DIAGNOSIS OF DERMATOLOGICAL DISEASES BY A NEURO-FUZZY SYSTEM

G. Castellano, C. Castiello, A.M. Fanelli, C. Leone Dipartimento di Informatica, Universit` degli Studi di Bari a Via Orabona, 4 70125 Bari - ITALY [castellano, castiello, fanelli]@di.uniba.it

Abstract
In this paper we present the application of a particular neuro-fuzzy system, named KERNEL, to the problem of dierential diagnosis of erythematosquamous diseases, which represents a major problem in dermatology. A multistep learning strategy is adopted to obtain, starting directly from available data, a fuzzy rule base that can be used to identify the particular disease. The obtained classication results at the end of a two-phase experimental session are reported. Keywords: Neuro-fuzzy systems, medical application.

Neuro-fuzzy systems lend themselves well to prognosis and diagnosis and nd application in an increasing number of biomedical domains, since the human experts can check and verify the learned classication knowledge before using it in realworld problems. Moreover, some previously unknown facts and patterns may be brought to the attention of human experts, leading to interesting discoveries in the eld. In this paper we present the application of a particular neuro-fuzzy system, called KERNEL, to the problem of dierential diagnosis of erythemato-squamous diseases, which represents a major issue in dermatology. The KERNEL system is rstly illustrated, presenting its main features and the way it processes the data. Then the medical domain concerning the erythematosquamous disease diagnosis is introduced and experimental results are provided.

Introduction 2 The KERNEL System

In recent years the need for tools to automatically process and manage information drove researchers to make use of intelligent systems capable to deal with the uncertainty typical of real data [1]. The integration of neural networks and fuzzy logic provides an eective way to exploit the powerful processing capabilities of a neurocomputing system and to organize the knowledge embedded into the system in an easily accessible form [11], [13]. These signicant features, which characterize neuro-fuzzy systems, enable to tackle a wide range of problems related to many elds, including economy, control theory, engineering, industrial application, neuro-science and medicine [2], [4], [9], [12], [14].

KERNEL (Knowledge Extraction and Renement by NEural Learning) is a multistep neurofuzzy system which works on the basis of successive phases. It is capable to initialize and then to rene a fuzzy rule base to be applied in classication or regression tasks. The peculiarity of KERNEL consists in its ability to extract and rene knowledge starting directly from observational data (without any human expert intervention) making use of neural learning. The KERNEL system, which has been already presented in our previous works [3], [5], [7], is endowed with a core that consists of a particular neural network the neuro-fuzzy network - embodying in its topol-

The diagnosis problem and the adopted dataset

Figure 1: The scheme of the KERNEL system ogy the structure of the fuzzy rule base. KERNEL is organized into three distinct and independent components performing dierent assignments (as depicted in Figure 1): The rst component extracts knowledge starting from available data and expresses the acquired information in form of a fuzzy rule base. This is accomplished by means of a data clustering performed via an unsupervised learning phase of the neurofuzzy network. A peculiarity of this learning process consists in automatically providing the proper number of clusters matching with the number of rules in the fuzzy model. The second component modies the parameters of the initial fuzzy rule base in order to improve its accuracy by applying a supervised learning of the neuro-fuzzy network. The third component alters again the fuzzy rule base adjusting its parameters and structure (number of rules) to increase readability while preserving accuracy. A combination of a pruning procedure and a genetic algorithm is applied in this stage. Actually, only the procedures related to the rst and the second component, which will be referred as Unsupervised Learning and Supervised Learning in the following, have been employed in our experimentation. Further details about algorithms underlying each component can be found in [6], [8].

The KERNEL system has been exploited to address a dicult problem in dermatology: the classication of an erythemato-squamous disease in one of the following category: psoriasis, seboreic dermatitis, lichen planus, pityriasis rosea, chronic dermatitis, pityriasis rubra pilaris. All these diseases compose a pathological group where the symptoms tend to mingle and the clinical feature of erythema and scaling are shared. Only few differences (such as the localizations of the disease on the skin, the denition of the lesion borders, the presence of itching, the formation of papules) contribute to dierentiate the single illnesses [10]. Moreover, a disease may show a histopathological feature of another disease at the beginning stage while its own characteristic features appear at the following stage: this makes harder the classication task. The adopted dataset has been obtained from the UCI Machine Learning Repository (http://www.ics.uci.edu/mlearn/MLRepository.html) and has been employed in [10]. It collects 366 samples presenting 34 attributes: each sample contains 12 clinical features (i.e. age, family history and so on) and 22 histopathological features obtained after a biopsy of a patient skin sample. In the dataset, the family history feature assumes value 1 or 0 depending if the disease has been or not observed in the family. Other clinical and histopathological features can assume, instead, a degree in the range 0-3: value 0 indicates the absence of the particular feature, the largest possible amount of feature is represented by degree 3, while 1 and 2 denote intermediate values. The age feature, simply representing the patient age, presents missing values in some instances. Hence, before starting simulations with KERNEL, the dataset has been subjected to a pre-processing phase concerning the undened age feature values: missing data have been replaced by the median values calculated over all the other complete instances.

Experimental results

Table 1: Classication results obtained by replacing missing values in feature age

set 1 2 3 4 5 6 7 8 9 10 mean value Final rules 10 7 10 9 9 9 9 9 10 9 9 Unsuper. Learn. Tr. set 59,7 37,6 51,6 46,4 43,4 59,7 36,7 45,5 57,3 30,3 46,82 Ts. set 55,6 33,4 41,7 44,5 38,4 63,9 36,2 50 55,6 37,2 45,70 Super. Learn. Tr. set 72,8 68,5 71,6 65,2 68,5 78,8 66,4 77,3 71,9 66,2 70,72 Ts. set 61,2 58,4 66,7 55,6 69,5 77,8 66,7 86,2 61,2 65,8 66,91

In this section we present preliminary experimental results derived from the application of KERNEL to the diagnosis of the above described dermatological diseases. These initial simulations involved only the Unsupervised Learning and Supervised Learning processes of KERNEL. Namely, the neuro-fuzzy system has been employed rstly to generate a fuzzy rule base starting from input/output data and then to rene it in terms of classication accuracy. In particular, a 10-fold cross validation technique has been adopted, i.e. the dataset was divided into 10 subsets, nine of them being used as training set and one as test set in each of the repeated trial (nal results have been obtained by averaging the intermediate outcomes). This produced a splitting of the data set into 10 subsets, the overall training set (made up by the union of nine subsets) containing 330 samples and the test set containing the 36 instances left. The rst simulation session has been conducted using the parameter settings empirically deemed best for both the Unsupervised and Supervised Learning phase of KERNEL. First, the Unsupervised Learning algorithm, which was started with 20 initial guessed clusters, provided raw fuzzy rule bases with a number of rules ranging from 7 to 10. The obtained fuzzy rule bases have been successively rened via the Supervised Learning algorithm performed over 1000 epochs. Table 1 reports, for each of the 10 trials, the nal number of rules (corresponding to the automatically determined number of clusters) and the rate of correct classication both for training and test sets after the application of the two learning algorithms of KERNEL. Looking at the average classication results (summarized at the bottom of the table) we can observe that, in most cases, KERNEL fails to provide a reliable diagnosis of dermatological diseases. The poor results achieved in this rst phase of simulations suggested that a further preprocessing of the dataset could be necessary. In particular, a feature selection process was performed by removing the feature age that was characterized by the presence of missing values.

Table 2: Classication results obtained by removing feature age

set 1 2 3 4 5 6 7 8 9 10 mean value Final rules 12 12 12 12 12 12 12 12 12 12 12 Unsuper. Learn. Tr. set 87,3 83,4 88,2 81,3 79,1 81,9 77,0 78,5 80,4 89,5 82,66 Ts. set 83,4 77,8 83,4 86,2 75,0 83,4 73,0 83,4 80,6 88,6 81,48 Super. Learn. Tr. set 91,3 95,5 95,2 95,8 95,8 94,6 95,2 96,4 96,1 95,5 95,14 Ts. set 94,5 88,9 91,7 97,3 94,5 100 94,5 94,5 97,3 91,5 94,47

Then, the two learning processes of KERNEL were applied, using the same parameter setting as in the rst simulation session. The results of this second experimental session are summarized in Table 2. As it can be observed, the results obtained by removing the age feature outperform those obtained by replacing missing values, even if the nal number of rules has slightly increased on average. This shows that KERNEL can provide good classication of erythemato-squamous diseases, provided that a proper treatment of features with missing values is carried out. These preliminary results encourage the application of the whole multistep methodology underlying KERNEL, which involves also the third

component devoted to increase readability of the extracted rules. Further work is currently in progress to evaluate the ability of KERNEL to extract fuzzy classication rules that provide a good diagnosis tool, not only in terms of classication accuracy, but also in terms of interpretability of the extracted knowledge.

in Lecture Notes in Articial Intelligence AI*IA 2001: Advances in Articial Intelligence, vol. 2175, pages. 40-50, Springer Verlag, Berlin Heidelberg. [8] G. Castellano, A. M. Fanelli, (2001). Information granulation via neural network based learning. In Proc. of Joint 9th IFSA World Congress and 20th NAFIPS International Conference (IFSA-NAFIPS 2001), Vancouver, Canada. Invited paper. [9] T. Chin-Ting Du, P. M. Wolfe (1997). Implementation of fuzzy logic systems and neural networks in industry. In Computers in Industry, vol. 32, pp. 261-272. [10] H. A. Guvenir, G. Demirov, N. Ilter, (1998). Learning dierential diagnosis of erythemato-squamous diseases using voting feature intervals. In Articial Intelligence in Medicine, vol.13, pp.147165. [11] J. R. Jang, (1993). ANFIS: AdaptiveNetwork-based Fuzzy Inference System. IEEE Trans. System, Man and Cybernetics, vol. 23, pp. 665-685. [12] C. Lin, C. S. G. Lee, (1991). Neural-networkbased fuzzy logic control and decision system. In IEEE Trans. Comput., vol. 40(12), pp. 1320-1336. [13] D. Nauck, F. Klawonn, R. Kruse (1997). Foundations of Neuro-Fuzzy Systems. New York: Wiley. [14] H. N. Teodorescu, A. Kandel, L. C. Jain (1998). Fuzzy and Neuro-Fuzzy Systems in Medicine. CRC Press.

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