Selection of Aggregation Function in Fuzzy Inference System for Metabolic Syndrome

Sri Kusumadewi, Linda Rosita, Elyza Gustri Wahyuni

Abstract


Metabolic syndrome (MetS) has long-term, very detrimental effects, including chronic kidney disease, cardiovascular disease, stroke, and diabetes mellitus. Therefore, early detection of MetS is very important. Numerous global health organizations have made some Metabolic Syndrome (MetS) diagnosis criteria, but they are still mostly in a dichotomous form. On the other hand, a continuous MetS risk score has been proven to be more sensitive and with less risk of error. This study aims to build a Fuzzy Inference System (FIS) model. MetS diagnostic criteria issued by NCEP-APT III are used as a reference for generating rules. This model uses max, probor, and additive functions to obtain membership values as a result of rules aggregation in seven steps: 1) Identification of variables; 2) Determination of fuzzy sets and their membership functions; 3) Knowledge base generation; 4) Implementation of the implication functions; 5) Fuzzy rules aggregation; 6) Defuzzification; 7) Performance testing of the model and selecting the best aggregation function. The findings show the max function as the most suitable function for the aggregation process with an accuracy, sensitivity, specificity, and precision value of 100% according to the measurement results with NCEP-ATP III. A continuous risk score between 0% and 99.99% is considered a non-high risk, whereas a score of 100% indicates a high risk. This function also has an ideal risk value distribution according to the neighborhood level of the NCEP-ATP III diagnostic criteria.

Keywords


Metabolic syndrome; risk score; fuzzy; aggregation function; performance.

Full Text:

PDF

References


N. Nebhinani et al., “Correlates of metabolic syndrome in patients with depression: A study from north-western India,†Diabetes and Metabolic Syndrome: Clinical Research and Reviews, vol. 14, no. 6, 2020, doi: 10.1016/j.dsx.2020.10.013.

P. Zimmet et al., “The Circadian Syndrome: is the Metabolic Syndrome and much more!,†Journal of Internal Medicine, vol. 286, no. 2. 2019. doi: 10.1111/joim.12924.

H. Xu, X. Li, H. Adams, K. Kubena, and S. Guo, “Etiology of metabolic syndrome and dietary intervention,†International Journal of Molecular Sciences, vol. 20, no. 1. 2019. doi: 10.3390/ijms20010128.

M. G. Saklayen, “The Global Epidemic of the Metabolic Syndrome,†Current Hypertension Reports, vol. 20, no. 2. 2018. doi: 10.1007/s11906-018-0812-z.

M. Kazamel, A. M. Stino, and A. G. Smith, “Metabolic syndrome and peripheral neuropathy,†Muscle and Nerve, vol. 63, no. 3. 2021. doi: 10.1002/mus.27086.

D. N. Friedman, E. S. Tonorezos, and P. Cohen, “Diabetes and Metabolic Syndrome in Survivors of Childhood Cancer,†Hormone Research in Paediatrics, vol. 91, no. 2. 2019. doi: 10.1159/000495698.

I. Lemieux and J. P. Després, “Metabolic syndrome: Past, present and future,†Nutrients, vol. 12, no. 11. 2020. doi: 10.3390/nu12113501.

D. L. Mendrick et al., “Metabolic syndrome and associated diseases: From the bench to the clinic,†Toxicological Sciences, vol. 162, no. 1, 2018, doi: 10.1093/toxsci/kfx233.

S. Ghoneim, M. U. Butt, O. Hamid, A. Shah, and I. Asaad, “The incidence of COVID-19 in patients with metabolic syndrome and non-alcoholic steatohepatitis: A population-based study,†Metabolism Open, vol. 8, 2020, doi: 10.1016/j.metop.2020.100057.

S. Wu, H. He, Y. Wang, R. Xu, B. Zhu, and X. Zhao, “Association between benign prostate hyperplasia and metabolic syndrome in men under 60 years old: a meta-analysis,†Journal of International Medical Research, vol. 47, no. 11. 2019. doi: 10.1177/0300060519876823.

S. J. Lee et al., “Metabolic syndrome status over 2 years predicts incident chronic kidney disease in mid-life adults: a 10-year prospective cohort study,†Scientific Reports, vol. 8, no. 1, 2018, doi: 10.1038/s41598-018-29958-7.

W. L. Lu, Y. T. Lee, and G. T. Sheu, “Metabolic syndrome prevalence and cardiovascular risk assessment in hiv-positive men with and without antiretroviral therapy,†Medicina (Lithuania), vol. 57, no. 6, 2021, doi: 10.3390/medicina57060578.

R. Gobin, D. Tian, Q. Liu, and J. Wang, “Periodontal diseases and the risk of metabolic syndrome: An updated systematic review and meta-analysis,†Frontiers in Endocrinology, vol. 11. 2020. doi: 10.3389/fendo.2020.00336.

C. Li et al., “Effect of metabolic syndrome on coronary heart disease in rural minorities of Xinjiang: A retrospective cohort study,†BMC Public Health, vol. 20, no. 1, 2020, doi: 10.1186/s12889-020-08612-w.

S. Kusumadewi, L. Rosita, and E. G. Wahyuni, Model of Clinical Decision Support System for Metabolic Syndrome, 1st ed. Yogyakarta: UII Press, 2020.

S. Siwarom et al., “Metabolic syndrome in Thai adolescents and associated factors: the Thai National Health Examination Survey V (NHES V),†BMC Public Health, vol. 21, no. 1, 2021, doi: 10.1186/s12889-021-10728-6.

O. Sison et al., “Prevalence of metabolic syndrome and cardiovascular risk factors among community health workers in selected villages in the Philippines,†Journal of the ASEAN Federation of Endocrine Societies, vol. 34, no. 2, 2019, doi: 10.15605/jafes.034.02.08.

Y. Krishnamoorthy, S. Rajaa, S. Murali, T. Rehman, J. Sahoo, and S. S. Kar, “Prevalence of metabolic syndrome among adult population in India: A systematic review and meta-analysis,†PLoS ONE, vol. 15, no. 10 October, 2020, doi: 10.1371/journal.pone.0240971.

A. S. Ramli et al., “JIS definition identified more malaysian adults with metabolic syndrome compared to the NCEP-ATP III and IDF criteria,†BioMed Research International, vol. 2013, 2013, doi: 10.1155/2013/760963.

H. S. Kim and Y. H. Cho, “Factors associated with metabolic syndrome among middle-aged women in their 50s: Based on national health screening data,†International Journal of Environmental Research and Public Health, vol. 17, no. 9, 2020, doi: 10.3390/ijerph17093008.

J. H. Huh, J. H. Lee, J. S. Moon, K. C. Sung, J. Y. Kim, and D. R. Kang, “Metabolic syndrome severity score in Korean adults: Analysis of the 2010-2015 Korea National Health and Nutrition Examination Survey,†Journal of Korean Medical Science, vol. 34, no. 6, 2019, doi: 10.3346/jkms.2019.34.e48.

H. Y. Ngai, K. K. S. Yuen, C. M. Ng, C. H. Cheng, and S. K. P. Chu, “Metabolic syndrome and benign prostatic hyperplasia: An update,†Asian Journal of Urology, vol. 4, no. 3. 2017. doi: 10.1016/j.ajur.2017.05.001.

S. Nahmias, “Fuzzy variables,†Fuzzy Sets and Systems, vol. 1, no. 2, 1978, doi: 10.1016/0165-0114(78)90011-8.

National Institute of Health, “NCEP Cholesterol Guidelines,†[NCEP] National Cholesterol Education Program ATP III, vol. 329, no. 3, 2001.

American Heart Association, “Understanding Blood Pressure Readings | American Heart Association,†Aha. 2017.

S. Kusumadewi, E. G. Wahyuni, and S. Mulyati, Decision Support and Intelligent System, 1st ed. Yogyakarta: UII Press, 2021.

The Mathworks, Inc. MATLAB, Version 9.6, “MATLAB - MathWorks - MATLAB,†www.mathworks.com/products/matlab. 2019.

C. R. Bharathi and V. Shanthi, “Hybrid approach for analyzing acute spots of clinical speech data using fuzzy inference system,†in Artificial Intelligence: Concepts, Methodologies, Tools, and Applications, vol. 4, 2016. doi: 10.4018/978-1-5225-1759-7.ch098.

S. Thukral and V. Rana, “Versatility of fuzzy logic in chronic diseases: A review,†Medical Hypotheses, vol. 122, 2019, doi: 10.1016/j.mehy.2018.11.017.

G. Arji et al., “Fuzzy logic approach for infectious disease diagnosis: A methodical evaluation, literature and classification,†Biocybernetics and Biomedical Engineering, vol. 39, no. 4, 2019, doi: 10.1016/j.bbe.2019.09.004.

T. Gangavarapu, A. Jayasimha, G. S. Krishnan, and S. Sowmya Kamath, “Predicting ICD-9 code groups with fuzzy similarity based supervised multi-label classification of unstructured clinical nursing notes,†Knowledge-Based Systems, vol. 190, 2020, doi: 10.1016/j.knosys.2019.105321.

H. Ahmadi, M. Gholamzadeh, L. Shahmoradi, M. Nilashi, and P. Rashvand, “Diseases diagnosis using fuzzy logic methods: A systematic and meta-analysis review,†Computer Methods and Programs in Biomedicine, vol. 161. 2018. doi: 10.1016/j.cmpb.2018.04.013.

F. Hamedan, A. Orooji, H. Sanadgol, and A. Sheikhtaheri, “Clinical decision support system to predict chronic kidney disease: A fuzzy expert system approach,†International Journal of Medical Informatics, vol. 138, 2020, doi: 10.1016/j.ijmedinf.2020.104134.

M. I. Fale and Y. G. Abdulsalam, “Dr. Flynxz – A First Aid Mamdani-Sugeno-type fuzzy expert system for differential symptoms-based diagnosis,†Journal of King Saud University - Computer and Information Sciences, 2020, doi: 10.1016/j.jksuci.2020.04.016.

S. Nazari, M. Fallah, H. Kazemipoor, and A. Salehipour, “A fuzzy inference- fuzzy analytic hierarchy process-based clinical decision support system for diagnosis of heart diseases,†Expert Systems with Applications, vol. 95, 2018, doi: 10.1016/j.eswa.2017.11.001.

F. Sabahi, “Bimodal fuzzy analytic hierarchy process (BFAHP) for coronary heart disease risk assessment,†Journal of Biomedical Informatics, vol. 83, 2018, doi: 10.1016/j.jbi.2018.03.016.

C. Tian, J. juan Peng, S. Zhang, W. yu Zhang, and J. qiang Wang, “Weighted picture fuzzy aggregation operators and their applications to multi-criteria decision-making problems,†Computers and Industrial Engineering, vol. 137, 2019, doi: 10.1016/j.cie.2019.106037.

T. Senapati and R. R. Yager, “Fermatean fuzzy weighted averaging/geometric operators and its application in multi-criteria decision-making methods,†Engineering Applications of Artificial Intelligence, vol. 85, 2019, doi: 10.1016/j.engappai.2019.05.012.

X. Y. Zou, S. M. Chen, and K. Y. Fan, “Multiple attribute decision making using improved intuitionistic fuzzy weighted geometric operators of intuitionistic fuzzy values,†Information Sciences, vol. 535, 2020, doi: 10.1016/j.ins.2020.05.011.

K. Ahmadi and M. Ebrahimi, “A novel algorithm based on information diffusion and fuzzy MADM methods for analysis of damages caused by diabetes crisis,†Applied Soft Computing Journal, vol. 76, 2019, doi: 10.1016/j.asoc.2018.12.004.




DOI: http://dx.doi.org/10.18517/ijaseit.12.5.15552

Refbacks

  • There are currently no refbacks.



Published by INSIGHT - Indonesian Society for Knowledge and Human Development