A Fuzzy Strategy to Eliminate Uncertainty in Grading Positive Tuberculosis

R. Samuel, B. R. Kanna
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Abstract

Sputum smear microscopic examination is an effective, fast, and low-cost technique that is highly specific in areas with a high prevalence of pulmonary tuberculosis. Since manual screening needs trained pathologist in high prevalence zones, the possibility of deploying adequate technicians during the epidemic sessions would be impractical. This condition can cause overburdening and fatigue of working technicians which may tend to reduce the potential efficiency of Tuberculosis (TB) diagnosis. Hence, automation of sputum inspection is the most appropriate aspect in TB outbreak zones to maximize the detection ability. Sputum collection, smear preparing, staining, interpreting smears, and reporting of TB severity are all part of the diagnosis of tuberculosis. This study has analyzed the risk of automating TB severity grading. According to the findings of the analysis, numerous TB-positive cases do not fit into the standard TB severity grade while applying direct rule-driven strategy. The manual investigation, on the other hand, arbitrarily labels the TB grade on those cases. To counter the risk of automation, a fuzzy-based Tuberculosis Severity Level Categorizing Algorithm (TSLCA) is introduced to eliminate uncertainty in classifying the level of TB infection. TSLCA introduces the weight factors, which are dependent on the existence of maximum number of Acid-Fast Bacilli (AFB) per microscopic Field of View (FOV). The fuzzification and defuzzification operations are carried out using the triangular membership function. In addition, the [Formula: see text]-cut approach is used to eliminate the ambiguity in TB severity grading. Several uncertain TB microscopy screening reports are tested using the proposed TSLCA. Based on the experimental results, it is observed that the TB grading by TSLCA is consistent, error-free, significant and fits exactly into the standard criterion. As a result of the proposed TSLCA, the uncertainty of grading is eliminated and the reliability of tuberculosis diagnosis is ensured when adapting automatic diagnosis.
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消除结核阳性分级不确定性的模糊策略
痰涂片镜检是一种有效、快速、低成本的技术,在肺结核高发地区具有高度特异性。由于在高流行区需要训练有素的病理学家进行人工筛查,在流行病会议期间部署足够的技术人员的可能性是不切实际的。这种情况可能导致工作技术人员负担过重和疲劳,这可能会降低结核病诊断的潜在效率。因此,痰液检测自动化是结核病疫区最合适的方面,以最大限度地提高检测能力。痰液采集、涂片制备、染色、涂片解释和结核病严重程度报告都是结核病诊断的组成部分。本研究分析了自动化结核病严重程度分级的风险。根据分析结果,在采用直接规则驱动策略时,许多结核病阳性病例不符合标准的结核病严重程度等级。另一方面,人工调查武断地给这些病例贴上结核病等级的标签。为了应对自动化带来的风险,引入了一种基于模糊的结核病严重程度分类算法(TSLCA),消除了结核病感染程度分类的不确定性。TSLCA引入了权重因子,该权重因子依赖于每个显微镜视野(FOV)中抗酸杆菌(AFB)最大数量的存在。利用三角隶属函数进行模糊化和去模糊化操作。此外,采用[Formula: see text]-cut方法消除结核病严重程度分级中的歧义。使用拟议的TSLCA测试了几个不确定的结核显微镜筛查报告。实验结果表明,TSLCA分级结果具有一致性、无误差、显著性,与标准标准完全吻合。该方法在适应自动诊断的同时,消除了分级的不确定性,保证了结核病诊断的可靠性。
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