Malik Et Al. - 2023

Multimedia Tools and Applications (2023) 82:13855–13880
https://doi.org/10.1007/s11042-022-13843-7
CDC_Net: multi-classification convolutional neural

network model for detection of COVID-19,
pneumothorax, pneumonia, lung Cancer,
and tuberculosis using chest X-rays
Hassaan Malik 1 2 3
& Tayyaba Anees & Muizzud Din & Ahmad Naeem
1
Received: 17 January 2022 / Revised: 30 June 2022 / Accepted: 6 September 2022 /

Published online: 20 September 2022
# The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022
Abstract
Coronavirus (COVID-19) has adversely harmed the healthcare system and economy
throughout the world. COVID-19 has similar symptoms as other chest disorders such
as lung cancer (LC), pneumothorax, tuberculosis (TB), and pneumonia, which might
mislead the clinical professionals in detecting a new variant of flu called coronavirus.
This motivates us to design a model to classify multi-chest infections. A chest x-ray is the
most ubiquitous disease diagnosis process in medical practice. As a result, chest x-ray
examinations are the primary diagnostic tool for all of these chest infections. For the sake
of saving human lives, paramedics and researchers are working tirelessly to establish a
precise and reliable method for diagnosing the disease COVID-19 at an early stage.
However, COVID-19’s medical diagnosis is exceedingly idiosyncratic and varied. A
multi-classification method based on the deep learning (DL) model is developed and
tested in this work to automatically classify the COVID-19, LC, pneumothorax, TB, and
pneumonia from chest x-ray images. COVID-19 and other chest tract disorders are
diagnosed using a convolutional neural network (CNN) model called CDC Net that
incorporates residual network thoughts and dilated convolution. For this study, we used
this model in conjunction with publically available benchmark data to identify these
diseases. For the first time, a single deep learning model has been used to diagnose five
different chest ailments. In terms of classification accuracy, recall, precision, and f1-score,
we compared the proposed model to three CNN-based pre-trained models, such as Vgg-
19, ResNet-50, and inception v3. An AUC of 0.9953 was attained by the CDC Net when
* Hassaan Malik
[email protected]
1
Department of Computer Science, University of Management and Technology, Lahore 54000,
Pakistan
2
Department of Software Engineering, University of Management and Technology, Lahore 54000,
Pakistan
3
Department of Computer Science, Ghazi University, Dera Ghazi Khan 32200, Pakistan
13856 Multimedia Tools and Applications (2023) 82:13855–13880
it came to identifying various chest diseases (with an accuracy of 99.39%, a recall of

98.13%, and a precision of 99.42%). Moreover, CNN-based pre-trained models Vgg-19,
ResNet-50, and inception v3 achieved accuracy in classifying multi-chest diseases are
95.61%, 96.15%, and 95.16%, respectively. Using chest x-rays, the proposed model was
found to be highly accurate in diagnosing chest diseases. Based on our testing data set, the
proposed model shows significant performance as compared to its competitor methods.
Statistical analyses of the datasets using McNemar’s, and ANOVA tests also showed the
robustness of the proposed model.
Keywords COVID-19 . Pneumonia . Deep learning . Chest x-rays . Coronavirus
1 Introduction
Several patients with unknown causes of pneumonia disease were reported at Wuhan city of
chine in early December 2019 [42, 60]. In the early stages of this pneumonia with an unknown
cause, severe acute respiratory syndrome (SARS) has been observed in some patients. On the
other hand, only a small number of patients have shown signs of rapid increase in acute
respiratory distress (ARD) disorder and other concerning complications have also been noted.
[41]. The “Chinese Center for Disease Control and Prevention” (CCDC) identified a novel
coronavirus (nCoV) on January 7, 2020, from a throat swab sample taken from a patient in
Wuhan and was later named 2019-nCoV by “World Health Organization” (WHO) [100]. A
total of 284,992,606 coronavirus-infected cases, 5,440,570 death cases, and 252,735,264
recovered cases have been reported since December 31, 2021, around the world [101]. In this
challenging situation, the frontline experts initially used a real-time reverse transcription-
polymerase chain reaction (RT-PCR) test for the detection of COVID-19 [91]. The reverse
transcription procedure is used to get the DNA of the infected person, which is then allocated
to PCR for strengthening DNA before being analyzed. Therefore, it can detect the coronavirus
because this virus only carries RNA patterns [17]. Due to higher demand, the COVID-19 tests
have delayed the result obtained using PCR kits. The outcomes produced by PCR kits are not
reliable because it also contains the false-negative (FN) outputs [8].
Globally, 7% of the populace is infected by pneumonia in a year and it may also cause
death [75]. Pneumonia is considered as being a lethal disease and has relentless results within a
diminutive time, due to the stream of fluid inside the lungs, which leads to drowning.
Pneumonia has an incendiary reaction in the portion of lung sacs known as alveoli due to
the bacteria, microbes, etc. [48]. As the microorganisms yield in the lung, white blood cells
start the process to take any action against the bacteria, and fungi and produce sores in the sacs.
Thus, the portion of the lung sacs gets replete with an infected fluid of pneumonia and causes a
problem with breathing, tussis, and pyrexia. If this perilous pneumonia infection is not dealt
with in the medicines at the earlier stages, it may cause the death of a person [6, 56].
The COVID-19 infected patients have the symptoms of fever, cough, loss of taste or smell,
sore throat, chest pain, and shortness of breath [41]. These symptoms are also most commonly
occurred in pneumonia, pneumothorax, LC, and TB-infected patients. Therefore, it is difficult
for doctors in detecting the COVID-19. The health experts and researchers are working
tirelessly in finding an effective solution for diagnosing the COVID-19. They choose the x-
ray imaging analysis for the identification of coronavirus [44]. Today, one of the most
economical and conventional clinical diagnostic methods is chest radiography (chest x-rays)
Multimedia Tools and Applications (2023) 82:13855–13880 13857
[78]. Even in impoverished countries, modern digital radiography machines are easily afford-
able [53]. Hence, this practice is broadly used by health experts in their medical practices for
the detection and diagnosis of fatal diseases such as TB, pulmonary nodules, pneumonia, and
the initial stage of LC [104]. Chest x-rays contain an enormous quantity of information about a
patient’s health biography. Although, accurately identifying COVID-19 from the chest radio-
graph is always a foremost task for health experts. In chest x-rays, overlapped structures of the
tissue have greatly increased the complexity of the correct analysis. Therefore, detection of
COVID-19 is challenging for the human diagnostician when the amount of the dissimilarity
among the lesion and the adjacent tissues is very low, or the lesion partially covers the ribs.
Even for an experienced health expert, it is sometimes not simple to identify the COVID-19,
pneumothorax, pneumonia, LC, and TB from the chest x-rays. Therefore, the automated
diagnosis of these diseases from chest radiographs through artificial intelligence (AI), basically
in the subfield of deep learning models, might be able to solve this dilemma [52]. The reports
of deep learning and transfer learning approaches exceeding humans in diagnostic evaluation
have designed considerable elation. In AI, both methods i.e., deep learning present a frame-
work to exploit previously acquired knowledge to address new but relevant tasks much more
rapidly and effectively [59]. The major factor of the transfer learning process is their capability
to fine-tune based on pre-trained models. This feature makes them the dominant tool for the
classification of diseases from medical imaging.
Deep learning models have revolutionized the process of disease classification and opened
a new door for medical professionals [35, 36, 40, 85, 103]. Chest infections [43], Cancer cell
diagnosis [15], brain and breast tumor segmentation and identification [67], and gene analysis
[7, 73, 79, 80] have all improved dramatically as a result of medical systems working together
with CNN. The Chest Disease Classifier Network (CDC Net) is a novel multi-classification
model based on the CNN model that includes the combination of the residual network though
and dilated convolution has been developed for this study. The CDC_Net is applied to classify
the COVID-19 infected chest x-rays from the pneumothorax, pneumonia, LC, and TB. The
objective of the study is to accurately detection of the COVID-19 and other chest-related
diseases i.e., pneumothorax, pneumonia, LC, and TB by using chest x-rays and to assist our
doctors in identifying the irregular or abnormal patterns that happened due to these diseases.
To the best of our knowledge, this is the first study that presents the single CNN model for the
detection of a collection of chest diseases using x-rays images. We believe that our work also
reduces the burden on the doctor to employ various approaches for the detection of each chest
condition individually. In addition, the CDC_Net model is also compared with three well-
known pre-trained classifiers such as Vgg-19 [36, 85], ResNet-50 [98], and inception v3 [40]
in terms of accuracy (ACC), sensitivity (SEN), specificity (SPEC), F1-score, and area under
the receiver operating characteristic curves AU(ROC).
In summary, the main contributions of this study are stated as follows:
1. We design a novel end-to-end CNN model in combination with the residual network
thought and dilated convolution (CDC_Net) for the classification of COVID-19, pneu-
mothorax, pneumonia, LC, and TB by using chest x-rays. Furthermore, depth comparison
has been done with state-of-the-art classifiers as well as three baseline classifiers such as
Vgg-19, ResNet-50 & Inception v3.
2. The CDC_Net has been trained and tested on a wide range of chest radiography datasets
for the categorization of COVID-19, pneumothorax, pneumonia, TB, and LC chest x-rays.
Radiopaedia.org [28], SIRM database [19], TCIA [27], Mendeley [2], Chest Radiographs
of COVID-19 infected [62], NIH chest X-ray photos [70], GitHub source [18], and
Kaggle repository [68] were used to obtain the images of COVID-19 x-rays. About
20,000 chest x-rays and CT scans were gathered from [84] for use in compiling a lung
cancer database. The 12,000 x-rays in the Kaggle repository [72] were used to compile the
dataset on pneumothorax. Radiologists in North America (RSNA) [50] provided the
dataset of pneumonia x-rays. A total of 5216 x-ray images (3867 pneumonia and 1349
normal) are included in this dataset. A total of around 4200 chest x-rays, including 3500
normal images and 700 infected x-rays, were gathered from [95].
3. The CDC_Net efficiently solves the dilemma of low resolution, partial overlap in the
inflammatory portion of chest x-rays. We also demonstrate that chest radiography can
provide the different patterns of chest disease infection during the time of the
convolutional process and provide significant information, which helps to enhance the
classification accuracy.
4. The CDC_Net showed significant results in terms of accuracy (99.39%), recall (98.13%),
precision (99.42%), and F1-score (98.26%).
5. Using chest x-rays, we developed a new framework for detecting COVID-19-infected
patients.
This manuscript is structured as follows. State-of-the-art is discussed in section 2. In section 3,

the context of materials and methods is presented. Section 4 consists of extensive experimental
results and their discussion. The conclusion and future work of this study is described in
section 5.
2 State-of-the-art
One of the most essential tasks in deep learning is the classification of disorders of the
respiratory system using various medical imaging modalities, such as MRI, radiography, CT
scans, and sonography. X-rays have been used in numerous studies to detect COVID-19,
which saves time and effort for medical professionals [26, 31, 33]. It has been a challenging
area of the current study to identify COVID-19 at an early stage of the disease. Here are some
of the most important and appropriate papers on AI approaches for the identification of
COVID-19 pneumonia, pneumothorax, LC, and TB. In Table 1, current research on
COVID-19 is compared to research on other chest disorders.
The authors of the present work have recently developed a BDCNet model (based on CNN)
for the classification of COVID-19 contaminated chest radiographs [64]. COVID-19, PN, and
LC, three different types of lung illnesses, were all examined in this research utilizing one deep
learning model. This model was tested against the ResNet-50 [14], Vgg-16, Vgg-19 [29], and
inception v3 models in terms of performance measures. With an accuracy rate greater than
99.10%, the BDCNet model was found to be superior to other competing approaches. Using a
patch-based technique, Oh et al. [71] created a CNN model for a small number of datasets. In
order to get the desired result, the patching classifiers were asked to vote for the majority of
their peers. A total of 15,043 x-ray images were used in the study, comprising 6012 photos of
pneumonia, 180 images of infection with COVID-19, and 8851 photographs of healthy
subjects. Accuracy of 88.9%, the sensitivity of 84.9%, the f1-score of 84.4%, the precision
of 83.4%, and specificity of 96.4% were attained by the model. Based on three important
contributions, Zhang et al. [105] built an 18-layer of residual CNN model for chest-radiograph
Table 1 Comparative study of literature related to COVID-19 detection and other chest-related diseases
Ref Datasets Objective Models Results
[1] COVID-19 and SARS images To identify the COVID-19 using ResNet Accuracy=95.12%
[16], chest x-rays.
Normal images [10, 45].
[58] COVID-19 images [16], To classify the COVID-19 x-rays GoogleNet Accuracy=80.56%
Normal and Pneumonia from the pneumonia-infected
images [50]. x-rays.
[74] COVID-19 images [16], Using x-rays to automatically di- Xception + Accuracy=91.40%
Normal and Pneumonia agnose COVID-19 and pneu- ResNet50-
images [51]. monia. V2
[71] COVID-19 images [16], To diagnose pneumonia and Patch based Accuracy=88.90%
Normal and Pneumonia coronavirus infected images. CNN
images [46].
[105] COVID-19 images [16], Classification of COVID-19 posi- 18-layer Accuracy=72.31%
Normal images [97]. tive and healthy images. residual
CNN
[4] COVID-19 images [16, 21], Classification of COVID-19, MobileNet-V2 Accuracy=96.78%
Normal and Pneumonia pneumonia, and healthy
images [50] images.
[94] COVID-19 images [16], To detect pneumonia, COVID-19, Inception V3 Accuracy=76.0%
Normal and Pneumonia and normal images.
images [50, 97].
[83] COVID-19 images [16, 21], To classify COVID-19, Resnet50+ Accuracy=95.33%
Normal and Pneumonia pneumonia, and normal images SVM
images [50]. using chest x-rays.
[32] Normal and Pneumonia To detect pneumonia (normal, CNN Accuracy =95.72%
images [97]. bacterial, and viral) cases from
chest X-rays
[25] Normal and Pneumonia To detect and evaluate pneumonia CNN Accuracy =94.84%
images [50, 97]. (bacterial, viral, COVID-19 and
normal)
pictures, and their analysis was based on that. As part of their first phase, they used a CNN
model to identify the most prominent features, then worked on classification. To detect model
scores in the last stage, the anomaly module was used. There were a total of 1531 x-ray photos
used in their investigation, with 100 images showing good results for COVID-19 and the
remaining images showing signs of infection with pneumonia. For the detection of COVID-
19, they had a recall of 96% and a precision of 70.65%.
On two distinct datasets, Apostolopoulos et al. [4] employed a MobileNet-V2 and CNN
model. The first dataset contains 1427 photos, of which 224 images are COVID-19 positives,
700 images are bacterial infections, and the balance of the images is normal. A similar number
of COVID-19, pneumonia and normal pictures may be found in the second dataset. In
comparison with CNN, the MobileNet-V2 model had an improved accuracy of 96.78%, a
recall of 98.6%, and a specificity of 96%. Using a pre-trained model called Inception V3,
Tsiknakis et al. [94] suggested a new method for automatic detection of COVID-19. 572
instances of bacterial and viral illnesses were studied using this approach, together with 122
photos taken using COVID-19 and 150 photographs taken of healthy individuals. An accuracy
of 76% was achieved. The 381 chest x-ray pictures were fed into nine different pre-trained
models in the study [83]. COVID-19 was detected using these features extracted by the SVM
and ResNet-50 models. The ResNet-50 model demonstrates the highest accuracy and f1-score
of 95.33% and 95.3%, respectively, when it comes to obtaining features.
For the detection of coronaviruses in x-ray images, Saha et al. [82] developed a new model
called EMCNet. To extract the feature from the chest x-rays, the EMCNet model uses a simple
CNN structure. An ensemble of machine learning (ML) classifiers was used to categorize the
COVID-19 infected photos after extracting the features using CNN. Greater classification
accuracy of 98.91% was attained by the EMCNet model. For the classification of COVID-19
images, they [61] created a model called CovXNet based on CNN. For automatic detection,
the CNN model was utilized to extract the feature and its depth-wise convolution phenomena.
Gradient-based discriminative localization and a slack method are included in the CovXNet
model for COVID-19 identification. X-ray images of pneumonia and healthy people were used
to develop this model. Among cases of normal and COVID-19, the model achieved a
classification accuracy of 97.4%, while creating a classification accuracy of 90.2% for all
other cases, such as pneumonia, including viral and bacterial infections. For the classification
of COVID-19 contaminated pictures, Horry et al. [39] used four well-known medical transfer
learning classifiers. A total of 60,798 photos were used to test the model, comprising 115
images with COVID-19 positive x-rays, 60,361 images with normal contrast, and 322 images
with pneumonia infection. Vgg-19 was able to correctly categorize 81.0% of the COVID-19
positive instances in all four transfer learning models.
Kermany et al., [50] evaluate the performance criterion of a pre-trained model, such as
Inception v3 to diagnose pneumonia from pediatric chest radiographs. The model achieved a
diagnostics accuracy of 92.8%; recall or true negative (TN) value was 93.2% and 90.1%,
respectively. Wang et al., [97] consider the consequence of localization approaches to identify
and locate the pneumonia infection in chest X-rays. Their method concludes the area under the
curve (AUC) of 63,3% for the classification of pneumonia. Rajpurkar et al. [76] applied a
proposed “121- layer of CNN and achieved the AUC of 0.768 in diagnosing pneumonia from
X-rays. Moreover, they also named their model “CheXNet” which was further evaluated and
validated on the publically available “ChestX-ray14” images dataset [69] having 112,120
frontal chest radiographs. Guan et al., [30] compute the consummation of two-branch CNN for
the classification of chest disease. Their model achieves an AUC of 0.776 on the open-access
‘ChestX-ray14’ dataset for detecting pneumonia. Diagnosis of diseases from radiographs
images was monitored in [66], and the segmentation process was applied to different body
organs by using chest X-ray imaging was performed in [38].
Wang et al. [99] observed the patterns of pneumonia disease related to the deadly
coronavirus (COVID-19), which infected the severe acute respiratory of humans, started in
Wuhan, China. The stats about ailing people with the COVID-19 pandemic are scarce and to
control the spread of this type of disease a large number of screenings are required. The
pathogenic laboratory was a good option at the time of the pandemic, but their testing process
was lengthy with false negative (FN) results generated [55]. Consequently, the screening of
this disease through different medical imaging such as CT scan, MRI, etc. using deep learning
methods was performed. The initial screening achieved an AUC of (89.5%) with a specificity
of 0.88 and a recall of 0.87. Ayan et al. [5] described that COVID-19 disease is an infection
with the initial symptoms of flu and fever and later it converts into pneumonia. In this research
article, they applied deep learning approaches to screen the patient’s chest X-ray with the hope
to bring precision and diagnosing confirmation of coronavirus or pneumonia patients.
Stephen et al. [88] applied the CNN model to classify pneumonia patients from a database
of chest X-ray images. CNN model was trained from scratch to extract the substantial and
dominant features from the chest x-rays and diagnose pneumonia. This model dealt with
medical imaging of a large number of pneumonia datasets and attains significant results. Other
approaches rely solely on pre-trained and handcrafted methods to accomplish a notable

classification performance. Wang et al. [98] used a deep regression framework for automatic
screening of pneumonia and train the model with the information and multi-channel images to
simulate the clinical monitoring process. Firstly, they extract the visual features from multi-
mode of images and improve the ability to screen the pneumonia disease. Secondly, the
structure of chest scans has been analyzed by using RCNN, which can extract automatically
multiple image features from multi-channel image slices. The proposed model showed an
increase in diagnostic accuracy of 2.3% and sensitivity by 3.1% to the baseline model i.e.
RCNN(ResNet).
Janizek et al. [49] defined pneumonia as an infection and illness which happens in the
respiratory system and is caused by fungi, bacteria, and viruses. This kind of infection affects
the human lung’s air sacs with a load full of fluid. The common practice which is used to
diagnose pediatric pneumonia is using chest x-rays of patients. In this modern era, the
development of an automatic system to detect pneumonia and treat the disease is now possible.
The CNN method was widely used by researchers in detecting pediatric pneumonia and assists
the medical experts in early and possible treatment. The variant kind of CNN model based on
pre-trained layers such as LeNet, VGGNet, ResNet, and GoogleNet achieved tremendous
accuracy in diagnosing pneumonia from medical imaging. Dansana et al. [22] evaluate the pre-
trained convolutional networks such as VGG-19, Inception-v2, and decision tree (DT) on
COVID-19 infected chest X-rays and computed tomography (CT). They divulge that VGG-19
achieved 91% of diagnostics accuracy and out-class the other approaches in classifying
COVID-19 infected patients’ radiographs and CT scans. Chohan et al. [12] proposed a novel
deep learning framework for the detection of pneumonia disease for health experts. They
extracted dominant features from the chest X-rays by applying different types of pre-trained
neural networks and analyzed their classification accuracy. Afterward, they ensemble the
output layers of all pre-trained models and achieved the best diagnostics accuracy. Waheed
et al. [96] generate synthetic chest radiographs (CXR) in their study by evolving an “Auxiliary
Classifier Generative Adversarial Network” (ACGAN) based model named COVIDGAN.
Their models improve the accuracy of the CNN model in the detection of pediatric pneumonia
and are considered the more efficient and helpful model for radiologists.
3 Materials and methods
This section presents the results of an experiment that was carried out to determine the
classification accuracy of CDC_Net as well as three baseline transfer learning models, namely
Vgg-19, ResNet-50, and Inception-V3. The human respiratory system is susceptible to a wide
variety of diseases, some of which include pneumonia, LC, TB, and most recently, COVID-19
[25, 32]. X-rays are required for the diagnosis of disorders that affect the chest tract [90]. In
this study, we developed an automated CDC_Net model for the detection of chest tract
diseases. This system was trained and tested on a total of twelve different databases. The
collected x-ray datasets have a fixed image size of 299 × 299 pixels. 10-fold cross-validation
(CV) was used to divide the database x-rays into three categories: training, validation, and
testing. Images of normal, COVID-19, pneumothorax, pneumonia, LC, and TB were used to
train the CDC_Net model. With a batch size of 64, the experiment was run for up to 500
epochs. The CDC_Net achieved the required and appropriate training and validation accuracy
after completing all epochs. The multiclassification confusion matrix was used to evaluate and
compare the classification performance of the CDC_Net model with three other transfer
learning classifiers. The proposed structure of the present study is shown in Fig. 1.
3.1 Dataset descriptions
The CDC_Net was trained and tested using twelve different chest disease databases that were
acquired from various sources. At first, we retrieve 660 COVID-19 chest x-rays from a
repository on GitHub that was established by Cohen et al. [16]. This archive contains x-ray
images that have been gathered from different hospitals as well as public sources. Although the
entire metadata information was not supplied, the age range of COVID-19-positive patients
was approximately 50 to 55 years old on average. After that, 1711 COVID-19 positive chest x-
rays were obtained from the SIRM database [19], the TCIA [27], radiopaedia.org [28],
Mendeley [2], Chest Radiographs of COVID-19 infected [62], as well as the GitHub source
[18]. Thus, a total of 2371 COVID-positive chest x-rays were employed in this investigation.
The normal person’s chest x-rays were acquired from two repositories such as NIH chest X-ray
pictures [70] and the Kaggle repository [68]. The LC dataset encompassing chest x-rays and
CT scan images was taken from [84], including roughly 20,000 chest x-rays and CT scans. On
the other hand, the CT scans of patients with LC were not taken into consideration for this
investigation. The pneumothorax dataset was taken from the Kaggle repository [72], which
consists of 12,000 x-rays. The RSNA [50] was the source from which the dataset of x-rays of
pneumonia was obtained. This dataset includes a total of 5216 x-ray images, including 3867
pneumonia-related images and 1349 normal x-rays. The dataset of TB x-rays was obtained
from [95], and it contains approximately 4200 chest x-rays, of which 3500 are considered
Fig. 1 The proposed framework for diagnosing multiple chest infections was used in this study
normal and 700 are TB infected. Figure 2, represents the instances of the normal, COVID-19,
pneumothorax, pneumonia, LC, and TB.
The k-fold cross-validation technique is used in applied ML to measure the model’s ability
to predict data that was not utilized in the model’s training [77]. In this study, 10-fold cross-
validation is used for the CDC_Net model. Thus, 90% of the data was utilized for training, and
10% was used to test the classifiers. Finally, we calculated the average metrics for 10-fold
techniques. The total statistics for the division of all datasets are presented in Table 2.
3.2 Data preprocessing, augmentation, and normalization
The dimensions of the chest x-rays images varied between 1350 to 2800 pixels in width and
690 to 1340 pixels in height. For consistency, we resized the images to the fixed 299 × 299
resolutions. It is observed that (see Table 2) the training and validation images of COVID-19
are comparatively less than other chest diseases. Thus, we used Synthetic Minority
Oversampling Technique (SMOTE) [11] on COVID-19, pneumonia, LC, TB, and normal
chest x-rays to increase the number of images at the time of training which addresses the
overfitting dilemma [57]. SMOTE generates synthetic data using a k-nearest neighbor tech-
nique. SMOTE begins by selecting random data from the minority class, i.e. COVID-19,
pneumonia, LC, TB, and normal chest x-rays, and then determining the data. There are
different data normalization [87] techniques available to normalize the data. For this study,
Fig. 2 Sample images of multi-chest diseases such as COVID-19, pneumonia, pneumothorax, LC, and TB
Table 2 Splitting of the dataset for training, testing, and validation
Data Splitting COVID-19 Pneumothorax Pneumonia Lung Cancer Tuberculosis Normal Total
Training 1670 8400 2707 3500 2940 2065 21,282

Validation 467 2400 773 1000 840 589 6069
Testing 234 1200 387 500 420 295 3036
Total 2371 12,000 3867 5000 4200 2949 30,387
the pixel normalization techniques were used to normalize the data for the proper training of
the CDC_Net. Now, the datasets are ready to be fed into the CDC_Net model for the training.
3.3 Transfer learning image classifiers
For the clinical task of categorizing COVID-19 and chest disorders, this section offers the most
recent pre-trained classifiers. ImageNet (ILSVR) database [98] was utilized to train a pre-
trained Deep Convolutional Neural Networks (DCNN) architecture. To train and evaluate
picture classification algorithms, this database contains thousands of diverse objects. As a
general open-source platform for chest illness diagnostics and other research applications [51,
63, 88], VGG-16 and VGG-19 [49] have been developed specifically for this purpose.
Sigmoid functions were used to replace the final three layers of VGG-16 architecture, allowing
the model to diagnose sickness. The VGG-19 is also a lot deeper than the VGG-16, too. As
compared to VGG-16, the training parameters in VGG-19 are far more extensive and
expensive to implement. To achieve strong convergence tendencies, He et al. [37] devised
the Residual Neural Network (ResNet) model using skip connections to move over some
layers of the network. ResNet-50 is the name given to the improved version of ResNet.
ResNet’s architecture is similar to that of the VGGNet, although it is approximately eight (8)
times deeper [92]. The classification of medical images is mostly accomplished using a CNN-
based inception model. They were chosen because they have been thoroughly tested [81, 89],
reviewed, and recognized as state-of-the-art classifiers for medical picture classification tasks
[85]. Aside from the final and completely linked layers, the weights of these models were
randomly initialized after pre-training on an extensive ImageNet database. These models were
pre-trained with initial weights based on previously trained ImageNet data, which allowed us
to unlock the last layer so that the weights of these models could be modified as we progressed
through the training process.
3.4 Proposed CDC_Net model
When evaluating the proposed model’s architecture, it is necessary to comprehend the chest x-
ray patterns of COVID-19, pneumothorax, pneumonia, LC, and tubercular infection. Texture,
shape, and spatial interactions between pixels are distinctive sequences in various disorders.
Researchers typically use the local texture feature to identify the infected area of the radio-
graphs because they altered the texture of the lung. A simple visual notion, however many
studies do not define the texture of COVID-19 and other chest disorders [86, 89]. The
grayscale image of a radiograph displays the image’s texture and distributes the image’s pixel
values based on the image’s neighboring pixel values [54]. Texture can be viewed here as a set
of repeating values of the local area that is present across all the x-rays being produced. The
feature extractors in CNN are the kernel parameters. The input of each neuron is connected to
the preceding levels in a stack in the CNN architecture to extract local information. By fine-
tuning the convolutional layers of the CNN, we can get better results in finding effective
texture patterns. The texture of radiographs, on the other hand, appears to lack some basic
features. Therefore, selecting merely textures will not provide you with all the image’s
information. Increasing the depth of the model reduces the resolution of the feature map.
Figure 3 depicts the design of our proposed model, which incorporates residual networks and
dilated convolution by the designs stated above. Differences between expected and actual
values are calculated using the residual network in statistical mathematics. Our CDC Net
model is fed these tiny changes by using deep residual thinking to remove the identical parts of
the radiographs. Large-resolution images necessitate both more sophisticated computations per
layer and a significant increase in memory consumption [57]. Because of this, the model’s
input has been limited to 299 × 299 pixel-resolution radiographs, which have been
convolutionally layered. Filter sizes of 3 × 3 were then used for the convolutional layer.
Using the ReLU function, we can observe non-linear activation and use a kernel size of less
than or equal to 5 × 5 and 7 × 7. We believe that the size of each neuron is smaller compared
to the receptive portion of the input radiographs used for fetching the local texture character-
istics associated with the intended outputs.
In the present study, the authors have presented the dilated convolutional layers, with the
belief that the resolution size of the original chest x-rays is constant, which reduces the chance
of resolution loss. The rule of dilated convolution network is illustrated in Fig. 4. Dilated
convolution appears to limit the ability of the kernel to grow as the receptive field expands.
This method will help keep feature map resolution at a reasonable level. The non-linear
activation function input value was positioned in the sensitive region of the input by adding
batch normalization layers after the convolution layer. The problem of gradient disappearances
caused by increasing the number of training steps will be less of a concern. The final
convolutional layer is coupled to a global average pooling layer that measures the average
value of the feature map. Two fully linked networks are used to feed the feature map of the
final convolutional layer (FCN). In the first dense layer, there are 512 nodes of hidden neurons,
while the second comprises six dense layers that are utilized to classify the x-ray into one of the
Fig. 3 Proposed CDC_Net model used for classifying multiple chest infections
Fig. 4 Different dilated values corresponding (from left to right): the dilated value of 1 with a 3 × 3
convolutional kernel, which is like the normal convolution process. Dilated value of 2 with 3 × 3 convolutional
kernel contains the receptive field of 5 × 5 convolution process and contains the receptive field of 7 × 7 with a
dilated value of 4
chest disorders, such as a COVID-19, LC, TB, normal, pneumothorax, and pneumonia. To
avoid overfitting, the model’s learning rate is set to 0.5. Complex tasks can be better
understood by looking at the model’s activation function. The convolutional layers were
triggered using the ReLU function. The sigmoid function is used to classify diseases in the
final layer of FCN’s dense layer, which incorporates ReLU. In the classification process,
the accuracy and dependability of the model can be certain only when a large amount of
training and test data of similar feature patterns are available, which means that model
requires a training process each time the image data is modified. Even in clinical applica-
tions, previously marked illnesses dataset samples may be erroneous or vary with the
distribution of fresh test data for reasons. Due to patient privacy concerns, it is difficult
to obtain a substantial number of medical images dataset. Researchers are turning to
transfer learning (pre-trained) algorithms to solve this issue. Loss function explanation
and backpropagation method selection are the most important aspects of CNN training.
Cross-entropy loss (CELF) was reduced using the Adam optimizer [87] in this work. This is
used to update the CNN weight at the time of training. Unlike, stochastic gradient descent
(SGD), this optimizer performs independently for different values by estimating the first
and second moment of the gradient. The value measured by CELF demonstrates the
difference between the actual and the predicted results. Moreover, the magnitude shows
the proximity of their probability distribution. The entire number of trainable parameters
(TPs) is 49,66,118, while the total number of non-trainable parameters (NTPs) is 161. The
TPs are the parameters that vary during training and are necessary for training to achieve the
optimal value of these parameters, whereas NTPs are the parameters that do not change
during training and are not necessary for training to achieve the optimal value of these
parameters. As a result, NTPs will have no impact on classification. Table 3 discusses the
CDC_Net model’s layer and provides a full description.
Table 3 CDC_Net Model Summary
No. of Layers Layers Shape Parameters
0 chest_input_1 (InputImage) (299, 299, 3) 0

1 block1_conv1 (Conv2D) (297, 297, 64) 1882
2 block1_conv1 (Conv2D) (295, 295, 64) 37,828
3 block1_pool1 (MaxPooling2D) (147, 147, 64) 0
4 dropout_1 (Dropout) (147, 147, 64) 0
5 block2_conv2 (Conv2D) (145, 145, 128) 74,956
6 block2_conv2 (Conv2D) (143, 143, 128) 158,584
8 dropout_2 (Dropout) (71, 71, 128) 0
9 block3_conv3 (Conv2D) (69, 69, 256) 306,278
10 block3_conv3 (Conv2D) (67, 67, 256) 600,080
12 dropout_3 (Dropout) (33, 33, 256) 0
13 block4_conv4 (Conv2D) (31, 31, 512) 1,191,160
14 block4_conv4 (Conv2D) (29, 29, 512) 2,359,809
15 block4_conv4 (Conv2D) (27, 27, 512) 2,469,809
17 dropout_4 (Dropout) (13, 13, 512) 0
18 reshape_layer (ReshapeLayer) (13,13,32) 9349
19 residual_layer1 (Conv2D) (11, 11, 128) 9349
20 residual_layer2 (Conv2D) (9, 9, 128) 9549
21 dilated_conv1 (Conv2D) (7, 7, 256) 18,496
22 dilated_conv2 (Conv2D) (5, 5, 128) 20,596
23 dilated_conv2 (BatchNormalization) (5, 5, 128) 22,846
24 dilated_pool5 (MaxPooling2D) (2,2128) 0
25 dropout_5 (Dropout) (2,2128) 0
26 flatten_1 (Flatten) 64 0
27 dense_1 (Dense) 512 34,390
28 dropout_6 (Dropout) 512 0
29 dense_2 (Dense) 6 1127
3.5 Performance evaluation
For the present study, we solved the multi-classification chest disease problem i.e., Normal,
COVID-19, pneumothorax, pneumonia, LC, and TB. A confusion matrix was then created to
compare the performance of CDC_Net, Vgg-19, ResNet-50, and Inception-v3 classifiers.
Accuracy (ACC), sensitivity (SEN) (sometimes called recall), specificity (SPEC), f1-score,
and AUC were used to evaluate the proposed model’s classification performance in indepen-
dent testing data. The ACC, SEN, SPEC, and f1-score values of the following eqs. (1), (2), (3),
and (4) are each represented by the following equations:
TP þ TN
Accuracy ¼ ð1Þ
TP þ TN þ FP þ FN
TP
Sensitivity ¼ ð2Þ
TP þ FN
TN
Specificity ¼ ð3Þ
TN þ FP

* specficity* sensitivity
F1−Score ¼ 2 ð4Þ
specficity þ sensitivity
4 Experimental results and discussions
Chest x-rays are used in the CDC_Net model to diagnose disorders of the chest such as
COVID-19, pneumothorax, pneumonia, LC, and TB. By modifying the CDC_Net model’s
hyperparameters (epoch, batch size, and learning rate), grid search was utilized to fine-tune the
model’s performance. The CDC Net model was trained with a batch size of 64 and epochs up
to 500 for testing. The “stochastic gradient descent” (SGD) optimizer was used to set the
starting learning rate of CDC_Net and all three transfer learning classifiers to 0.05. When
training didn’t make any progress after 20 epochs, we lowered the learning rate parameter by
0.1. The reason behind this is to prevent the CDC_Net and other three models i.e., Vgg-19,
ResNet-50, and Inception-v3 from overfitting [3]. The ACC, SEN, SPEC, f1-score, confusion
matrix and AUC of the CDC Net for each class label were examined.
4.1 Experimental process
Three transfer learning classifiers and the CDC Net model were implemented using Keras. In
addition, Python is used to program the methodologies that aren’t immediately related to
convolutional networks. On a Linux operating system with an 11 GB NVIDIA GPU and
32 GB of RAM, the experiment was carried out.
4.2 Visualization of test outputs
Here, we visualize the performance of the CDC_Net model to make the classification process
clearer. Figure 5 illustrates the visualization of a first convolutional layer with the partial output
of the feature map. It is observed that the convolutional layer can detect the edges of the chest
radiographs and other methods apprehend the basic edge modes.
In addition, we utilized the Grad-CAM [63] heatmap approach to provide a graphical
representation of the results that were generated by the CDC_Net model. The heatmap’s
primary objective is to draw attention to the significant part of the chest x-rays that the model
focuses on emphasizing. A representation of the heatmap produced by using the proposed
model is shown in Fig. 6. In addition, the section of the lungs that are affected is represented by
the black dotted line.
4.3 Results analysis
A 10-fold CV technique was used to analyze the complete dataset on CDC Net and three
baseline models – Vgg-19, ResNet-50, and inception v3 classifiers. The CNN model was run
up to 500 epochs. The maximum training accuracy was 99.01%, while the validation accuracy
was 98.93%. These values showed that the CDC_Net model trained well and could correctly
Fig. 5 Proposed method partial visualization of feature maps. a Feature maps extracted from the initial block, b
Feature maps extracted from the second block, c Added layer of the first bottleneck designed module d Last
added layer
classify the chest diseases versus normal cases. The training loss was 0.0051 and the validation
loss was 0.065. As shown in Fig. 7, the 10-fold CV approaches accurately trained and
validated the classifiers CDC_Net, Vgg-19, ResNet-50, and inception v3.
Several metrics were used to evaluate the model’s ability to accurately diagnose COVID-19 and
other chest disorders. Figure 8 describes the confusion matrix for the proposed CDC_Net model and
three transfer learning classifiers. In the independent test set, there were 295 normal, 234 COVID-19,
1200 pneumothorax, 387 pneumonia, 500 LC, and 420 TB x-ray images. In the confusion matrix,
actual cases were placed along rows, and predicted cases were placed along with columns. For the
CDC_Net, among 234 COVID-19 x-rays, the model detected 232 x-rays and misclassified 2 x-rays
images as pneumothorax and pneumonia. In pneumothorax, the CDC_Net model correctly detected
1190 images and misclassified 10 images as COVID-19, pneumonia, LC, and TB. In addition, this
model also accurately classified the 386 images, 497 images, and 418 images of pneumonia, LC,
and TB, respectively. For Vgg-19 (where pre-trained weights were used to train the model), the
model detected 210 cases and misclassified 24 cases as normal, pneumothorax, pneumonia, LC, and
Fig. 6 Heatmap of all five chest diseases
TB among 234 COVID-19 images. Moreover Vgg-19 also accurately detected the exact class label
of pneumothorax having 1165 images, 370 images of pneumonia, 480 images of LC, and 407
images of TB. ResNet-50 predicted the exact class label of 227 COVID-19 cases and misclassified 7
cases as normal, pneumothorax, pneumonia, LC, and TB. This model also accurately classifies the
1185 images of pneumothorax, 379 pneumonia images, 490 LC images, and 410 TB images. For
inception v3, among 234 COVID-19 images, the model detected 203 cases and misclassified 31
cases as normal, pneumothorax, pneumonia, LC, and TB. Among 295 normal cases, the model
detected 280 cases and misclassified 15 cases as COVID-19, pneumothorax, pneumonia, LC, and
TB. Furthermore, 1160 pneumothorax, 366 pneumonia, 473 LC, and 400 TB cases were also
correctly classified by inception v3.
Table 4 displays the classifiers’ ACC, SEN, SEN, and f1-score assessment matrices for all
chest classes. As shown in this table, the CDC_Net achieved 99.42% precision, 98.13% recall,
99.39% accuracy, and 98.26% f1-score for automatic diagnosis of COVID-19 and other chest
diseases. For the vgg-19 model, the accuracy was 95.61%, the recall was 95.42%, precision
Fig. 7 10-fold cross-validation performance analysis of the CDC_Net; Vgg-19, ResNet-50, and Inception-v3
was 96.41%, and f1-score was 95.47%. For the ResNet-50 model, the accuracy was 96.15%,
the recall was 96.19%, precision was 96.91%, and f1-score was 96.18%. Finally, inception v3
achieved 95.16% accuracy, 95.01% recall, 95.15% precision, and 95.19% f1-score.
Fig. 8 Confusion matrix (a) CDC_Net; (b) Vgg-19, (c) ResNet-50, and (d) Inception-v3
Table 4 Performance comparison of the proposed model with pre-trained models
Sr.# Models ACC (%) SEN (%) Precision (%) F1 score (%)
1 Vgg-19 95.61 95.42 96.41 95.47

2 ResNet-50 96.15 96.19 96.91 96.18
3 Inception v3 95.16 95.01 95.15 95.19
4 CDC_Net 99.39 98.13 99.42 98.26
A comparison of the three transfer learning classifiers (inception v3, Vgg-19, and ResNet-
50) shows that the CDC Net model outperformed them all. Transfer learning classifiers are
deep networks, and the spatial resolution of the feature map for their final Conv layer outcomes
has been significantly reduced, resulting in poor classification accuracy. These transfer
learning classifiers’ filter size is not suited for such issues, and crucial properties such as the
neuron’s receptive fields were not taken into account when developing the large input. There
are no more concerns with low resolution and overlap in COVID-19 x-rays due to this
CDC_Net model. This approach reduces the impact of structured noise and improves classi-
fication performance by using a suitable filter size and a faster convergence time. The model is
considered to be suitable and effective if it attained the highest value of AU (ROC). The ROC
of the model is calculated by using TP and FP values. Figure 9 shows the AU(ROC) of the
CDC_Net and the other three transfer learning classifier. The CDC_Net model achieved an
AU(ROC) of 0.9953. For Vgg-19, Resnet-50 and inception-v3 the AU(ROC) were 0.9598,
0.9907, and 0.9305, respectively. The results of AU(ROC) divulge that the CDC_Net model
outperforms the other three transfer learning classifiers. We believe that the CDC_Net model
would be helpful for medical experts in detecting the COVID-19 positive cases from chest x-
rays.
4.4 Statistical analysis
McNemar’s statistical test [23] and the analysis of variance (ANOVA) test [20] were used to
evaluate the CDC_Net model’s viability, comparing it to the base classifiers, whose probabil-
ity scores were utilized to decide the construction of the proposed model. Table 5 shows the
results of McNemar’s and ANOVA tests on the multi-chest disease x-ray dataset used in this
study. There must be a lower p value (i.e., 0.05) in both McNemar’s and ANOVA tests to
reject the null hypothesis. Table 5 shows that the p values are less than 0.05 in all dataset
examples. Both statistical tests showed that the null hypothesis was rejected. This shows that
the CDC_Net model incorporates additional information from the base classifiers and that its
predictions are superior, ensuring that this model is statistically unique from the other
contributing models.
4.5 Discussions
X-rays of the chest are typically performed to diagnose multiple chest conditions at once. It
produces a detailed view of a specific region, which enables us to diagnose chest problems as
well as inside infections utilizing those images. When compared to the more modern technol-
ogy of RT-PCR, the procedure of classifying patients with COVID-19, pneumothorax,
pneumonia, LC, and TB infection using chest x-rays is quick, reliable, and efficient. However,
Fig. 9 ROC curves of (a) CDC_Net, (b) Vgg-19, (c) Resnet, (d) Inception-v3
the number of people who have tested positive for COVID-19 is increasing daily; therefore, an
automatic detection approach was required to discover this new flu virus at an earlier stage.
Chest x-rays can be analyzed with the use of artificial intelligence (AI), which enables us to
automatically diagnose cases of COVID-19 as well as other chest disorders. As a result, we
built a CNN-based model named CDC_Net that accurately detects x-ray images of COVID-
19, pneumothorax, pneumonia, LC, and TB. This model can assist medical professionals in
initiating the treatment process for COVID-19 infected persons at an earlier stage. The
experimental work that was performed above demonstrates that the CDC_Net model is
significantly and effectively trained on COVID-19, pneumothorax, pneumonia, LC, and TB
infection appearing on the lungs and that it correctly classifies these infected cases through x-
Table 5 Results of McNemar’s test and ANOVA test of the CDC_Net model
Statistical Analysis P Value
McNemar’s test 0.0230

ANOVA test 0.0021
rays. The CDC_Net has achieved outstanding classification accuracy in detecting chest-related
diseases using x-ray images, having an accuracy of 99.39% when compared to the classifica-
tion performance of three CNN-based pre-trained classifiers. On datasets with a fixed size of
299 × 299 × 3 image resolutions, the CDC Net, Vgg-19, Resnet-50, and Inception-v3 neural
networks were trained. In addition to this, the cross-entropy loss method was utilized when it
came to the training of the CDC Net model. Table 4 displays a comparison of the classification
performance of the CDC_Net model and the other three pre-trained classifiers that were
evaluated for this work in terms of a variety of parameters, including accuracy, precision,
recall, and f1-score. It has been observed that the CDC_Net model has accomplished a
remarkable level of performance, achieving the best levels of accuracy (99.39%), precision
(99.42%), and f1-score (98.26%), recall (98.13%), and AUC (0.9953). With pre-trained
weights, the categorization performance of the other three models has slightly deteriorated.
The AUC score for ResNet-50 was 0.9907, which was higher than the AUC scores of Vgg-19
and Inception-v3, which were 0.9598 and 0.9305, respectively. In comparison to all other
methods, inception-v3 yields the lowest less AUC score of 0.9583, the accuracy of 95.16%,
recall of 95.01%, f1-score of 95.19%, and precision of 95.15%. Pre-trained CNN models did
not have an impact on the overall binary classification problems. In contrast to this, these
models are more suited for recognizing several disease kinds [3] or for more complex
problems, such as segmentation. Additionally, most of the researchers [3, 9, 13, 20, 23, 24,
34, 47, 65, 86, 89, 102] believe that when the number of CNN layers rises for a given binary
classification task, these classifiers did not work appropriately.
The classification accuracy of the CDC_Net model is compared with the state-of-the-art
classifiers. The analysis of experimental outcomes with recent state-of-the-art methods shows
that the CDC_Net model of detecting the COVID-19, pneumothorax, pneumonia, LC, and
TB-infected x-rays has added considerable output in assisting the clinical expert. Jain et al.
[47] proposed an Xception model and achieved a classification accuracy of 97.97% in
identifying COVID-19 infected patients. Saha et al. [82] designed a novel CNN model which
is ensembled with different ML classifiers in classifying the COVID-19 radiograph images.
They achieved an accuracy of 98.91%. Apostolopoulos et al. [4] developed a MobileNet-V2
model for classifying COVID-19, and pneumonia including viral and bacterial, and normal
images. Their proposed model achieved an accuracy of 96.78%. Tsiknakis et al. [94] proposed
a CNN-based Inception-V3 model for classifying multi-chest diseases. They achieved an
accuracy of 76.0%. The work presented by Zhang et al. [105], achieved the classification
performance of the CNN model on multi-chest diseases using chest radiographs in terms of
accuracy was 72.77%. A CNN model called “dense connection network with parallel attention
module” (PAM-DenseNet) was constructed for the identification of COVID-19 in lung images
by Xiao et al. [102]. This model has achieved a recall of 95.74%, a specificity of 96.77%, an
accuracy of 94.29%, and a precision of 93.75%. When using chest x-rays to detect COVID-19,
pneumonia, and normal patients, Chowdhury et al. [13] developed the CNN-based
EfficientNet model known as ECOVNet. The ECOVNet model has a detection accuracy of
chest illnesses of 96.07%. The authors of the study [65] have designed an automated system to
classify multi-chest diseases using EfficientNet, and they achieved an average accuracy of
96.70%. For the diagnosis of COVID-19, Canayaz [9] proposed a novel hybrid technique
based on CBAM and EfficientNet. 99%of COVID-19 contaminated images are correctly
predicted by their model. Using MobileNet, Trivedi and Gupta [93] developed a lightweight
deep learning algorithm that can automatically diagnose pediatric pneumonia based on chest x-
rays. They were able to accurately diagnose 97% of the time.
Table 4 shows that CDC_Net is more capable of identifying abnormalities and extracting
the dominant and discriminative patterns in x-ray imaging samples, with the greatest accuracy
result of 99.39%. There are three more CNN-based pre-trained classifiers whose results are
also discussed in Table 4, and we provide a comprehensive explanation for why prior arts
show less classification performance by investigating the nature of COVID-19, pneumonia,
pneumothorax, and TB-infected chest x-rays and LC. As a first step, the deep networks of the
CNN-based pre-trained classifiers have been reduced to their final convolutional (Conv)
layers, which limits their classification performance. These pre-trained classifiers also have a
filter size that is unsuitable because the neurons connected to the input are so vast that the
major elements are ignored completely. These issues can be resolved using the CDC_Net
model. To diagnose several chest ailments utilizing x-ray images, we developed an end-to-end
CNN-based model in conjunction with the residual network thought and dilated convolution
values. In the inflammatory portion of chest x-rays, the CDC_Net model has solved the
problem of low resolution and overlapping. This model greatly reduces the detrimental impact
of structured noise and further enhances classification performance while accelerating conver-
gence. The CDC_Net model has a filter size of 3 × 3 as well. COVID-19, pneumothorax, LC,
PNEU, and TB were all successfully classified using the CDC_Net approach using x-rays, and
the results show that this method has provided great assistance to medical professionals.
5 Conclusion
In this study, the proposed CDC_Net model efficiently classifies the COVID-19, pneumotho-
rax, pneumonia, LC, and TB using chest x-rays. As a demonstration of the viability of our
approach, we compared the classification accuracy of the CDC_Net model with three transfer
learning models i.e., Vgg-19, ResNet-50, and Inception-v3. The proposed model was success-
ful in distinguishing the COVID-19 from other chest-related disorders with a rate of accuracy
of 99.39%. These findings demonstrate that the CDC Net model may be able to provide
automated viewing and detection of chest ailments by monitoring the lung’s opaqueness from
chest x-rays with a high accuracy rate and repeatability. These repercussions are primarily
significant to other medical professionals who rely mainly on subjective medical imaging-
based diagnostic characteristics. They have the potential to revolutionize the diagnostic process
that radiologic technologists use to identify these diseases from chest x-rays soon. In future
work, COVID-19 additional diagnostic values will be compared to standard morphological
aspects by the deep learning architecture, and CNN-based algorithms will be evaluated for
their performance in other chest-related cases. AI integration into radiology systems could be a
valuable tool to advise at the point of care and improve COVID-19 diagnosis from chest x-ray
quality, usability, and cost worldwide.
Funding No funding was received.
Data availability The authors declare that all data supporting the findings of this study are available within the article.
Declarations
Conflict of interest The authors declare no conflict of interest.

References
1. Abbas A, Abdelsamea MM, Gaber MM (2020) Classification of COVID-19 in chest X-ray images using
DeTraC deep convolutional neural network. Appl Intell 51:854–864. https://doi.org/10.1007/s10489-020-
01829-7
2. Alqudah AM, Qazan S (2020) Augmented COVID-19 X-ray images dataset, 4. https://doi.org/10.17632/
2FXZ4PX6D8.4
3. Alqudah AM, Qazan S, Masad IS (2021) Artificial intelligence framework for efficient detection and
classification of pneumonia using chest radiography images. J Med Biol Eng 41:599–609
4. Apostolopoulos ID, Mpesiana TA (2020) COVID-19: automatic detection from X-ray images utilizing
transfer learning with convolutional neural networks. Phys Eng Sci Med 43(2):635–640. https://doi.org/10.
1007/s13246-020-00865-4
5. Ayan E, Ünver HM (2019) Diagnosis of pneumonia from chest x-ray images using deep learning. In: 2019
scientific meeting on Electrical-Electronics & Biomedical Engineering and computer science (EBBT).
IEEE. pp 1-ll
6. Aydogdu M, Ozyilmaz E, Aksoy H, Gursel G, Numan E (2010) Mortality prediction in community-
acquired pneumonia requiring mechanical ventilation; values of pneumonia and intensive care unit severity
scores. TuberkToraks 58(1):25–34
7. Berahmand K, Nasiri E, Li Y (2021) Spectral clustering on protein-protein interaction networks via
constructing affinity matrix using attributed graph embedding. Comput Biol Med 138:104933
8. Bezier C, Anthoine G, Charki A (2020) Reliability of real-time RT-PCR tests to detect SARS-Cov-2: a
literature review. Int J Metrol Qual Eng 11:13
9. Canayaz M (2021) C+ EffxNet: a novel hybrid approach for COVID-19 diagnosis on CT images based on
CBAM and EfficientNet. Chaos, Solitons Fractals 151:111310
10. Candemir S, Jaeger S, Palaniappan K, Musco JP, Singh RK, Xue Z, Karargyris A, Antani S, Thoma G,
McDonald CJ (2014) Lung segmentation in chest radiographs using anatomical atlases with nonrigid
registration. IEEE Trans Med Imag 33(2):577–590. https://doi.org/10.1109/TMI.2013.2290491
11. Chawla NV, Bowyer KW, Hall LO, Kegelmeyer WP (2002) SMOTE: synthetic minority over-sampling
technique. J Artif Intell Res 16:321–357
12. Chouhan V, Singh SK, Khamparia A, Gupta D, Tiwari P, Moreira C, De Albuquerque VHC (2020) A
novel transfer learning based approach for pneumonia detection in chest X-ray images. Appl Sci 10(2):559
13. Chowdhury NK, Kabir MA, Rahman MM, Rezoana N (2021) ECOVNet: a highly effective ensemble
based deep learning model for detecting COVID-19. PeerJ Comput Sci 7:e551
14. Cifci MA (2020) Deep learning model for diagnosis of corona virus disease from CT images. Int J Sci Eng
Res 11(4):273–278
15. Cireşan DC, Giusti A, Gambardella LM, Schmidhuber J (2013) Mitosis detection in breast cancer
histology images with deep neural networks. Lect Notes Comput Sci 8150 LNCS(PART 2):411–418.
https://doi.org/10.1007/978-3-642-40763-5_51
16. Cohen JP, Morrison P, Dao L, Roth K, Duong TQ, Ghassemi M (2020) COVID-19 image data collection:
prospective predictions are the future [Online]. Available: http://arxiv.org/abs/2006.11988
17. Corman VM et al (2020) Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro
Surveill 25(3):2000045. https://doi.org/10.2807/1560-7917.ES.2020.25.3.2000045
18. COVID 19 chest X-ray [Online] (n.d.) Available: https://github.com/agchung
19. COVID-19 DATABASE | SIRM [Online] (n.d.) Available: https://www.sirm.org/en/category/articles/
COVID-19-database/
20. Cuevas A, Febrero M, Fraiman R (2004) An anova test for functional data. Comput Stat Data Anal 47:
111–122. https://doi.org/10.1016/j.csda.2003.10.021
21. Dadario AM (2020) COVID-19 X rays | Kaggle. https://www.kaggle.com/andrewmvd/convid19-x-rays.
22. Dansana D, Kumar R, Bhattacharjee A, Hemanth DJ, Gupta D, Khanna A, Castillo O (2020) Early
diagnosis of COVID-19-affected patients based on X-ray and computed tomography images using deep
learning algorithm. Soft Comput:1–9. https://doi.org/10.1007/s00500-020-05275-y
23. Dietterich T (1998) Approximate statistical tests for comparing supervised classification learning algo-
rithms. Neural Comput 10:1895–1923. https://doi.org/10.1162/089976698300017197
24. Dunnmon JA, Yi D, Langlotz CP, Ré C, Rubin DL, Lungren MP (2019) Assessment of convolutional
neural networks for automated classification of chest radiographs. Radiology 290:537–544
25. El Asnaoui K (2021) Design ensemble deep learning model for pneumonia disease classifcation. Int J
Multimed Inf Retr 10:55–68
26. Esteva A, Kuprel B, Novoa RA, Ko J, Swetter SM, Blau HM, Thrun S (2017) Dermatologist-level
classification of skin cancer with deep neural networks. Nature 542(7639):115–118
27. Frederick Nat Lab (2018) The cancer imaging archive (TCIA). The Cancer Imaging Archive, p 1 [Online].
Available: https://www.cancerimagingarchive.net
28. Gaillard F (2014) Radiopaedia.org, the wiki-based collaborative Radiology resource. Radiopaedia.org;
[Online]. Available: http://radiopaedia.org/
29. Grewal M, Srivastava MM, Kumar P, Varadarajan S (2018) Radnet: radiologist level accuracy using deep
learning for hemorrhage detection in ct scans. In: 2018 IEEE 15th international symposium on biomedical
imaging (ISBI 2018). IEEE, pp 281–284
30. Guan Q, Huang Y, Zhong Z, Zheng Z, Zheng L, Yang Y (2018) Diagnose like a radiologist: attention
guided convolutional neural network for thorax disease classification. arXiv:1801.09927. Retrieved from
https://arxiv.org/abs/1801.09927v1
31. Gulshan V, Peng L, Coram M, Stumpe MC, Wu D, Narayanaswamy A, Venugopalan S, Widner K,
Madams T, Cuadros J, Kim R, Raman R, Nelson PC, Mega JL, Webster DR (2016) Development and
validation of a deep learning algorithm for detection of diabetic retinopathy in retinal fundus photographs.
JAMA 316(22):2402–2410
32. Hammoudi K, Benhabiles H, Melkemi M, Dornaika F, Arganda-Carreras I, Collard D, Scherpereel A
(2021) Deep learning on chest X-ray images to detect and evaluate pneumonia cases at the era of
COVID19. J Med Syst 45:75–75
33. Hannun AY, Rajpurkar P, Haghpanahi M, Tison GH, Bourn C, Turakhia MP, Ng AY (2019) Cardiologist-
level arrhythmia detection and classification in ambulatory electrocardiograms using a deep neural
network. Nat Med 25(1):65–69
34. Hassantabar S, Ahmadi M, Sharifi A (2020) Diagnosis and detection of infected tissue of COVID-19
patients based on lung x-ray image using convolutional neural network approaches. Chaos, Solitons
Fractals 140:110170
35. He K, Zhang X, Ren S, Sun J (2016) Deep residual learning for image recognition. In: Proceedings of the
IEEE conference on computer vision and pattern recognition, pp 770–778
36. He K, Zhang X, Ren S, Sun J (2016) Deep residual learning for image recognition. In: Proceedings of the
IEEE conference on computer vision and pattern recognition. IEEE, pp 770–778
37. He K, Zhang X, Ren S, Sun J (2016) In: 2016 IEEE conference on computer vision and pattern recognition
IEEE conference on computer vision and pattern recognition. IEEE, pp 770–778
38. Hermann S (2014) Evaluation of scan-line optimization for 3D medical image registration. In: Proceedings
of the IEEE conference on computer vision and pattern recognition, pp 3073–3080
39. Horry M et al (2020) X-ray image based COVID-19 detection using pre-trained deep learning models.
https://doi.org/10.31224/osf.io/wx89s
40. Huang G, Liu Z, Van Der Maaten L, Weinberger KQ (2017) Densely connected convolutional networks.
In: Proceedings of the IEEE Conference on Computer Vision and Pattern Recognition. IEEE, pp 4700–
4708
41. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z (2020) Clinical
features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 395:497–506. https://
doi.org/10.1016/S0140-6736(20)30183-5
42. Hui DS, Azhar EI, Madani TA et al (2020) The continuing 2019nCoV epidemic threat of novel
coronaviruses to global health the latest 2019 novel coronavirus outbreak in Wuhan, China. Int J Infect
Dis 91:264–266
43. Hwang EJ et al (2019) Development and validation of a deep learning-based automated detection
algorithm for major thoracic diseases on chest radiographs. JAMA Netw Open 2(3):e191095. https://
doi.org/10.1001/jamanetworkopen.2019.1095
44. Islam MM, Karray F, Alhajj R, Zeng J (2021) A review on deep learning techniques for the diagnosis of
novel coronavirus (COVID-19). IEEE Access 9:30551–30572
45. Jaeger S, Karargyris A, Candemir S, Folio L, Siegelman J, Callaghan F, Xue Z, Palaniappan K, Singh RK,
Antani S, Thoma G, Wang Y-X, Lu P-X, McDonald CJ (2014) Automatic tuberculosis screening using
chest radiographs. IEEE Trans Med Imag 33(2):233–245. https://doi.org/10.1109/TMI.2013.2284099
46. Jaeger S, Candemir S, Antani S, Wáng Y-XJ LP-X, Thoma G (2014) Two public chest Xray datasets for
computer-aided screening of pulmonary diseases. Quant Imag Med Surg 4(6):475–477. https://doi.org/10.
3978/j.issn.2223-4292.2014.11.20
47. Jain R, Gupta M, Taneja S, Hemanth DJ (2021) Deep learning-based detection and analysis of COVID-19
on chest X-ray images. Appl Intell 51(3):1690–1700
48. Jaiswal AK, Tiwari P, Kumar S, Gupta D, Khanna A, Rodrigues JJ (2019) Identifying pneumonia in chest
X-rays: a deep learning approach. Measurement 145:511–518
49. Janizek JD, Erion G, DeGrave AJ, Lee SI (2020) An adversarial approach for the robust classification of
pneumonia from chest radiographs. In: Proceedings of the ACM conference on health, inference, and
learning, pp 69–79
50. Kermany DS, Goldbaum M, Cai W, Valentim C, Liang H, Baxter SL et al (2018) Identifying medical
diagnoses and treatable diseases by image-based deep learning. Cell 172(5 Feb 2018):1122–1131. https://
doi.org/10.1016/j.cell.2018.02.010
51. Kermany D, Zhang K, Goldbaum M (2018) Labeled optical coherence tomography (OCT) and chest X-
ray images for classification. Mendeley Data 2(2):651
52. King BF Jr (2018) Artificial intelligence and radiology: what will the future hold? J Am CollRadiol 15:
501–503
53. Komal A, Malik H (2022) Transfer learning method with deep residual network for COVID-19 diagnosis
using chest radiographs images. In: Proceedings of international conference on information technology and
applications. Springer, Singapore, pp 145–159
54. Liang G, Zheng L (2020) A transfer learning method with deep residual network for pediatric pneumonia
diagnosis. Comput Methods Prog Biomed 187:104964
55. Litjens G, Kooi T, Bejnordi BE, Setio AAA, Ciompi F, Ghafoorian M, van der Laak J, van Ginneken B,
Sanchez CI (2017) A survey on deep learning in medical image analysis. Med Image Anal 42:60–88.
https://doi.org/10.1016/j.media.2017.07.005
56. Liu J, Liu F, Liu Y, Wang HW, Feng ZC (2014) Lung ultrasonography for the diagnosis of severe neonatal
pneumonia. Chest 146(2):383–388
57. Liu W, Wang Z, Liu X, Zeng N, Liu Y, Alsaadi FE (2017) A survey of deep neural network architectures
and their applications. Neurocomputing 234:11–26
58. Loey M, Smarandache F, Khalifa NEM (2020) Within the lack of chest COVID-19 X-ray dataset: a novel
detection model based on GAN and deep transfer learning. Symmetry 12(4):651. https://doi.org/10.3390/
SYM12040651
59. Lu J, Behbood V, Hao P, Zuo H, Xue S, Zhang G (2015) Transfer learning using computational
intelligence: a survey. Knowl-Based Syst 80:14–23
60. Lu H, Stratton CW, Tang YW (2020) Outbreak of pneumonia of unknown etiology in Wuhan China: the
mystery and the miracle. J Med Virol 92:401–402 (published online Jan 16). https://doi.org/10.1002/jmv.
25678
61. Mahmud T, Rahman MA, Fattah SA (2020) CovXNet: a multi-dilation convolutional neural network for
automatic COVID-19 and other pneumonia detection from chest X-ray images with transferable multi-
receptive feature optimization. Comput Biol Med 122:103869. https://doi.org/10.1016/j.compbiomed.
2020.103869
62. Malik H, Anees T, Naeem A (2020) Chest Radiographs of COVID-19 infected. Mendeley Data V1.
https://doi.org/10.17632/67dmnmx33v.1
63. Malik H, Farooq MS, Khelifi A, Abid A, Qureshi JN, Hussain M (2020) A comparison of transfer learning
performance versus health experts in disease diagnosis from medical imaging. IEEE Access 8:139367–
139386
64. Malik H, Anees T, Mui-zzud-din (2022) BDCNet: multi-classification convolutional neural network
model for classification of COVID-19, pneumonia, and lung cancer from chest radiographs. Multimedia
Systems 28:815–829. https://doi.org/10.1007/s00530-021-00878-3
65. Marques G, Agarwal D, de la Torre DI (2020) Automated medical diagnosis of COVID-19 through
EfficientNet convolutional neural network. Appl Soft Comput 96:106691
66. Melendez J, van Ginneken B, Maduskar P, Philipsen RH, Reither K, Breuninger M, Sánchez CI (2014) A
novel multiple-instance learning-based approach to computer-aided detection of tuberculosis on chest x-
rays. IEEE Trans Med Imaging 34(1):179–192
67. Mohsen H, El-Dahshan E-SA, El-Horbaty E-SM, Salem A-BM (2018) Classification using deep learning
neural networks for brain tumors. Futur Comput Informatics J 3(1):68–71. https://doi.org/10.1016/j.fcij.
2017.12.001
68. Mooney P (2018) Chest X-ray images (pneumonia) | Kaggle. Kaggle.com. https://www.kaggle.com/
paultimothymooney/chest-xray-pneumonia%0A https://www.kaggle.com/paultimothymooney/chest-
xray-pneumonia%0A https://data.mendeley.com/datasets/rscbjbr9sj/2. Accessed 30 Aug 2021
69. National Institutes of Health Chest X-Ray Dataset (2019) Retrieved January 29, 2020 from https://nihcc.
app.box.com/v/ChestXray-NIHCC/folder/36938765345
70. NIH chest X-rays (2018) Kaggle; [Online]. Available: https://www.kaggle.com/nih-chest-xrays/data
71. Oh Y, Park S, Ye JC (2020) Deep learning COVID-19 features on CXR using limited training data sets.
IEEE Trans Med Imag 39(8):2688–2700. https://doi.org/10.1109/TMI.2020.2993291
72. Pneumothorax Database (2021) Kaggle; [online]. Available: https://www.kaggle.com/vbookshelf/
pneumothorax-chest-xray-images-and-masks
73. Quang D, Xie X (2016) DanQ: a hybrid convolutional and recurrent deep neural network for quantifying
the function of DNA sequences. Nucleic Acids Res 44(11):e107. https://doi.org/10.1093/nar/gkw226
74. Rahimzadeh M, Attar A (2020) A modified deep convolutional neural network for detecting COVID-19
and pneumonia from chest X-ray images based on the concatenation of Xception and ResNet50V2.
Informatics Med Unlocked 19:100360. https://doi.org/10.1016/j.imu.2020.100360
75. Rajaraman S, Candemir S, Kim I, Thoma G, Antani S (2018) Visualization and interpretation of
convolutional neural network predictions in detecting pneumonia in pediatric chest radiographs. Appl
Sci 8(10):1715
76. Rajpurkar P, Irvin J, Zhu K, Yang B, Mehta H, Duan T et al (2017) CheXNet: radiologist-level pneumonia
detection on chest x-rays with deep learning. arXiv:1711.05225. Retrieved from https://arxiv.org/abs/1711.
05225
77. Refaeilzadeh P, Tang L, Liu H (2009) Cross-validation. Encyclopedia Database Syst 5:532–538
78. Resnick S, Inaba K, Karamanos E, Skiada D, Dollahite JA, Okoye O, Demetriades D (2017) Clinical
relevance of the routine daily chest X-ray in the surgical intensive care unit. Am J Surg 214(1):19–23
79. Rostami M, Berahmand K, Nasiri E, Forouzandeh S (2021) Review of swarm intelligence-based feature
selection methods. Eng Appl Artif Intell 100:104210
80. Rostami M, Forouzandeh S, Berahmand K, Soltani M, Shahsavari M, Oussalah M (2022) Gene selection
for microarray data classification via multi-objective graph theoretic-based method. Artif Intell Med 123:
102228
81. Russakovsky O, Deng J, Su H, Krause J, Satheesh S, Ma S, Huang Z, Karpathy A, Khosla A, Bernstein M,
Berg AC, Fei-Fei L (2015) ImageNet large scale visual recognition challenge. Int J Comput Vis 115:211–
252
82. Saha P, Sadi MS, Islam MM (2021) EMCNet: automated COVID-19 diagnosis from X-ray images using
convolutional neural network and ensemble of machine learning classifiers. Inform Med Unlocked 22:
100505
83. Sethy PK, Behera SK, Ratha PK, Biswas P (2020) Detection of coronavirus disease (COVID- 19) based
on deep features and support vector machine. Int J Math Eng Manag Sci 5(4):643–651. https://doi.org/10.
33889/IJMEMS.2020.5.4.052
84. Shiraishi J, Katsuragawa S, Ikezoe J, Matsumoto T, Kobayashi T, Komatsu KI, Matsui M, Fujita H,
Kodera Y, Doi K (2000) Development of a digital image database for chest radiographs with and without a
lung nodule: receiver operating characteristic analysis of radiologists' detection of pulmonary nodules. Am
J Roentgenol 174(1):71–74
85. Simonyan K, Zisserman A (2015) Very deep convolutional networks for large-scale image recognition. In:
International Conference on Learning Representations (ICLR)
86. Singh D, Kumar V (2020) Vaishali et al. classification of COVID-19 patients from chest CT images using
multi-objective differential evolution–based convolutional neural networks. Eur J Clin Microbiol Infect
Dis 39:1379–1389. https://doi.org/10.1007/s10096-020-03901-z
87. Srivastava N, Hinton G, Krizhevsky A, Sutskever I, Salakhutdinov R (2014) Dropout: a simple way to
prevent neural networks from overfitting. J Mach Learn Res 15(1):1929–1958
88. Stephen O, Sain M, Maduh UJ, Jeong DU (2019) An efficient deep learning approach to pneumonia
classification in healthcare. J Healthc Eng 2019:1–7
89. Szegedy C, Wei L, Yangqing J et al (eds) (2015) Going deeper with convolutions. In: 2015 IEEE
conference on computer vision and pattern recognition (CVPR)
90. Szegedy C, Ioffe S, Vanhoucke V, Alemi A (2017) Inception-v4, inception-resnet and the impact of
residual connections on learning. In: Proceedings of the AAAI conference on artificial intelligence (Vol.
31, no. 1)
91. Tahamtan A, Ardebili A (2020) Real-time RT-PCR in COVID-19 detection: issues affecting the results.
Expert Rev Mol Diagn 20(5):453–454. https://doi.org/10.1080/14737159.2020.1757437
92. Too EC, Yujian L, Njuki S, Yingchun L (2019) A comparative study of fine-tuning deep learning models
for plant disease identification. Comput Electron Agric 161:272–279
93. Trivedi M, Gupta A (2021) A lightweight deep learning architecture for the automatic detection of
pneumonia using chest X-ray images. Multimed Tools Appl 81:5515–5536. https://doi.org/10.1007/
s11042-021-11807-x
94. Tsiknakis N, Trivizakis E, Vassalou E, Papadakis G, Spandidos D, Tsatsakis A, Sánchez-García J, López-
González R, Papanikolaou N, Karantanas A, Marias K (2020) Interpretable artificial intelligence frame-
work for COVID-19 screening on chest X-rays. Exp Ther Med 20:727–735. https://doi.org/10.3892/etm.
2020.8797
95. Tuberculosis (TB) Chest X-ray Database (2021) Kaggle; [online]. Available: https://www.kaggle.com/
tawsifurrahman/tuberculosis-tb-chest-xray-dataset
96. Waheed A, Goyal M, Gupta D, Khanna A, Al-Turjman F, Pinheiro PR (2020) COVIDgan: data
augmentation using auxiliary classifier Gan for improved COVID-19 detection. IEEE Access 8:91916–
91923
97. Wang X, Peng Y, Lu L, Lu Z, Bagheri M, Summers RM (2017) ChestX-ray8: hospital-scale chest X- ray
database and benchmarks on weakly-supervised classification and localization of common thorax diseases.
In: Proceedings of the 30th IEEE conference on computer vision and pattern recognition (CVPR).
(Honolulu, Hawaii, USA, 21-26 July 2017), pp 3462–3471. https://doi.org/10.1109/CVPR.2017.369
98. Wang Q, Yang D, Li Z, Zhang X, Liu C (2020) Deep regression via Multi-Channel multi-modal learning
for pneumonia screening. IEEE Access 8:78530–78541
99. Wang S, Kang B, Ma J, Zeng X, Xiao M, Guo J, Xu B (2020) A deep learning algorithm using CT images
to screen for Corona virus disease (COVID-19). MedRxiv
100. WHO (2020) Clinical management of severe acute respiratory infection when Novel coronavirus (nCoV)
infection is suspected: interim guidance. https://www.who.int/internalpublicationsdetail/
clinicalmanagementofsevereacuterespiratoryinfectionwhennovelcoronavirus(ncov)infectionissuspected
101. Worldometer (2020) Coronavirus update (live): cases and deaths from COVID-19 virus pandemic.
Worldometers. https://www.worldometers.info/coronavirus/%0A https://www.worldometers.info/
coronavirus/?
102. Xiao B, Yang Z, Qiu X, Xiao J, Wang G, Zeng W, Chen W (2021) PAM-DenseNet: a deep convolutional
neural network for computer-aided COVID-19 diagnosis. IEEE Trans Cybern:1–12
103. Yu F, Koltun V, Funkhouser T (2017) Dilated residual networks. In: Proceedings of the IEEE conference
on computer vision and pattern recognition, pp 472–480
104. Zakirov AN, Kuleev RF, Timoshenko AS, Vladimirov AV (2015) Advanced approaches to computer-
aided detection of thoracic diseases on chest X-rays. Appl Math Sci 9(88):4361–4369
105. Zhang J, Xie Y, Li Y, Shen C, Xia Y (2020) COVID-19 screening on chest X-ray images using deep
learning based anomaly detection. aeXiv.2002.12338 vol. 1
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Multimedia Tools and Applications (2023) 82:13855–13880

CDC_Net: multi-classification convolutional neural

Received: 17 January 2022 / Revised: 30 June 2022 / Accepted: 6 September 2022 /

it came to identifying various chest diseases (with an accuracy of 99.39%, a recall of

Keywords COVID-19 . Pneumonia . Deep learning . Chest x-rays . Coronavirus

This manuscript is structured as follows. State-of-the-art is discussed in section 2. In section 3,

Ref Datasets Objective Models Results

approaches rely solely on pre-trained and handcrafted methods to accomplish a notable

3 Materials and methods

3.1 Dataset descriptions

3.2 Data preprocessing, augmentation, and normalization

Table 2 Splitting of the dataset for training, testing, and validation

Training 1670 8400 2707 3500 2940 2065 21,282

3.3 Transfer learning image classifiers

3.4 Proposed CDC_Net model

Table 3 CDC_Net Model Summary

No. of Layers Layers Shape Parameters

0 chest_input_1 (InputImage) (299, 299, 3) 0

3.5 Performance evaluation

4 Experimental results and discussions

4.1 Experimental process

4.2 Visualization of test outputs

4.3 Results analysis

Fig. 6 Heatmap of all five chest diseases

Table 4 Performance comparison of the proposed model with pre-trained models

1 Vgg-19 95.61 95.42 96.41 95.47

4.4 Statistical analysis

Statistical Analysis P Value

McNemar’s test 0.0230

Funding No funding was received.

Conflict of interest The authors declare no conflict of interest.

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