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      Computer Aided Detection System for Prediction of the Malaise during Hemodialysis

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          Abstract

          Monitoring of dialysis sessions is crucial as different stress factors can yield suffering or critical situations. Specialized personnel is usually required for the administration of this medical treatment; nevertheless, subjects whose clinical status can be considered stable require different monitoring strategies when compared with subjects with critical clinical conditions. In this case domiciliary treatment or monitoring can substantially improve the quality of life of patients undergoing dialysis. In this work, we present a Computer Aided Detection (CAD) system for the telemonitoring of patients' clinical parameters. The CAD was mainly designed to predict the insurgence of critical events; it consisted of two Random Forest (RF) classifiers: the first one (RF 1) predicting the onset of any malaise one hour after the treatment start and the second one (RF 2) again two hours later. The developed system shows an accurate classification performance in terms of both sensitivity and specificity. The specificity in the identification of nonsymptomatic sessions and the sensitivity in the identification of symptomatic sessions for RF 2 are equal to 86.60% and 71.40%, respectively, thus suggesting the CAD as an effective tool to support expert nephrologists in telemonitoring the patients.

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          The meaning and use of the area under a receiver operating characteristic (ROC) curve.

          A representation and interpretation of the area under a receiver operating characteristic (ROC) curve obtained by the "rating" method, or by mathematical predictions based on patient characteristics, is presented. It is shown that in such a setting the area represents the probability that a randomly chosen diseased subject is (correctly) rated or ranked with greater suspicion than a randomly chosen non-diseased subject. Moreover, this probability of a correct ranking is the same quantity that is estimated by the already well-studied nonparametric Wilcoxon statistic. These two relationships are exploited to (a) provide rapid closed-form expressions for the approximate magnitude of the sampling variability, i.e., standard error that one uses to accompany the area under a smoothed ROC curve, (b) guide in determining the size of the sample required to provide a sufficiently reliable estimate of this area, and (c) determine how large sample sizes should be to ensure that one can statistically detect differences in the accuracy of diagnostic techniques.
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            Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline.

            The Kidney Disease: Improving Global Outcomes (KDIGO) organization developed clinical practice guidelines in 2012 to provide guidance on the evaluation, management, and treatment of chronic kidney disease (CKD) in adults and children who are not receiving renal replacement therapy. The KDIGO CKD Guideline Development Work Group defined the scope of the guideline, gathered evidence, determined topics for systematic review, and graded the quality of evidence that had been summarized by an evidence review team. Searches of the English-language literature were conducted through November 2012. Final modification of the guidelines was informed by the KDIGO Board of Directors and a public review process involving registered stakeholders. The full guideline included 110 recommendations. This synopsis focuses on 10 key recommendations pertinent to definition, classification, monitoring, and management of CKD in adults.
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                Author and article information

                Journal
                Comput Math Methods Med
                Comput Math Methods Med
                CMMM
                Computational and Mathematical Methods in Medicine
                Hindawi Publishing Corporation
                1748-670X
                1748-6718
                2016
                6 March 2016
                : 2016
                : 8748156
                Affiliations
                1Istituto Nazionale di Fisica Nucleare, Sezione di Bari, Via Orabona 4, 70125 Bari, Italy
                2Dipartimento Interateneo di Fisica “M. Merlin”, Università degli studi di Bari “A. Moro”, Via Orabona 4, 70125 Bari, Italy
                3Nephrology, Dialysis and Transplantation Unit, University of Bari “A. Moro”, Piazza G. Cesare, 11 – Policlinico, 70124 Bari, Italy
                4Department of Physical Sciences, Earth and Environment, University of Siena, Strada Laterina 8, 53100 Siena, Italy
                Author notes

                Academic Editor: Maria N. D. S. Cordeiro

                Author information
                http://orcid.org/0000-0002-1372-3916
                http://orcid.org/0000-0003-0211-0783
                Article
                10.1155/2016/8748156
                4799825
                27042200
                fd08fd34-9a3f-40d8-8cf1-be63d4bf8035
                Copyright © 2016 Sabina Tangaro et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 11 December 2015
                : 13 February 2016
                : 15 February 2016
                Categories
                Research Article

                Applied mathematics
                Applied mathematics

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