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Emerging Trends and
Applications in Cognitive
Computing

Pradeep Kumar Mallick

St. Peter’s University, India

Samarjeet Borah
Sikkim Manipal University, India

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Table of Contents

Foreword.............................................................................................................. xii

Preface.................................................................................................................xiii

Chapter 1
Design of Cognitive Healthcare System for Coronary Cardiac Disease .
Detection.................................................................................................................1
Mihir Narayan Mohanty, Siksha ‘O’ Anusandhan University, India

Chapter 2
A Cognitive Information Retrieval Using POP Inference Engine Approaches....35
Parul Kalra, Amity University, India
Deepti Mehrotra, Amity University, India
Abdul Wahid, Maulana Azad National Urdu University, India

Chapter 3
Assessing Animal Emotion and Behavior Using Mobile Sensors and
Affective Computing.............................................................................................49
Heath Yates, Kansas State University, USA
Brent Chamberlain, Utah State University, USA
William Baldwin, Biosecurity Research Institute, USA
William Hsu, Kansas State University, USA
Dana Vanlandingham, Biosecurity Research Institute, USA

Chapter 4
Neuro-Fuzzy Models and Applications................................................................78
Sushruta Mishra, KIIT University, India
Soumya Sahoo, C. V. Raman College of Engineering, India
Brojo Kishore Mishra, C. V. Raman College of Engineering, India

Chapter 5
Human Health Risk Assessment via Amalgamation of Probability and Fuzzy
Numbers................................................................................................................99
Palash Dutta, Dibrugarh University, India
 

Chapter 6
Green Computing: A Step Towards Eco-Friendly Computing...........................124
Sunil Kumar Mohapatra, College of Engineering and Technology, India
Priyadarshini Nayak, Central Institute of Plastic Engineering and
Technology, India
Sushruta Mishra, KIIT University, India
Sukant Kishoro Bisoy, C. V. Raman College of Engineering, India

Chapter 7
Software Quality Measurement: State of the Art................................................150
Dalila Amara, SMART Lab, Université de Tunis, Institut Supérieur de
Gestion, Tunis, Tunisie
Latifa Ben Arfa Rabai, SMART Lab, Université de Tunis, Institut
Supérieur de Gestion, Tunis, Tunisie & College of Business,
University of Buraimi, Al Buraimi, Oman

Chapter 8
A Study on Risk Management in Financial Market............................................182
Smruti Rekha Das, SOA University, India
Kuhoo, College of Engineering and Technology, India
Debahuti Mishra, SOA University, India
Pradeep Kumar Mallick, Gurukula Kangri Vishwavidyalaya, India

Chapter 9
Clustering Techniques: A Review on Some Clustering Algorithms..................198
Harendra Kumar, Gurukula Kangri Vishwavidyalaya, India

Chapter 10
Addressing Security Issues and Standards in Internet of Things........................224
Sushruta Mishra, KIIT University, India
Soumya Sahoo, C. V. Raman College of Engineering, India
Brojo Mishra, C. V. Raman College of Engineering, India

Compilation of References............................................................................... 258

About the Contributors.................................................................................... 295

Index................................................................................................................... 299
Detailed Table of Contents

Foreword.............................................................................................................. xii

Preface.................................................................................................................xiii

Chapter 1
Design of Cognitive Healthcare System for Coronary Cardiac Disease .
Detection.................................................................................................................1
Mihir Narayan Mohanty, Siksha ‘O’ Anusandhan University, India

This chapter focuses on clinical decision system (CDS) uses in healthcare units.
In this chapter, cognitive approaches are taken using soft computing techniques
to design clinical decision systems (CDS) for modern healthcare units. Cognitive
computing-based approach is considered. It focuses on cardiac disease detection
exclusively by considering its surrounding factors. Fuzzy logic is utilized as one
part. The other part includes diabetic detection using deep neural network (DNN) for
the automatic identification of the disease. The experiment was done with the Pima
Indian dataset. The classification result has been presented in the result section. The
decision system in the healthcare unit is a suitable example of a multi-agent system.

Chapter 2
A Cognitive Information Retrieval Using POP Inference Engine Approaches....35
Parul Kalra, Amity University, India
Deepti Mehrotra, Amity University, India
Abdul Wahid, Maulana Azad National Urdu University, India

The focus of this chapter is to design a cognitive information retrieval (CIR)

framework using inference engine (IE). IE permits one to analyze the central
concepts of information retrieval: information, information needs, and relevance.
The aim is to propose an inference engine in which adequate user preferences are
considered. As the cognitive inference engine (CIE) approach is involved, the
complex inquiries are required to return more important outcomes as opposed to
customary database questions which get irrelevant and unsolicited responses or
results. The chapter highlights the framework of a cognitive rule-based engine in
 

which preference queries are dealt with while keeping in mind the intention of the
user, their performance, and optimization.

Chapter 3
Assessing Animal Emotion and Behavior Using Mobile Sensors and
Affective Computing.............................................................................................49
Heath Yates, Kansas State University, USA
Brent Chamberlain, Utah State University, USA
William Baldwin, Biosecurity Research Institute, USA
William Hsu, Kansas State University, USA
Dana Vanlandingham, Biosecurity Research Institute, USA

Affective computing is a very active and young field. It is driven by several promising
areas that could benefit from affective intelligence such as virtual reality, smart
surveillance, perceptual interfaces, and health. This chapter suggests new design for
the detection of animal affect and emotion under an affective computing framework
via mobile sensors and machine learning. The authors review existing literature and
suggest new use cases by conceptual reevaluation of existing work done in affective
computing and animal sensors.

Chapter 4
Neuro-Fuzzy Models and Applications................................................................78
Sushruta Mishra, KIIT University, India
Soumya Sahoo, C. V. Raman College of Engineering, India
Brojo Kishore Mishra, C. V. Raman College of Engineering, India

The modern techniques of artificial intelligence have found application in almost all
the fields of human knowledge. Among them, two important techniques of artificial
intelligence, fuzzy systems (FS) and artificial neural networks (ANNs), have found
many applications in various fields such as production, control systems, diagnostic,
supervision, etc. They evolved and improved throughout the years to adapt arising
needs and technological advancements. However, a great emphasis is given in the
engineering field. The techniques of artificial intelligence based on fuzzy logic and
neural networks are frequently applied together for solving engineering problems
where the classic techniques do not supply an easy and accurate solution. Separately,
each one of these techniques possesses advantages and disadvantages that, when
mixed together, provide better results than the ones achieved with the use of each
isolated technique. As ANNs and fuzzy systems have often been applied together,
the concept of a fusion between them started to take shape. Neuro-fuzzy systems
were born which utilize the advantages of both techniques. Such systems show two
distinct ways of behavior. In a first phase, called learning phase, it behaves like neural
networks that learn internal parameters off-line. Later, in the execution phase, it
behaves like a fuzzy logic system. A neuro-fuzzy system is a fuzzy system that uses a


learning algorithm derived from or inspired by neural network theory to determine its
parameters (fuzzy sets and fuzzy rules) by processing data samples. Neural networks
and fuzzy systems can be combined to join its advantages and to cure its individual
illness. Neural networks introduce its computational characteristics of learning in
the fuzzy systems and receive from them the interpretation and clarity of systems
representation. Thus, the disadvantages of the fuzzy systems are compensated by
the capacities of the neural networks. These techniques are complementary, which
justifies its use together. This chapter deals with an analysis of neuro-fuzzy systems.
Benefits of these systems are studied with its limitations too. Comparative analyses
of various categories of neuro-fuzzy systems are discussed in detail. Apart from
these, real-time applications of such systems are also presented.

Chapter 5
Human Health Risk Assessment via Amalgamation of Probability and Fuzzy
Numbers................................................................................................................99
Palash Dutta, Dibrugarh University, India

This chapter presents an approach to combine probability distributions with imprecise

(fuzzy numbers) parameters (mean and standard deviation) as well as fuzzy numbers
(FNs) of various types and shapes within the same framework. The amalgamation of
probability distribution and fuzzy numbers are done by generating three algorithms.
Human health risk assessment is performed through the proposed algorithms. It is
found that the chapter provides an exertion to perform human health risk assessment
in a specific manner that has more efficacies because of its capacity to exemplify
uncertainties of risk assessment model in its own fashion. It affords assistance to
scientists, environmentalists, and experts to perform human health risk assessment
providing better efficiency to the output.

Chapter 6
Green Computing: A Step Towards Eco-Friendly Computing...........................124
Sunil Kumar Mohapatra, College of Engineering and Technology, India
Priyadarshini Nayak, Central Institute of Plastic Engineering and
Technology, India
Sushruta Mishra, KIIT University, India
Sukant Kishoro Bisoy, C. V. Raman College of Engineering, India

With the increase in the number of computers, the amount of energy consumed by
them is on a significant rise, which in turn is increasing carbon content in atmosphere.
With the realization of this problem, measures are being taken to minimize the power
usage of computers. The solution is green computing. It is the efficient utilization
of computing resources while minimizing environmental impact and ensuring
both economic and social benefits. Green computing is a balanced and sustainable
approach towards achieving a healthier and safer environment without compromising
the technological needs of the current and future generations. This chapter studies
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the architectural aspects, the scope, and the applications of green computing. The
emphasis of this study is on current trends in green computing, challenges in the
field of green computing, and the future trends of green computing.

Chapter 7
Software Quality Measurement: State of the Art................................................150
Dalila Amara, SMART Lab, Université de Tunis, Institut Supérieur de
Gestion, Tunis, Tunisie
Latifa Ben Arfa Rabai, SMART Lab, Université de Tunis, Institut
Supérieur de Gestion, Tunis, Tunisie & College of Business,
University of Buraimi, Al Buraimi, Oman

Software measurement helps to quantify the quality and the effectiveness of

software to find areas of improvement and to provide information needed to make
appropriate decisions. In the recent studies, software metrics are widely used for
quality assessment. These metrics are divided into two categories: syntactic and
semantic. A literature review shows that syntactic ones are widely discussed and are
generally used to measure software internal attributes like complexity. It also shows
a lack of studies that focus on measuring external attributes like using internal ones.
This chapter presents a thorough analysis of most quality measurement concepts.
Moreover, it makes a comparative study of object-oriented syntactic metrics to identify
their effectiveness for quality assessment and in which phase of the development
process these metrics may be used. As reliability is an external attribute, it cannot
be measured directly. In this chapter, the authors discuss how reliability can be
measured using its correlation with syntactic metrics.

Chapter 8
A Study on Risk Management in Financial Market............................................182
Smruti Rekha Das, SOA University, India
Kuhoo, College of Engineering and Technology, India
Debahuti Mishra, SOA University, India
Pradeep Kumar Mallick, Gurukula Kangri Vishwavidyalaya, India

The basic aim of risk management is to recognize, assess, and prioritize risk in order
to assure that the uncertainty should not deviate from the intended purpose of the
business goals. Risk can take place from various sources, which includes uncertainty
in financial markets, recessions, inflation, interest rates, currency fluctuations, etc.
Various methods used for this management of risk are faced with various decisions
such as the market price, historical data, statistical methodologies, etc. For stock
prices, the information derives from the historical data where the next price depends
only upon the current price and some of the outside factors. Financial market is very
risky to invest money, but the proper prediction with handling the risk will benefit
a lot. Various types of risk in the financial market and the appropriate solutions to
overcome the risk are analyzed in this study.


Chapter 9
Clustering Techniques: A Review on Some Clustering Algorithms..................198
Harendra Kumar, Gurukula Kangri Vishwavidyalaya, India

Clustering is a process of grouping a set of data points in such a way that data
points in the same group (called cluster) are more similar to each other than to data
points lying in other groups (clusters). Clustering is a main task of exploratory data
mining, and it has been widely used in many areas such as pattern recognition, image
analysis, machine learning, bioinformatics, information retrieval, and so on. Clusters
are always identified by similarity measures. These similarity measures include
intensity, distance, and connectivity. Based on the applications of the data, different
similarity measures may be chosen. The purpose of this chapter is to produce an
overview of much (certainly not all) of clustering algorithms. The chapter covers
valuable surveys, the types of clusters, and methods used for constructing the clusters.

Chapter 10
Addressing Security Issues and Standards in Internet of Things........................224
Sushruta Mishra, KIIT University, India
Soumya Sahoo, C. V. Raman College of Engineering, India
Brojo Mishra, C. V. Raman College of Engineering, India

In the IoTs era, the short-range mobile transceivers will be implanted in a variety of
daily requirements. In this chapter, a detail survey in several security and privacy
concerns related to internet of things (IoTs) by defining some open challenges are
discussed. The privacy and security implications of such an evolution should be
carefully considered to the promising technology. The protection of data and privacy
of users has been identified as one of the key challenges in the IoT. In this chapter,
the authors present internet of things with architecture and design goals. They survey
security and privacy concerns at different layers in IoTs. In addition, they identify
several open issues related to the security and privacy that need to be addressed by
research community to make a secure and trusted platform for the delivery of future
internet of things. The authors also discuss applications of IoTs in real life. A novel
approach based on cognitive IoT is presented, and a detailed study is undertaken.
In the future, research on the IoTs will remain a hot issue.

Compilation of References............................................................................... 258

About the Contributors.................................................................................... 295

Index................................................................................................................... 299
xii

Foreword

Cognitive Informatics (CI) is a burgeoning interdisciplinary domain comprising of

the cognitive and information sciences that focuses on human information processing,
mechanisms and processes within the context of computing and computer applications.
The main goal is to research and develop technologies to facilitate and extend
the information management capacity of individuals through the development and
application of novel concepts in human-system integration to address cognitive
bottlenecks (e.g., limitations in attention, memory, learning, comprehension,
visualization abilities, and decision making). Such mitigations may include
applications and technologies informed by research in psychology/behavioural
science, neuroscience, artificial intelligence, or linguistics.
As initiated by Dr. Pradeep Kumar Mallick and Dr. Samarjeet Borah, Handbook
of Research on Emerging Trends and Applications in Cognitive Computing
presents new approaches and methods for solving real-world problems. It offers,
in particular, exploratory research that describes novel approaches in the fields of
Cognitive Informatics, Cognitive Computing, Computational Intelligence, Advanced
Computing, Hybrid Intelligent Models and Applications. New algorithms and methods
in a variety of fields are also presented, together with solution-based approaches. The
topics addressed include various theoretical aspects and applications of Computer
Science, Artificial Intelligence, Cybernetics, Automation Control Theory and
Software Engineering.
People are working on these with enthusiasm, tenacity, and dedication to develop
new methods of analysis and provide new solutions to keep up with the ever-changing
cognitive informatics. This book is a good step in Cognitive Computing direction.

Gyoo-Soo Chae
Baekseok University, South Korea
 xiii

Preface

Emerging Trends and Applications in Cognitive Computing is a collection of research

findings of various authors working in the domain.
The first chapter of this volume discusses a design of cognitive healthcare system
for coronary cardiac diseases detection. It is basically a Cognitive Information
Retrieval (CIR) framework using Inference Engine (IE). It explains a framework
of a cognitive rule-based engine in which preference queries are dealt with keeping
in mind the intention of the user, their performance and optimization. Next chapter
is cognitive radio network spectrum (“white spaces”) holes sensing, assignment
methods and access in dual technologies. As per the authors prime challenge for
optional radio frameworks is to have the capacity to robustly detect when they are
inside such a frequencies hole. We review existing literature and suggest new use
cases by conceptual reevaluation of existing work done in affective computing and
animal sensors. A study on neuro-fuzzy models and applications is presented by
Mishra et al. in their chapter. Benefits of these systems are studied with its limitations
too. They are presenting a comparative analyses of various categories of Neuro-
Fuzzy systems are discussed in detail. The evaluation of health risk is the procedure
to assess the character and chance of hostile human health consequences those are
affected by radiation or other harmful compounds in polluted ecological medium,
at the present or in the upcoming days. Palash Dutta discusses the aspects in the
chapter human health risk assessment via amalgamation of probability and fuzzy
numbers. The nest presents a pattern mining algorithm - FTISPAM using hybrid
genetic algorithm. The next chapter studies the architectural aspects, the scope and
applications of green computing. A work on software quality management presents
a thorough analysis of most quality measurement concepts. Authors also discuss
how reliability can be measured using its correlation with syntactic metrics. The
basic aim of risk management is to recognize, assess and prioritize risk, in order to
assure that the uncertainty should not deviate the intended purpose of the business
goals. A study on risk management in financial market is presented by Das et al. The
next chapter provides an overview of much of clustering algorithms. The chapter
is covering the little much valuable survey, the types of clusters, methods used for
 Preface

constructing the clusters. Mishra et al. are addressing security issues and standards
in Internet of Things.
This volume represents a global forum for research on cognitive computing.
It includes mostly the current works and research findings from various research
labs, universities and institutions and may lead to development of market demanded
products. The works reports substantive results on a wide range of learning methods
applied to a variety of learning problems. It provides solid support via empirical
studies, theoretical analysis, or comparison to psychological phenomena. The
volume includes works to show how to apply learning methods to solve important
applications problems as well as how machine learning research is conducted.
The volume editors are very thankful to all the authors, contributors, reviewers
and the publisher for making this effort a successful one.

Pradeep Kr. Mallick

St. Peter’s University, India

Samarjeet Borah
Sikkim Manipal University, India

xiv
 1

Chapter 1
Design of Cognitive Healthcare
System for Coronary
Cardiac Disease Detection
Mihir Narayan Mohanty
Siksha ‘O’ Anusandhan University, India

ABSTRACT
This chapter focuses on clinical decision system (CDS) uses in healthcare units.
In this chapter, cognitive approaches are taken using soft computing techniques
to design clinical decision systems (CDS) for modern healthcare units. Cognitive
computing-based approach is considered. It focuses on cardiac disease detection
exclusively by considering its surrounding factors. Fuzzy logic is utilized as one part.
The other part includes diabetic detection using deep neural network (DNN) for
the automatic identification of the disease. The experiment was done with the Pima
Indian dataset. The classification result has been presented in the result section. The
decision system in the healthcare unit is a suitable example of a multi-agent system.

INTRODUCTION

Human being has always been a curious creature, constantly aiming at increasing
his knowledge about the world he lives in. Towards achieving new knowledge,
the typical process of learning consists thus of following steps: (1) collecting a
large amount of observations, (2) extracting relevant information, (3) designing a
general model that best explains past and future observations. Machine learning
found applications in many fields such as genetics, search engines, natural language
processing, computational finance or stock market analysis and computer vision. In

DOI: 10.4018/978-1-5225-5793-7.ch001

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 Design of Cognitive Healthcare System for Coronary Cardiac Disease Detection

the case of medical applications, the interest for learning-based methods seems more
recent. Nevertheless, this trend is increasing, and more works containing machine
learning as keyword are published each year.
In spite of their effective usefulness, it is not popular clinically that remains a
concern to researchers as well as medical practitioners. The objective is to changes
in clinical effectiveness related to patient care. The design of the evaluated CDSs
relies on either randomized controlled clinical trials (RCTs) or laboratory experiments
to determine the performance of the physicians or systems under controlled
environment. Lack of elaborate surveys on methodologies that indicates reasons for
not using CDSs by clinicians and their practice patterns. It requires the involvement
of other medical professionals and computer applications. These are computer based
patient records (CPRs), hospital information systems (HISs), ancillary care systems,
physician order entry (POE), etc. (Devi, Ramani & Pandian, 2014; Singh, Mohanty
& Choudhury, 2013; Mohanty, 2016). Such research seems useful in solving issues
related to acceptance or use of CDSs and their relative relevance.
Cognitive informatics (CI) is an area related to cognitive and information
sciences. The focus is on processing of human information, computing and computer
applications mechanisms as well as processes (Al-Sakran, 2015).In this the CI focuses
on understanding of activities and work processes related to human cognition that
include the interventional solutions concerned to finding solutions to engineering,
computer applications and information technology for better human activities. In
the framework of biomedical informatics, CI helps in describing, understanding,
and predicting the clinical work activities and its nature that benefits the patients,
clinicians as well as lay public. It assists in engineering development and finding
computing solutions to boost clinical practice such as efficient decision-support
system, patient involvement by providing a tool for timely medication schedule. It
also helps public health interventions by providing a suitable mobile application to
determine the spread of an epidemic (Ozcift & Gulten, 2011; Chi, Street & Katz,
2010; Su, 2008).
Many attempts have been made to design automatic machines in the field
of intelligent and cognitive field. These cognitive machines must know their
environments involving similar machines as well as human beings. The machines
may vary from self-evidenced practical reasons like computer maintenance expenses
to wearable computing in health care which have the cognitive capabilities parallel
to the human brain. The aim of this work is to describe the challenges concerned
to this new design paradigm which may take into account the systemic problems
as well as the design issues. It also includes the teaching of undergraduates in the
field of electrical and computer engineering, researchers, etc. Most studies use an
experimental or RCT in order to assess system capabilities in a varying clinical
environment for better patient care (Silverman et al., 2015). Some of these researches

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Design of Cognitive Healthcare System for Coronary Cardiac Disease Detection

are in the field of CDS whereas none follow a naturalistic design as far as the routine
clinical settings concerned to real patients are considered. The studies mainly focus
on physicians but not on other clinicians. Further, evaluation of CDS studies is
insulated from evaluations of the informatics applications.

Cognitive Technology

Artificial intelligence (AI) technique supports to many technological developments

in current scenario of digital world. The technique of cognitive computing has
the major role to apply reason in numerous data and by interacting with man and
machines. At a decision-making layer, technologies such as machine learning, and
deep learning are helping systems interpret information and arrive at effective,
informed decisions (Zhang et al., 2018; Liu et al., 2017; Jan et al., 2017).
In healthcare, cognitive applications are helping doctors screen and diagnose
patients faster, while allowing companies to broaden their reach across large and
dispersed populations.

Machine Learning

Machine learning systems are capable of learning over time without needing to
be explicitly programmed. These have capabilities and techniques are helping
applications identify patterns in large amounts of information, classify information,
make predictions and detect anomalies. These techniques help organizations build
systems that can process large amounts of data while applying human-like thinking
to information, classify and correlate disparate pieces of information, make more
informed decisions and trigger actions in downstream activities.

Deep Learning

Deep learning methods are based on learning representations of data. As a branch of

machine learning, deep learning attempts to model high level abstractions in data.
It applies multiple layers of processing units where each successive layer uses the
output of the previous layer as input. Each layer corresponds to different layers of
abstraction, forming a hierarchy of concepts. Deep learning solutions help create
applications that can be trained both in a supervised and unsupervised ways. Numerous
techniques such as neural networks are under development in the field of deep
learning and are expected to be part of current scenario (Craven & Shavlik, 1997)

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 Design of Cognitive Healthcare System for Coronary Cardiac Disease Detection

Neural Networks

Neural networks are among the most used deep learning methods to create learning
and reasoning systems. The application of back propagation, as part of neural
networks, helps to generate continuous improvement in deep learning algorithms
and train multi-layered deep learning systems to enhance their knowledge bases.
Neural networks are helping us solve complex problems that typically took skills
acquired over many years of learning and human experience. These capabilities are
expected to help organizations to analyze audio, video and images as well as any
human expert would, only at exponentially faster speeds and at much greater levels
of depth and quantity (Al Rahhal et al., 2016; Haykin, 1999; Mohapatra, Palo &
Mohanty, 2017).
Cognitive computing represents the state-of-the-art in the management of
knowledge and computer-human interaction, integrating a number of advanced
disciplines such as artificial intelligence, signal processing, natural language
processing, machine learning, speech and vision analysis, and capacities for dialogue
and descriptive narrative. The aim of cognitive computing is the development of
systems that emulate human behavior, learn for themselves through example and can
be deployed in human working environments (Tupe & Kulkarni, 2015; Elayathingal
& Sethuramalinga, 2014). The CIis related to multidisciplinary study of cognitive and
information sciences. It investigates the mechanisms of human information processing
and their engineering applications in the field of computing. The community aims
to find technology-based solutions to reduce the workload of a decision maker,
increases the throughput and production quality. The computer-based MIS (medical
information systems) requires an understanding of computer technology as well as
emphasizes on complex behavioral and social processes.
Cognitive science is basically a science research of the fundamental aspects
relating to cognition. It involves memory, attention, early language acquisition
including applied research. In this context the applied cognitive research helps
efficient human–computer interaction (HCI) that benefits the society in many ways
including educational research.
In last few decades, have witnessed a few practical and experiential knowledge
on the design and implementation that require sensible and intuitive interfaces. It
considers a thorough understanding of work direction and consults the potential
clinicians to implement in advance.
However, there is a limit to experiential knowledge that can produce the robust
generalizations including a sound design as well as implementation principles. Hence,
a demand for the common theoretical foundation is essential. The cognitive systems
are characterized by two principles that are interdependent: (a) architectural theories

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Design of Cognitive Healthcare System for Coronary Cardiac Disease Detection

that have the potential with respect to every aspects of cognition using unified theory
(b) To distinguish different knowledge domains for effectiveness of a given domain.
Functionally, any cognitive system is based on the capabilities it is able to perform
such as: (a) focused attention corresponding to the chosen visual characteristics (b) the
procedure in which it constrains the performance of human cognitive such as memory
limitations (c) The development occurs in its life span. Concerning to the life span
problem, a few literature has been focused on cognitive aging as well as its aspects.
These are: memory, attention, vision, and change in motor skill as aging functions
(Rogers, 2002). It provides potential inputs to informatics related to development
of e-health care facilities for seniors, or to patients suffering from chronic health
hazards like heart disease, diabetes and arthritis. The field of usability engineering
with respect to cognitive task analysis assists to assess cognition corresponding to
complex medical environment and computer information systems.
Some features of cognitive systems are adaptiveness, Interactive, Contextual
and stateful. The application domains of CI are Multi agent networks, Networks
for computational intelligence, Distributed cognitive robots, sensors, and remote
control systems (Yan et al., 2008; Nahar et al., 2013). In similar manner models
like ANN, FNN, and DNN are able to learn features by means of non-linear data
transformations and learn the feature hierarchies. Use of unsupervised training
removes over-fitting issues.

Medical Cognition

Advances in technologies related to health information and computing during last

two decades brings about many permeate, useful diverse facets in the field of clinical
technology. The rapid developments of internet, handheld devices, and wireless
technologies can afford new opportunities that support, enhances, and extends user
experiences for interactions as well as communications. It is assisted by computer
literate health care individuals for better health care. However, the advances in health
care domain are slow due to lack of exposure to information technology for use in
their working environment. Further, the technologies are hindered by social, cultural,
and cognitive issues (Lokanath, Narayan & Srikanta, 2016; AlSharqi et al., 2014;
Sarangi, Mohanty & Pattanayak, 2016). There is still a need to adapt the technology
in many different diversified levels both in individual and institution category.
Absence of such steps may lead to workflow disruptions hence user dissatisfaction.
The knowledge representation, type of search with naturalness proves the success
of cognitive computing applications. In healthcare, bio-medical signal and image
analysis as well as processing is to increase the portability of screening and diagnosis
(Biswal et al., 2016; Biswal et al., 2016). For instance, specialized screening for

5
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 Design of Cognitive Healthcare System for Coronary Cardiac Disease Detection

conditions such as diabetic retinopathy traditionally was limited in availability due to

the need for specialized equipment and numerous specialists – thus precluding many
patients from being screened preventatively. However, the ability of deep learning
systems and neural networks, which learn from previous human diagnosed images,
is helping create systems of intelligence that can analyze medical images, predict
the risk and existence of such conditions, and recommend either immediate human
intervention or offer a reassurance of normality. This would help providers reach
larger at-risk populations, many of whom would probably not screen themselves
unless the problem was severe (Das, Turkoglu & Sengur, 2009; Ordonez, 2006;
Ram & Mohanty, 2017; Hannan et al., 2010).
The pneumonia diagnosis and its severity remains complex due to many
interacting factors, thus FCM has been used for decision support. It is suitable for
such problems, although, it requires experience and accumulated expert knowledge.
It is simple, implementable and requires less time (Sikchi, Sikchi & Ali, 2013;
Osowki & Linh, 2001; Pal et al., 2012; Sarangi, Mohanty & Patnaik, 2017). The
authors have developed a FCM method
for expert system that can diagnosis infectious diseases, their type and the severity
related to cardiac arrest (Sarangi, Mohanty & Patnaik, 2017, 2016; Rahman et al.,
2015; Forkan, Khalil & Tari, 2013). The FCM algorithm has been put as our future
work based on inputs from clinical data using data mining approaches.

METHODOLOGY

Proposed Multi-Agent System

Patient Agent

Communication gadgets such as a mobile or a personal computer is used to inform

the medical authority for hospital registration in case the patient is suffering from
a disease. Figure 1 shows the structure of the proposed multi-agent system.

Hospital Registration

A server is used to store the patient parameter during hospital registration and
forward these information to a doctor i.e. doctor1 agent who recommends for
pathological tests.

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Design of Cognitive Healthcare System for Coronary Cardiac Disease Detection

Figure 1. Patient consultancy multi-agent structure with a fuzzy system

Doctor 1

The doctor 1 agent functions as an OPD of the concerned hospital. With the help
of fuzzy IF-THEN rules, this agent suggests for any pathological tests desired of
the patient.

Diagnostic Centre Agent

This agent analyses and predicts the disease of the affected person based on the
information received from the patient. A two way data flow i.e. both transmitting
and receiving is accomplished by this agent.

Doctor 2 or Specialist Agent

This agent communicates using either SMS or e-mail with the concerned doctor
and notifies him/her about the abnormality observed in a patient so that the desired
prescription is provided. Ultimately, the prescription based on the disease is generated
and is delivered to the concerned patient. In case any further investigation is desired by
the doctor regarding the patient’s medical history or evaluation of patient parameters
in a continuous basis, it will made available to the doctor from the server. It helps
the doctor for future monitoring of the patient condition.

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 Design of Cognitive Healthcare System for Coronary Cardiac Disease Detection

Server Agent

It provides the desired disease information to all other agents. It communicates

with the diagnostic center by sending and receiving patient report. These reports
serve as inputs to the physician. The server agent takes the decision on data flow
management as and when required for providing efficient healthcare facilities to
the patient using disease information and making the data available for the doctor.
The flow of data in the diagnostic agent is shown in Figure 2. As shown in this
Figure, the diagnostic center receives information on the patient symptoms. Further
analyze and prediction of the disease is made based on the received data in the
diagnostic center. By implementing Fuzzy inference system an attempt has been
made in this work to detect heart disease.
An agent based consultancy system has been given in Figure 3 concerning to
the patient. Here, both the symptoms and the parameters of the disease is uploaded
by the patient into the server using the method of hospital registration. The data
uploaded are then passed to the server which communicates with the diagnostic
center for testing the symptoms. If the diagnostic parameters are in the normal range
then remedial steps has to be taken.

Figure 2. Diagnostic centre structure

Figure 3. Information centre

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Design of Cognitive Healthcare System for Coronary Cardiac Disease Detection

In case of any abnormalities, the diagnostic center informs the specialist or

Doctor 2 for further course of action. The fuzzy IF-THEN rules have been used
here to provide the desired information to the corresponding doctor. The doctor
then verifies the medical reports by sending a request for the same to the server for
further investigation of prescription.
The diagnostic agent problem can be formulated as below:
Using the FIS for the adaptive cardiac disease detection, we have used these
following parameters.

• The range of BP is 90 to 190(in mm Hg)

• The range of Serum Cholesterol is 120-560 (Mg/dl)
• FBS 60-140 (Mg/dl)
• ECG ST-T wave abnormality

These above mentioned inputs have been chosen due to the following.

• When BP is normal the heart function can be considered normal. With rise
in BP, the abnormally in heart occurs which indicates there is a chance of
cardiac disease. Hence, it tends to be an important parameter for heart disease
detection.
• The blood circulation path narrows due to the deposition of TG. This is due to
the presence of excess Cholesterol in blood. Ultimately the circulatory path
gradually narrows and can cause heart disease in a patient.
• Sugar happens to be a silent killer. It increases the fatality in a patient with
heart attacks in case the level is beyond the normal value.
• ECG signal happens to be the best predictor of heart ailment. It is indicated by
studying the ST-T wave. Any abnormality in this wave indicates the potential
heart disease even though the other symptoms mentioned earlier are normal.

In this work, our goal is to consider the experience of the physician in order
to store those in a set of fuzzy tables. The inference engine is used to develop a
computer program which can at its own find out whether a patient is affected with
some specified symptoms with certainty from the listed suspected diseases. A crisp
percentage value is assigned to this certainty for each suspected disease. The four
parameters are considered for the diagnosis using Fuzzy inference system is fuzzified.

9
 Design of Cognitive Healthcare System for Coronary Cardiac Disease Detection

Electrocardiogram

For the fuzzification of electrocardiogram three fuzzy sets has been considered
such as normal, ST-T abnormal and hypertrophy. The MFs of both normal and
hypertrophy fuzzy sets have been considered trapezoidal whereas the MF of ST-T
abnormal has been triangular.

Blood Pressure

Out of systolic and diastolic blood pressure parameters we have considered Systolic
blood pressure in our study and different input variables has been divided into three
fuzzy sets which are low, normal and high. The membership functions for low, normal
and high has been taken as trapezoidal, triangular and trapezoidal respectively.

Fasting Blood Sugar

The fasting blood sugar is also one of the important factors for abnormality detection
and therefore we have also considered in our investigation. We have defined the
range of blood sugar value into three, i.e., low, normal and high which has the range
below 70, 70–135, 130 and above respectively.

Cholesterol

Medical experts have the opinion that cholesterol has silent effect on the cardiac
malfunctioning and can make it worse very rapidly. The total cholesterol a combination
of high density lipoprotein (HDL), low density lipoprotein (LDL) and triglyceride
plays a significant role to predict the cardiac diseases. Therefore the total cholesterol
has been considered for the investigation. Here three fuzzy sets namely less risk,
borderline high and high MF has been assigned to the range of values less than
200, 190–245, 240and above respectively. The MFs are taken here as trapezoidal,
triangular and trapezoidal respectively.

Defuzzification

The process of conversion of fuzzy variables obtained as output from the fuzzy logic
rules into real values is known as defuzzification. The value gives the information
about the system and helps to take any action. In Sugeno model, there are two types
of defuzzification methods, i.e., weighted average (WA) and weighted sum (WS).
In this work, we have used the weighted average method for defuzzification.

10
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