member of the IEEE Engineering in Medicine and
Biology Society, Toronto Section. He currently serves as a
Technical Committee Member (Biomedical Signal Processing) of
IEEE EMBS.
Sri Krishnan is a recipient/awarded Fellow of Canadian
Academy of Engineering; Outstanding Canadian Biomedical
Engineer Award from the Canadian Medical and Biological
Engineering Society; Achievement in Innovation Award from
Innovate Calgary; Ryerson University’s Sarwan Sahota Distin-
guishedScholarAward;OntarioResearchInnovationAwardfrom
Biodiscovery Toronto; Canadian Engineers’ Young Engineer
Achievement Award from Engineers Canada; New Pioneers
xii About theauthor
Award in Science and Technology; South Asian Community
Achiever Award; Exemplary Service Award and Best Chapter
Chair Award from IEEE Toronto Section; and IEEE AESS Best
Chapter Chair Award.
Preface
Pursuit of knowledge and contributions to research and
innovationforthesocietalbenefitshavebeencoreaspectsofmy
scientific journey. The interest in biomedical signal analysis
started when I was in my undergraduate class on signals and
systems and happen to visit my uncle in the emergency ward in
which the monitor next to him displayed vital signals. The curi-
osity of representing those vital signals with the mathematical
concepts learnt in the signals and systems course led me to
pursue fourth-yearcapstonedesign projectfollowedbygraduate
studies in the area, and eventually as a professor investigating
variousmodel-basedanddata-drivenapproachesforbiomedical
signalprocessing,analysis,andinterpretation.Overthecourseof
learning, the ideas from electronics, telecommunication, infor-
mation theory, machine learning, and human-centered design
have shaped my understanding of the domain of biomedical
signal analysis for connected healthcare. In the past 10 years,
through the various workshops and tutorials that we have con-
ducted,the audience were more interestedto learn the concepts
systematically so that the techniques could apply to any
biomedical signal analysis. Followed by an IEEE Engineering in
Medicine and Biology Society (EMBS) conference workshop on
the same topic, the Elsevier team approached me to consider
writing a book on this topic. During book writing, the pandemic
stuck, and that also led to further strengthening certain topics of
thebookontheaspectsofconnectedandtelehealthpossibilities.
The book comprises seven chapters, and with a people-
centered approach, biomedical signal analysis topic has the
largestcoveragefollowedbywearablesdesign andthenmachine
learningandconnectivitytopics.Thebookcoversthesetopicsin
a logical flow as per the following sequence. The context of
current global healthcare situation and the role of digital tech-
nology in improving people’s lives are covered in Chapter 1. An
understanding of the applicability of biomedical signals in real-
world application can inspire hardware design considerations,
and the topic of wearables design is covered in Chapter 2.
Biomedical preprocessing techniques of sampling, quantization,
and filtering are covered in Chapter 3. In Chapter 4, details of
adaptive analysis of biomedical signal analysis are covered.
xiv Preface
Chapter 5 deals with various feature extraction and analysis
techniques. The role of biomedical signals in decision-making
applicationswillbenefitfromusingmachinelearningtechniques,
and some requirements of those are covered in Chapter 6. Ap-
proaches for digital transmission of biomedical signals for con-
nected healthcare, telemedicine, and electronic medical records
are covered in Chapter 7.
The contents of the book clearly fit an undergraduate course
in biomedical signal analysis, biomedical systems and signals,
digital health technologies, telemedicine, and also for an
advanced course at the graduate level. With the availability of a
plethora of open datasets with various forms of biomedical sig-
nals and computer programs for signal processing, feature
analysis, machine learning, and embedded systems program-
ming, the students can experience the concepts covered in the
book in individual or collaborative laboratory exercises and
projects.
The book was possible because of the many help I received
from my graduate students, clinical collaborators, international
research collaborators, industry partners, and peers in the area.
Specifically, I would like to thank my graduate students and
research assistants, Yashodhan Athavale, Fayez Qureshi, Garima
Sharma,and MagdaleenSingarajah, for helping withthecontent
of various chapters in this book. I am also grateful to Ryerson
University Signal Analysis Research (SAR) group members for
theirresearchcontributionsonvariousaspectsofthebooktopic.
Elsevierpublicationsteamhavebeendiligentintheirwork,andI
thank them for their help and support throughout the book
writing phase. I would like to place my gratitude for the uncon-
ditional support provided by my family and friends throughout
thisjourneyofknowledgedissemination.Mayweseeaconnected
world with good health and happiness!
Sri Krishnan
Toronto, Canada
June 2021
1
Opportunities for connected
healthcare
1. Introduction
Healthcare is an inevitable and core requirement of humanity
and its very own existence and sustainability. In this ever
resource constraint world, healthcare is under constant strain
of lack of adequate and appropriate medical attention at various
levels of the system. The requirements manifest in the form of
long-term needs for chronic healthcare, care for aging popula-
tion,remotedeliveryofvarioushealthservices,escalationofhos-
pitalization costs, and increased chances of infection due to
prolonged hospital stays. These challenges could be addressed
if the healthcare is able to harness the technology connectivity
we are all enjoying as part of the digital revolution and a
consciousefforttobridgethedigitaldividegaptherebyproviding
aplatform for anywhere, anytime connectivityand seamlessand
timelyhealthservices.AsshowninFig.1.1,amongtheTop10dis-
easesglobally,formostofthesediseases,ifnotall,theroleoftech-
nologyindiagnosing, managing,andintervening ishuge.Inspite
of the prevalence of these diseases worldwide, the good news is
the fact that the average life expectancy of humans continues to
increase worldwide. Fig. 1.2 shows the average life expectancy
map of the countries, and it is obvious that socio-economic fac-
tors and access to high-end technologies play a significant role
in influencing these statistics. The ever-increasing prevalence
ofaffordabledigitalhealthtechnologiesandthepenetrationofin-
formationandcommunicationtechnologies(ICTs)havegreatpo-
tential to bridge the digital divide and contribute to anequitable
access of healthcare services.
The idea of connecting human civilization on a global scale
gave birth to telephony in the 1920s. This was also augmented
by advancements in other communication modalities such as
Morse code, telegraphy, radar, and sonar techniques. Though
communication forms one aspect of human civilization, it is
indeed the most primal medium of survival, and through the
BiomedicalSignalAnalysisforConnectedHealthcare.https://doi.org/10.1016/B978-0-12-813086-5.00005-0 1
Copyright©2021ElsevierInc.Allrightsreserved.
2 Chapter 1 Opportunitiesforconnectedhealthcare
Figure1.1 Top10diseasesgloballyin2017.Source:IHME,GlobalBurdenofDisease,OurWorldinData,BBC[1].
Figure1.2 Worldlifeexpectancymap(2016).Source:Wikipedia[2].
20th and 21st centuries, communication technologies have
boostedarapidgrowthinmostverticalsincludinginfrastructure,
transportation, food, and healthcare. Up until the late 1960s,
most communication methods which were applied for