research paper on predictive analytics

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• J Am Med Inform Assoc
• v.26(12); 2019 Dec

Predictive analytics in health care: how can we know it works?

Ben van calster.

1 Department of Development and Regeneration, KU Leuven, Leuven, Belgium

2 Department of Biomedical Data Sciences, Leiden University Medical Center (LUMC), Leiden, The Netherlands

Laure Wynants

Dirk timmerman.

3 Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium

Ewout W Steyerberg

Gary s collins.

4 Centre for Statistics in Medicine, Nuffield, Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK

5 Oxford University Hospitals NHS Foundation Trust, Oxford, UK

Associated Data

There is increasing awareness that the methodology and findings of research should be transparent. This includes studies using artificial intelligence to develop predictive algorithms that make individualized diagnostic or prognostic risk predictions. We argue that it is paramount to make the algorithm behind any prediction publicly available. This allows independent external validation, assessment of performance heterogeneity across settings and over time, and algorithm refinement or updating. Online calculators and apps may aid uptake if accompanied with sufficient information. For algorithms based on “black box” machine learning methods, software for algorithm implementation is a must. Hiding algorithms for commercial exploitation is unethical, because there is no possibility to assess whether algorithms work as advertised or to monitor when and how algorithms are updated. Journals and funders should demand maximal transparency for publications on predictive algorithms, and clinical guidelines should only recommend publicly available algorithms.

The current interest in predictive analytics for improving health care is reflected by a surge in long-term investment in developing new technologies using artificial intelligence and machine learning to forecast future events (possibly in real time) to improve the health of individuals. Predictive algorithms or clinical prediction models, as they have historically been called, help identify individuals at increased likelihood of disease for diagnosis and prognosis (see Supplementary Material Table S1 for a glossary of terms used in this manuscript). 1 In an era of personalized medicine, predictive algorithms are used to make clinical management decisions based on individual patient characteristics (rather than on population averages) and to counsel patients. The rate at which new algorithms are published shows no sign of abating, particularly with the increasing availability of Big Data, medical imaging, routinely collected electronic health records, and national registry data. 2–4 The scientific community is making efforts to improve data sharing, increase study registration beyond clinical trials, and make reporting transparent and comprehensive with full disclosure of study results. 5 , 6 We discuss the importance of transparency in the context of medical predictive analytics.

ALGORITHM PERFORMANCE IS NOT GUARANTEED: FULLY INDEPENDENT EXTERNAL VALIDATION IS KEY

Before recommending a predictive algorithm for clinical practice, it is important to know whether and for whom it works well. First, predictions should discriminate between individuals with and without the disease (ie, higher predictions in those with the disease compared to those without the disease). Risk predictions should be also accurate (often referred to as calibrated). 7 Algorithm development may suffer from overfitting, which usually results in poorer discrimination and calibration when evaluated on new data. 8 Although the clinical literature tends to focus on discrimination, calibration is clearly crucial. Inaccurate risk predictions can lead to inappropriate decisions or expectations, even when discrimination is good. 7 Calibration has therefore been labeled the Achilles heel of prediction. 2

In addition, there is often substantial heterogeneity between populations, as well as changes in populations over time. 9 , 10 For example, there may be differences between patients in academic hospitals compared with patients at regional hospitals, ethnicities, or past versus contemporary patients due to advances in patient care. 11–13 Recent work indicated that the half-life of clinical data relevance can be remarkably short. 14 , 15 Hence, algorithms are likely to perform differently across centers, settings, and time. On top of overfitting and heterogeneity between populations, operational heterogeneity can affect algorithm performance. Different hospitals may, for example, use different EHR software, imaging machines, or marker kits. 2 , 10 , 16 As a result, the clinical utility of predictive algorithms for decision-making may vary greatly. It is well established that “internal validation” of performance using, for example, a train–test split of available data is insufficient. Rather, algorithms should undergo “external validation” on a different data set. 17 , 18 Notably, algorithms developed using traditional study designs may not validate well when applied on electronic health record data. 4 , 19 It is important to stress 3 issues. First, external validation should be extensive: it should take place at various sites in contemporary cohorts of patients from the targeted population. Second, performance should be monitored over time. 11 Third, external validation by independent investigators is imperative. 20 It is a good evolution to include an external validation as part of the algorithm development study, 18 but one can imagine that algorithms with poor performance on a different data set may be less likely to get published in the first place. If performance in a specific setting is poor, an algorithm can be updated—specifically, its calibration. 1 , 7 To counter temporal changes in populations, continual updating strategies may help. 1 For example, QRISK2 models ( www.qrisk.org ) are updated regularly as new data are continually being collected.

POTENTIAL HURDLES FOR MAKING PREDICTIVE ALGORITHMS PUBLICLY AVAILABLE

To allow others to independently evaluate the predictive accuracy, it is important to describe in full detail how the algorithm was developed. 21 Algorithms should be available in a format that can readily be implemented by others. Not adhering to these principles severely limits the usefulness of the findings—surely a research waste. 22 An analogous situation would be an article describing the findings from a randomized clinical trial without actually reporting the intervention effect or how to implement the intervention.

Transparent and full reporting

The Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) statement, a reporting guideline for studies on predictive algorithms, recommends that the equation behind an algorithm is presented in the publication describing its development. 21 More explicitly, the mathematical formula of an algorithm should be available in full. This includes details such as which predictors are included, how they are coded (including ranges of any continuous predictors, units of measurement), and the values of the regression coefficients. Publications presenting new algorithms often fail to include key information such as specification of the baseline risk (namely, the intercept in logistic regression models for binary outcomes; the baseline hazard at 1 or more clinically relevant time points for time-to-event regression models). 23 Without this information, making predictions is not possible. Below, we expand on modern artificial intelligence methods that do not produce straightforward mathematical equations.

Online calculators and mobile apps

It has become customary to implement algorithms as online calculators or mobile apps. Then, we depend on the researchers’ openness to provide clear and honest information about algorithm development and results of validation studies, with references to relevant publications. For example, FRAX predicts the 10-year probability of hip fracture and major osteoporotic fracture ( www.sheffield.ac.uk/FRAX/ ). FRAX is a collection of algorithms (eg, 68 country-specific equations), which are both freely available via a website interface or commercially available via a desktop application. However, none of these algorithms has been published in full. The release notes indicate that the algorithms are continually revised, but do not offer detailed information. This lack of full disclosure prohibits independent evaluation. 24 In theory, we can try “reverse engineering” by reconstructing the equation based on risk estimates for a sample of patients (see Supplementary Material ). However, such reverse engineering is not a realistic solution. The solution is to avoid hidden algorithms.

Online or mobile calculators allow the inclusion of algorithms into daily clinical routine, which is a positive evolution. However, it is impractical for large-scale independent validation studies, because information for every single patient has to be entered manually.

Machine learning algorithms

Machine learning methods, such as random forests or deep learning, are becoming increasingly popular to develop predictive algorithms. 3 , 25 The architecture of these algorithms is often too complex to fully disentangle and report the relation between a set of predictors and the outcome (“black box”). This is the commonly addressed problem when discussing transparency of predictive analytics based on machine learning. 26 We argue that algorithm availability is at least as important. A similar problem can affect regression-based algorithms that use complex spline functions to model continuous predictors. Software implementations are therefore imperative for validation purposes, in particular, because these algorithms have a higher risk of overfitting and instable performance. 8 , 17 Machine learning algorithms can be stored in computer files that may be transferred to other computers to allow validation studies. Recently, initiatives in this direction are being set up. 27 , 28

Proprietary algorithms

Developers may choose not to disclose an algorithm, and to offer the algorithm on a fee-for-service basis. 16 For example, a biomarker-based algorithm to diagnose ovarian cancer has a cost of $897 per patient ( http://vermillion.com/2436-2/ ). Assume we want to validate this algorithm in a center that has 20% malignancies in the target population. If we want to recruit at least 100 patients in each outcome group, following current recommendations for validation studies, the study needs at least 500 patients. 7 This implies a minimum cost of $448 500 in order to obtain useful information about whether this algorithm works in this particular center. It is important to emphasize this is just the cost required to judge whether the algorithm has any validity in this setting; there is no guarantee that it will be clinically useful.

Many predictive algorithms have been developed using financial support from public institutions. Then we believe that the results belong to the community and should be fully and publicly available. If this is the case, asking a small installation fee for an attractive and user-friendly calculator is defendable to cover software development and generate resources for maintenance and improvements. Such implementations facilitate uptake and inclusion into daily workflow.

Private companies may invest in the development of an algorithm that uses predictors for which the company offers measurement tools (eg, kits, biomarkers). In these instances, the return on investment should focus on the measurement tools, not on selling the algorithm. We argue that it is ethically unacceptable to have a business model that focuses on selling an algorithm. 29 However, such business models may facilitate Food and Drug Administration (FDA) approval or Conformité Européenne (CE) marking of predictive algorithms (eg, https://www.hcanews.com/news/predictive-patient-surveillance-system-receives-fda-clearance ). It is important to realize that regulatory approval does not imply clinical validity or usefulness of a predictive algorithm in a specific clinical setting. 30

THE IMPORTANCE OF ALGORITHM METADATA IN ORDER TO MAKE ALGORITHMS WORK

Although making algorithms fully and publicly available is imperative, the context of the algorithm is equally important. This extends the abovementioned issue of full and transparent reporting according to the TRIPOD guidelines. Reporting should provide full details of algorithm development practices. This includes—but is not limited to—the source of study data (e.g., retrospective EHR, randomized controlled trial data, or prospectively collected cohort data), the number and type of participating centers, the patient recruitment period, inclusion and exclusion criteria, clear definitions of predictors and the outcome, details on how variables were measured, detailed information on missing values and how these were handled, and a full account of the modeling strategy (eg, predictor selection, handling of continuous variables, hyperparameter tuning). Unfortunately, studies reveal time and again that such metadata are poorly reported. 21 , 31 Even when authors develop an algorithm using sensible procedures (eg ,with low risk of overfitting), poor reporting will lead to poor understanding of the context, which may contribute to decreased performance on external validation. Initiatives such as the Observational Health Data Sciences and Informatics (OHDSI; http://ohdsi.org ) focus on such contextual differences and aim to standardize procedures (eg, in terms of terminology, data formats, and definitions of variables) in order to lead to better and more applicable predictive algorithms. 27 , 32 In addition, when an algorithm is made available electronically, we recommend it include an indication of the extent to which the algorithm has been validated.

Predictive algorithms should be fully and publicly available to facilitate independent external validation across various settings ( Table 1 ). For complex algorithms, alternative and innovative solutions are needed; a calculator is a minimal requirement, but downloadable software to batch process multiple records is more efficient. We believe that selling predictions from an undisclosed algorithm is unethical. This article does not touch on legal consequences of using predictive algorithms, where issues such as algorithm availability or black-box predictions cannot be easily ignored. 33 When journals consider manuscripts introducing a predictive algorithm, its availability should be a minimum requirement before acceptance. Clinical guideline documents should focus on publicly available algorithms that have been independently validated.

Summary of arguments in favor of making predictive algorithms fully available, hurdles for doing so, and reasons why developers choose to hide and sell algorithms

SUPPLEMENTARY MATERIAL

Supplementary material is available at Journal of the American Medical Informatics Association online.

This work was funded by Research Foundation – Flanders (grant G0B4716N), Internal Funds KU Leuven (grant C24/15/037). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

CONTRIBUTIONS

Conception: BVC, LW, DT, EWS, GSC. Writing—original draft preparation: BVC. Writing—review and editing: BVC, LW, DT, EWS, GSC. All authors approved the submitted version and agreed to be accountable.

Conflict of interest statement

LW is a postdoctoral fellow of the Research Foundation – Flanders. GSC was supported by the NIHR Biomedical Research Centre, Oxford.

Supplementary Material

Ocz130_supplementary_data.

• Survey Paper
• Open access
• Published: 25 July 2020

Predictive big data analytics for supply chain demand forecasting: methods, applications, and research opportunities

• Mahya Seyedan 1 &
• Fereshteh Mafakheri   ORCID: orcid.org/0000-0002-7991-4635 1  

Journal of Big Data volume  7 , Article number:  53 ( 2020 ) Cite this article

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Big data analytics (BDA) in supply chain management (SCM) is receiving a growing attention. This is due to the fact that BDA has a wide range of applications in SCM, including customer behavior analysis, trend analysis, and demand prediction. In this survey, we investigate the predictive BDA applications in supply chain demand forecasting to propose a classification of these applications, identify the gaps, and provide insights for future research. We classify these algorithms and their applications in supply chain management into time-series forecasting, clustering, K-nearest-neighbors, neural networks, regression analysis, support vector machines, and support vector regression. This survey also points to the fact that the literature is particularly lacking on the applications of BDA for demand forecasting in the case of closed-loop supply chains (CLSCs) and accordingly highlights avenues for future research.

Introduction

Nowadays, businesses adopt ever-increasing precision marketing efforts to remain competitive and to maintain or grow their margin of profit. As such, forecasting models have been widely applied in precision marketing to understand and fulfill customer needs and expectations [ 1 ]. In doing so, there is a growing attention to analysis of consumption behavior and preferences using forecasts obtained from customer data and transaction records in order to manage products supply chains (SC) accordingly [ 2 , 3 ].

Supply chain management (SCM) focuses on flow of goods, services, and information from points of origin to customers through a chain of entities and activities that are connected to one another [ 4 ]. In typical SCM problems, it is assumed that capacity, demand, and cost are known parameters [ 5 ]. However, this is not the case in reality, as there are uncertainties arising from variations in customers’ demand, supplies transportation, organizational risks and lead times. Demand uncertainties, in particular, has the greatest influence on SC performance with widespread effects on production scheduling, inventory planning, and transportation [ 6 ]. In this sense, demand forecasting is a key approach in addressing uncertainties in supply chains [ 7 , 8 , 9 ].

A variety of statistical analysis techniques have been used for demand forecasting in SCM including time-series analysis and regression analysis [ 10 ]. With the advancements in information technologies and improved computational efficiencies, big data analytics (BDA) has emerged as a means of arriving at more precise predictions that better reflect customer needs, facilitate assessment of SC performance, improve the efficiency of SC, reduce reaction time, and support SC risk assessment [ 11 ].

The focus of this meta-research (literature review) paper is on “demand forecasting” in supply chains. The characteristics of demand data in today’s ever expanding and sporadic global supply chains makes the adoption of big data analytics (and machine learning) approaches a necessity for demand forecasting. The digitization of supply chains [ 12 ] and incoporporation Blockchain technologies [ 13 ] for better tracking of supply chains further highlights the role of big data analytics. Supply chain data is high dimensional generated across many points in the chain for varied purposes (products, supplier capacities, orders, shipments, customers, retailers, etc.) in high volumes due to plurality of suppliers, products, and customers and in high velocity reflected by many transactions continuously processed across supply chain networks. In the sense of such complexities, there has been a departure from conventional (statistical) demand forecasting approaches that work based on identifying statistically meannignful trends (characterized by mean and variance attributes) across historical data [ 14 ], towards intelligent forecasts that can learn from the historical data and intelligently evolve to adjust to predict the ever changing demand in supply chains [ 15 ]. This capability is established using big data analytics techniques that extract forecasting rules through discovering the underlying relationships among demand data across supply chain networks [ 16 ]. These techniques are computationally intensive to process and require complex machine-programmed algorithms [ 17 ].

With SCM efforts aiming at satisfying customer demand while minimizing the total cost of supply, applying machine-learning/data analytics algorithms could facilitate precise (data-driven) demand forecasts and align supply chain activities with these predictions to improve efficiency and satisfaction. Reflecting on these opportunities, in this paper, first a taxonmy of data sources in SCM is proposed. Then, the importance of demand management in SCs is investigated. A meta-research (literature review) on BDA applications in SC demand forecasting is explored according to categories of the algorithms utilized. This review paves the path to a critical discussion of BDA applications in SCM highlighting a number of key findings and summarizing the existing challenges and gaps in BDA applications for demand forecasting in SCs. On that basis, the paper concludes by presenting a number of avenues for future research.

Data in supply chains

Data in the context of supply chains can be categorized into customer, shipping, delivery, order, sale, store, and product data [ 18 ]. Figure  1 provides the taxonomy of supply chain data. As such, SC data originates from different (and segmented) sources such as sales, inventory, manufacturing, warehousing, and transportation. In this sense, competition, price volatilities, technological development, and varying customer commitments could lead to underestimation or overestimation of demand in established forecasts [ 19 ]. Therefore, to increase the precision of demand forecast, supply chain data shall be carefully analyzed to enhance knowledge about market trends, customer behavior, suppliers and technologies. Extracting trends and patterns from such data and using them to improve accuracy of future predictions can help minimize supply chain costs [ 20 , 21 ].

Taxonomy of supply chain data

Analysis of supply chain data has become a complex task due to (1) increasing multiplicity of SC entities, (2) growing diversity of SC configurations depending on the homogeneity or heterogeneity of products, (3) interdependencies among these entities (4) uncertainties in dynamical behavior of these components, (5) lack of information as relate to SC entities; [ 11 ], (6) networked manufacturing/production entities due to their increasing coordination and cooperation to achieve a high level customization and adaptaion to varying customers’ needs [ 22 ], and finally (7) the increasing adoption of supply chain digitization practices (and use of Blockchain technologies) to track the acitivities across supply chains [ 12 , 13 ].

Big data analytics (BDA) has been increasingly applied in management of SCs [ 23 ], for procurement management (e.g., supplier selection [ 24 ], sourcing cost improvement [ 25 ], sourcing risk management [ 26 ], product research and development [ 27 ], production planning and control [ 28 ], quality management [ 29 ], maintenance, and diagnosis [ 30 ], warehousing [ 31 ], order picking [ 32 ], inventory control [ 33 ], logistics/transportation (e.g., intelligent transportation systems [ 34 ], logistics planning [ 35 ], in-transit inventory management [ 36 ], demand management (e.g., demand forecasting [ 37 ], demand sensing [ 38 ], and demand shaping [ 39 ]. A key application of BDA in SCM is to provide accurate forecasting, especially demand forecasting, with the aim of reducing the bullwhip effect [ 14 , 40 , 41 , 42 ].

Big data is defined as high-volume, high-velocity, high-variety, high value, and high veracity data requiring innovative forms of information processing that enable enhanced insights, decision making, and process automation [ 43 ]. Volume refers to the extensive size of data collected from multiple sources (spatial dimension) and over an extended period of time (temporal dimension) in SCs. For example, in case of freight data, we have ERP/WMS order and item-level data, tracking, and freight invoice data. These data are generated from sensors, bar codes, Enterprise resource planning (ERP), and database technologies. Velocity can be defined as the rate of generation and delivery of specific data; in other words, it refers to the speed of data collection, reliability of data transferring, efficiency of data storage, and excavation speed of discovering useful knowledge as relate to decision-making models and algorithms. Variety refers to generating varied types of data from diverse sources such as the Internet of Things (IoT), mobile devices, online social networks, and so on. For instance, the vast data from SCM are usually variable due to the diverse sources and heterogeneous formats, particularly resulted from using various sensors in manufacturing sites, highways, retailer shops, and facilitated warehouses. Value refers to the nature of the data that must be discovered to support decision-making. It is the most important yet the most elusive, of the 5 Vs. Veracity refers to the quality of data, which must be accurate and trustworthy, with the knowledge that uncertainty and unreliability may exist in many data sources. Veracity deals with conformity and accuracy of data. Data should be integrated from disparate sources and formats, filtered and validated [ 23 , 44 , 45 ]. In summary, big data analytics techniques can deal with a collection of large and complex datasets that are difficult to process and analyze using traditional techniques [ 46 ].

The literature points to multiple sources of big data across the supply chains with varied trade-offs among volume, velocity, variety, value, and veracity attributes [ 47 ]. We have summarized these sources and trade-offs in Table  1 . Although, the demand forecasts in supply chains belong to the lower bounds of volume, velocity, and variety, however, these forecasts can use data from all sources across the supply chains from low volume/variety/velocity on-the-shelf inventory reports to high volume/variety/velocity supply chain tracking information provided through IoT. This combination of data sources used in SC demand forecasts, with their diverse temporal and spatial attributes, places a greater emphasis on use of big data analytics in supply chains, in general, and demand forecasting efforts, in particular.

The big data analytics applications in supply chain demand forecasting have been reported in both categories of supervised and unsupervised learning. In supervised learning, data will be associated with labels, meaning that the inputs and outputs are known. The supervised learning algorithms identify the underlying relationships between the inputs and outputs in an effort to map the inputs to corresponding outputs given a new unlabeled dataset [ 48 ]. For example, in case of a supervised learning model for demand forecasting, future demand can be predicted based on the historical data on product demand [ 41 ]. In unsupervised learning, data are unlabeled (i.e. unknown output), and the BDA algorithms try to find the underlying patterns among unlabeled data [ 48 ] by analyzing the inputs and their interrelationships. Customer segmentation is an example of unsupervised learning in supply chains that clusters different groups of customers based on their similarity [ 49 ]. Many machine-learning/data analytics algorithms can facilitate both supervised learning (extracting the input–output relationships) and unsupervised learning (extracting inputs, outputs and their relationships) [ 41 ].

Demand management in supply chains

The term “demand management” emerged in practice in the late 1980s and early 1990s. Traditionally, there are two approaches for demand management. A forward approach which looks at potential demand over the next several years and a backward approach that relies on past or ongoing capabilities in responding to demand [ 50 ].

In forward demand management, the focus will be on demand forecasting and planning, data management, and marketing strategies. Demand forecasting and planning refer to predicting the quantities and timings of customers’ requests. Such predictions aim at achieving customers’ satisfaction by meeting their needs in a timely manner [ 51 ]. Accurate demand forecasting could improve the efficiency and robustness of production processes (and the associated supply chains) as the resources will be aligned with requirements leading to reduction of inventories and wastes [ 52 , 53 ].

In the light of the above facts, there are many approaches proposed in the literature and practice for demand forecasting and planning. Spreadsheet models, statistical methods (like moving averages), and benchmark-based judgments are among these approaches. Today, the most widely used demand forecasting and planning tool is Excel. The most widespread problem with spreadsheet models used for demand forecasting is that they are not scalable for large-scale data. In addition, the complexities and uncertainties in SCM (with multiplicity and variability of demand and supply) cannot be extracted, analyzed, and addressed through simple statistical methods such as moving averages or exponential smoothing [ 50 ]. During the past decade, traditional solutions for SC demand forecasting and planning have faced many difficulties in driving the costs down and reducing inventories [ 50 ]. Although, in some cases, the suggested solutions have improved the day’s payable, they have pushed up the SC costs as a burden to suppliers.

The era of big data and high computing analytics has enabled data processing at a large scale that is efficient, fast, easy, and with reduced concerns about data storage and collection due to cloud services. The emergence of new technologies in data storage and analytics and the abundance of quality data have created new opportunities for data-driven demand forecasting and planning. Demand forecast accuracy can be significantly improved with data-mining algorithms and tools that can sift through data, analyze the results, and learn about the relationships involved. This could lead to highly accurate demand forecasting models that learn from data and are scalable for application in SCM. In the following section, a review of BDA applications in SCM is presented. These applications are categorized based on the employed techniques in establishing the data-drive demand forecasts.

BDA for demand forecasting in SCM

This survey aims at reviewing the articles published in the area of demand and sales forecasting in SC in the presence of big data to provide a classification of the literature based on algorithms utilized as well as a survey of applications. To the best of our knowledge, no comprehensive review of the literature specifically on SC demand forecasting has been conducted with a focus on classification of techniques of data analytics and machine learning. In doing so, we performed a thorough search of the existing literature, through Scopus, Google Scholar, and Elsevier, with publication dates ranging from 2005 to 2019. The keywords used for the search were supply chain, demand forecasting, sales forecasting, big data analytics, and machine learning.

Figure  2 shows the trend analysis of publications in demand forecasting for SC appeared from 2005 to 2019. There is a steadily increasing trend in the number of publications from 2005 to 2019. It is expected that such growth continues in 2020. Reviewing the past 15 years of research on big data analysis/machine learning applications in SC demand forecasting, we identified 64 research papers (excluding books, book chapters, and review papers) and categorized them with respect to the methodologies adopted for demand forecasting. The five most frequently used techniques are listed in Table  2 that includes “Neural Network,” “Regression”, “Time-series forecasting (ARIMA)”, “Support Vector Machine”, and “Decision Tree” methods. This table implies the growing use of big data analysis techniques in SC demand forecasting. It shall be mentioned that there were a few articles using multiple of these techniques.

Distribution of literature in supply chain demand forecasting from 2005 to 2019

It shall be mentioned that there are literature review papers exploring the use of big data analytics in SCM [ 10 , 16 , 23 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 ]. However, this study focuses on the specific topic of “demand forecasting” in SCM to explore BDA applications in line with this particular subtopic in SCM.

As Hofmann and Rutschmann [ 58 ] indicated in their literature review, the key questions to answer are why, what and how big data analytics/machine-learning algorithms could enhance forecasts’ accuracy in comparison to conventional statistical forecasting approaches.

Conventional methods have faced a number of limitations for demand forecasting in the context of SCs. There are a lot of parameters influencing the demand in supply chains, however, many of them were not captured in studies using conventional methods for the sake of simplicity. In this regard, the forecasts could only provide a partial understanding of demand variations in supply chains. In addition, the unexplained demand variations could be simply considered as statistical noise. Conventional approaches could provide shorter processing times in exchange for a compromise on robustness and accuracy of predictions. Conventional SC demand forecasting approaches are mostly done manually with high reliance on the planner’s skills and domain knowledge. It would be worthwhile to fully automate the forecasting process to reduce such a dependency [ 58 ]. Finally, data-driven techniques could learn to incorporate non-linear behaviors and could thus provide better approximations in demand forecasting compared to conventional methods that are mostly derived based on linear models. There is a significant level of non-linearity in demand behavior in SC particularly due to competition among suppliers, the bullwhip effect, and mismatch between supply and demand [ 40 ].

To extract valuable knowledge from a vast amount of data, BDA is used as an advanced analytics technique to obtain the data needed for decision-making. Reduced operational costs, improved SC agility, and increased customer satisfaction are mentioned among the benefits of applying BDA in SCM [ 68 ]. Researchers used various BDA techniques and algorithms in SCM context, such as classification, scenario analysis, and optimization [ 23 ]. Machine-learning techniques have been used to forecast demand in SCs, subject to uncertainties in prices, markets, competitors, and customer behaviors, in order to manage SCs in a more efficient and profitable manner [ 40 ].

BDA has been applied in all stages of supply chains, including procurement, warehousing, logistics/transportation, manufacturing, and sales management. BDA consists of descriptive analytics, predictive analytics, and prescriptive analytics. Descriptive analysis is defined as describing and categorizing what happened in the past. Predictive analytics are used to predict future events and discover predictive patterns within data by using mathematical algorithms such as data mining, web mining, and text mining. Prescriptive analytics apply data and mathematical algorithms for decision-making. Multi-criteria decision-making, optimization, and simulation are among the prescriptive analytics tools that help to improve the accuracy of forecasting [ 10 ].

Predictive analytics are the ones mostly utilized in SC demand and procurement forecasting [ 23 ]. In this sense, in the following subsections, we will review various predictive big data analytics approaches, presented in the literature for demand forecasting in SCM, categorized based on the employed data analytics/machine learning technique/algorithm, with elaborations of their purpose and applications (summarized in Table  3 ).

Time-series forecasting

Time series are methodologies for mining complex and sequential data types. In time-series data, sequence data, consisting of long sequences of numeric data, recorded at equal time intervals (e.g., per minute, per hour, or per day). Many natural and human-made processes, such as stock markets, medical diagnosis, or natural phenomenon, can generate time-series data. [ 48 ].

In case of demand forecasting using time-series, demand is recorded over time at equal size intervals [ 69 , 70 ]. Combinations of time-series methods with product or market features have attracted much attention in demand forecasting with BDA. Ma et al. [ 71 ] proposed and developed a demand trend-mining algorithm for predictive life cycle design. In their method, they combined three models (a) a decision tree model for large-scale historical data classification, (b) a discrete choice analysis for present and past demand modeling, and (c) an automated time-series forecasting model for future trend analysis. They tested and applied their 3-level approach in smartphone design, manufacturing and remanufacturing.

Time-series approach was used for forecasting of search traffic (service demand) subject to changes in consumer attitudes [ 37 ]. Demand forecasting has been achieved through time-series models using exponential smoothing with covariates (ESCov) to provide predictions for short-term, mid-term, and long-term demand trends in the chemical industry SCs [ 7 ]. In addition, Hamiche et al. [ 72 ] used a customer-responsive time-series approach for SC demand forecasting.

In case of perishable products, with short life cycles, having appropriate (short-term) forecasting is extremely critical. Da Veiga et al. [ 73 ] forecasted the demand for a group of perishable dairy products using Autoregressive Integrated Moving Average (ARIMA) and Holt-Winters (HW) models. The results were compared based on mean absolute percentage error (MAPE) and Theil inequality index (U-Theil). The HW model showed a better goodness-of-fit based on both performance metrics.

In case of ARIMA, the accuracy of predictions could diminish where there exists a high level of uncertainty in future patterns of parameters [ 42 , 74 , 75 , 76 ]. HW model forecasting can yield better accuracy in comparison to ARIMA [ 73 ]. HW is simple and easy to use. However, data horizon could not be larger than a seasonal cycle; otherwise, the accuracy of forecasts will decrease sharply. This is due to the fact that inputs of an HW model are themselves predicted values subject to longer-term potential inaccuracies and uncertainties [ 45 , 73 ].

Clustering analysis

Clustering analysis is a data analysis approach that partitions a group of data objects into subgroups based on their similarities. Several applications of clustering analysis has been reported in business analytics, pattern recognition, and web development [ 48 ]. Han et al. [ 48 ] have emphasized the fact that using clustering customers can be organized into groups (clusters), such that customers within a group present similar characteristic.

A key target of demand forecasting is to identify demand behavior of customers. Extraction of similar behavior from historical data leads to recognition of customer clusters or segments. Clustering algorithms such as K-means, self-organizing maps (SOMs), and fuzzy clustering have been used to segment similar customers with respect to their behavior. The clustering enhances the accuracy of SC demand forecasting as the predictions are established for each segment comprised of similar customers. As a limitation, the clustering methods have the tendency to identify the customers, that do not follow a pattern, as outliers [ 74 , 77 ].

Hierarchical forecasts of sales data are performed by clustering and categorization of sales patterns. Multivariate ARIMA models have been used in demand forecasting based on point-of-sales data in industrial bakery chains [ 19 ]. These bakery goods are ordered and clustered daily with a continuous need to demand forecasts in order to avoid both shortage or waste [ 19 ]. Fuel demand forecasting in thermal power plants is another domain with applications of clustering methods. Electricity consumption patterns are derived using a clustering of consumers, and on that basis, demand for the required fuel is established [ 77 ].

K-nearest-neighbor (KNN)

KNN is a method of classification that has been widely used for pattern recognition. KNN algorithm identifies the similarity of a given object to the surrounding objects (called tuples) by generating a similarity index. These tuples are described by n attributes. Thus, each tuple corresponds to a point in an n-dimensional space. The KNN algorithm searches for k tuples that are closest to a given tuple [ 48 ]. These similarity-based classifications will lead to formation of clusters containing similar objects. KNN can also be integrated into regression analysis problems [ 78 ] for dimensionality reduction of the data [ 79 ]. In the realm of demand forecasting in SC, Nikolopoulos et al. [ 80 ] applied KNN for forecasting sporadic demand in an automotive spare parts supply chain. In another study, KNN is used to forecast future trends of demand for Walmart’s supply chain planning [ 81 ].

Artificial neural networks

In artificial neural networks, a set of neurons (input/output units) are connected to one another in different layers in order to establish mapping of the inputs to outputs by finding the underlying correlations between them. The configuration of such networks could become a complex problem, due to a high number of layers and neurons, as well as variability of their types (linear or nonlinear), which needs to follow a data-driven learning process to be established. In doing so, each unit (neuron) will correspond to a weight, that is tuned through a training step [ 48 ]. At the end, a weighted network with minimum number of neurons, that could map the inputs to outputs with a minimum fitting error (deviation), is identified.

As the literature reveals, artificial neural networks (ANN) are widely applied for demand forecasting [ 82 , 83 , 84 , 85 ]. To improve the accuracy of ANN-based demand predictions, Liu et al. [ 86 ] proposed a combination of a grey model and a stacked auto encoder applied to a case study of predicting demand in a Brazilian logistics company subject to transportation disruption [ 87 ]. Amirkolaii et al. [ 88 ] applied neural networks in forecasting spare parts demand to minimize supply chain shortages. In this case of spare parts supply chain, although there were multiple suppliers to satisfy demand for a variety of spare parts, the demand was subject to high variability due to a varying number of customers and their varying needs. Their proposed ANN-based forecasting approach included (1) 1 input demand feature with 1 Stock-Keeping Unit (SKU), (2) 1 input demand feature with all SKUs, (3) 16 input demand features with 1 SKU, and (4) 16 input demand features with all SKUs. They applied neural networks with back propagation and compared the results with a number of benchmarks reporting a Mean Square Error (MSE) for each configuration scenario.

Huang et al. [ 89 ] compared a backpropagation (BP) neural network and a linear regression analysis for forecasting of e-logistics demand in urban and rural areas in China using data from 1997 to 2015. By comparing mean absolute error (MAE) and the average relative errors of backpropagation neural network and linear regression, they showed that backpropagation neural networks could reach higher accuracy (reflecting lower differences between predicted and actual data). This is due to the fact that a Sigmoid function was used as the transfer function in the hidden layer of BP, which is differentiable for nonlinear problems such as the one presented in their case study, whereas the linear regression works well with linear problems.

ANNs have also been applied in demand forecasting for server models with one-week demand prediction ahead of order arrivals. In this regard, Saha et al. [ 90 ] proposed an ANN-based forecasting model using a 52-week time-series data fitted through both BP and Radial Basis Function (RBF) networks. A RBF network is similar to a BP network except for the activation/transfer function in RBF that follows a feed-forward process using a radial basis function. RBF results in faster training and convergence to ANN weights in comparison with BP networks without compromising the forecasting precision.

Researchers have combined ANN-based machine-learning algorithms with optimization models to draw optimal courses of actions, strategies, or decisions for future. Chang et al. [ 91 ] employed a genetic algorithm in the training phase of a neural network using sales/supply chain data in the printed circuit board industry in Taiwan and presented an evolving neural network-forecasting model. They proposed use of a Genetic Algorithms (GA)-based cost function optimization to arrive at the best configuration of the corresponding neural network for sales forecast with respect to prediction precision. The proposed model was then compared to back-propagation and linear regression approaches using three performance indices of MAPE, Mean Absolute Deviation (MAD), and Total Cost Deviation (TCD), presenting its superior prediction precision.

Regression analysis

Regression models are used to generate continuous-valued functions utilized for prediction. These methods are used to predict the value of a response (dependent) variable with respect to one or more predictor (independent) variables. There are various forms of regression analysis, such as linear, multiple, weighted, symbolic (random), polynomial, nonparametric, and robust. The latter approach is useful when errors fail to satisfy normalcy conditions or when we deal with big data that could contain significant number of outliers [ 48 ].

Merkuryeva et al. [ 92 ] analyzed three prediction approaches for demand forecasting in the pharmaceutical industry: a simple moving average model, multiple linear regressions, and a symbolic regression with searches conducted through an evolutionary genetic programming. In this experiment, symbolic regression exhibited the best fit with the lowest error.

As perishable products must be sold due to a very short preservation time, demand forecasting for this type of products has drawn increasing attention. Yang and Sutrisno [ 93 ] applied and compared regression analysis and neural network techniques to derive demand forecasts for perishable goods. They concluded that accurate daily forecasts are achievable with knowledge of sales numbers in the first few hours of the day using either of the above methods.

Support vector machine (SVM)

SVM is an algorithm that uses a nonlinear mapping to transform a set of training data into a higher dimension (data classes). SVM searches for an optimal separating hyper-plane that can separate the resulting class from another) [ 48 ]. Villegas et al. [ 94 ] tested the applicability of SVMs for demand forecasting in household and personal care SCs with a dataset comprised of 229 weekly demand series in the UK. Wu [ 95 ] applied an SVM, using a particle swarm optimization (PSO) to search for the best separating hyper-plane, classifying the data related to car sales and forecasting the demand in each cluster.

Support vector regression (SVR)

Continuous variable classification problems can be solved by support vector regression (SVR), which is a regression implementation of SVM. The main idea behind SVR regression is the computation of a linear regression function within a high-dimensional feature space. SVR has been applied in financial/cost prediction problems, handwritten digit recognition, and speaker identification, object recognition, etc. [ 48 ].

Guanghui [ 96 ] used the SVR method for SC needs prediction. The use of SVR in demand forecasting can yield a lower mean square error than RBF neural networks due to the fact that the optimization (cost) function in SVR does not consider the points beyond a margin of distance from the training set. Therefore, this method leads to higher forecast accuracy, although, similar to SVM, it is only applicable to a two-class problem (such as normal versus anomaly detection/estimation problems). Sarhani and El Afia [ 97 ] sought to forecast SC demand using SVR and applied Particle swarm optimization (PSO) and GA to optimize SVR parameters. SVR-PSO and SVR-GA approaches were compared with respect to accuracy of predictions using MAPE. The results showed a superior performance by PSO in terms time intensity and MAPE when configuring the SVR parameters.

Mixed approaches

Some works in the literature have used a combination of the aforementioned techniques. In these studies, the data flow into a sequence of algorithms and the outputs of one stage become inputs of the next step. The outputs are explanatory in the form of qualitative and quantitative information with a sequence of useful information extracted out of each algorithm. Examples of such studies include [ 15 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 ].

In more complex supply chains with several points of supply, different warehouses, varied customers, and several products, the demand forecasting becomes a high dimensional problem. To address this issue, Islek and Oguducu [ 100 ] applied a clustering technique, called bipartite graph clustering, to analyze the patterns of sales for different products. Then, they combined a moving average model and a Bayesian belief network approaches to improve the accuracy of demand forecasting for each cluster. Kilimci et al. [ 101 ] developed an intelligent demand forecasting system by applying time-series and regression methods, a support vector regression algorithm, and a deep learning model in a sequence. They dealt with a case involving big amount of data accounting for 155 features over 875 million records. First, they used a principal component analysis for dimension reduction. Then, data clustering was performed. This is followed by demand forecasting for each cluster using a novel decision integration strategy called boosting ensemble. They concluded that the combination of a deep neural network with a boosting strategy yielded the best accuracy, minimizing the prediction error for demand forecasting.

Chen and Lu [ 98 ] combined clustering algorithms of SOM, a growing hierarchical self-organizing mapping (GHSOM), and K-means, with two machine-learning techniques of SVR and extreme learning machine (ELM) in sales forecasting of computers. The authors found that the combination of GHSOM and ELM yielded better accuracy and performance in demand forecasts for their computer retailing case study. Difficulties in forecasting also occur in cases with high product variety. For these types of products in an SC, patterns of sales can be extracted for clustered products. Then, for each cluster, a machine-learning technique, such as SVR, can be employed to further improve the prediction accuracy [ 104 ].

Brentan et al. [ 106 ] used and analyzed various BDA techniques for demand prediction; including support vector machines (SVM), and adaptive neural fuzzy inference systems (ANFIS). They combined the predicted values derived from each machine learning techniques, using a linear regression process to arrive at an average prediction value adopted as the benchmark forecast. The performance (accuracy) of each technique is then analyzed with respect to their mean square root error (RMSE) and MAE values obtained through comparing the target values and the predicted ones.

In summary, Table  3 provides an overview of the recent literature on the application of Predictive BDA in demand forecasting.

Discussions

The data produced in SCs contain a great deal of useful knowledge. Analysis of such massive data can help us to forecast trends of customer behavior, markets, prices, and so on. This can help organizations better adapt to competitive environments. To forecast demand in an SC, with the presences of big data, different predictive BDA algorithms have been used. These algorithms could provide predictive analytics using time-series approaches, auto-regressive methods, and associative forecasting methods [ 10 ]. The demand forecasts from these BDA methods could be integrated with product design attributes as well as with online search traffic mapping to incorporate customer and price information [ 37 , 71 ].

Predictive BDA algorithms

Most of the studies examined, developed and used a certain data-mining algorithm for their case studies. However, there are very few comparative studies available in the literature to provide a benchmark for understanding of the advantages and disadvantages of these methodologies. Additionally, as depicted by Table  3 , there is no clear trend between the choice of the BDA algorithm/method and the application domain or category.

Predictive BDA applicability

Most data-driven models used in the literature consider historical data. Such a backward-looking forecasting ignores the new trends and highs and lows in different economic environments. Also, organizational factors, such as reputation and marketing strategies, as well as internal risks (related to availability of SCM resources), could greatly influence the demand [ 107 ] and thus contribute to inaccuracy of BDA-based demand predictions using historical data. Incorporating existing driving factors outside the historical data, such as economic instability, inflation, and purchasing power, could help adjust the predictions with respect to unseen future scenarios of demand. Combining predictive algorithms with optimization or simulation can equip the models with prescriptive capabilities in response to future scenarios and expectations.

Predictive BDA in closed-loop supply chains (CLSC)

The combination of forward and reverse flow of material in a SC is referred to as a closed-loop supply chain (CLSC). A CLSC is a more complex system than a traditional SC because it consists of the forward and reverse SC simultaneously [ 108 ]. Economic impact, environmental impact, and social responsibility are three significant factors in designing a CLSC network with inclusion of product recycling, remanufacturing, and refurbishment functions. The complexity of a CLSC, compared to a common SC, results from the coordination between backward and forward flows. For example, transportation cost, holding cost, and forecasting demand are challenging issues because of uncertainties in the information flows from the forward chain to the reverse one. In addition, the uncertainties about the rate of returned products and efficiencies of recycling, remanufacturing, and refurbishment functions are some of the main barriers in establishing predictions for the reverse flow [ 5 , 6 , 109 ]. As such, one key finding from this literature survey is that CLSCs particularly deal with the lack of quality data for remanufacturing. Remanufacturing refers to the disassembly of products, cleaning, inspection, storage, reconditioning, replacement, and reassembling. As a result of deficiencies in data, optimal scheduling of remanufacturing functions is cumbersome due to uncertainties in the quality and quantity of used products as well as timing of returns and delivery delays.

IoT-based approaches can overcome the difficulties of collecting data in a CLSC. In an IoT environment, objects are monitored and controlled remotely across existing network infrastructures. This enables more direct integration between the physical world and computer-based systems. The results include improved efficiency, accuracy, and economic benefit across SCs [ 50 , 54 , 110 ].

Radio frequency identification (RFID) is another technology that has become very popular in SCs. RFID can be used for automation of processes in an SC, and it is useful for coordination of forecasts in CLSCs with dispersed points of return and varied quantities and qualities of returned used products [ 10 , 111 , 112 , 113 , 114 ].

Conclusions

The growing need to customer behavior analysis and demand forecasting is deriven by globalization and increasing market competitions as well as the surge in supply chain digitization practices. In this study, we performed a thorough review for applications of predictive big data analytics (BDA) in SC demand forecasting. The survey overviewed the BDA methods applied to supply chain demand forecasting and provided a comparative categorization of them. We collected and analyzed these studies with respect to methods and techniques used in demand prediction. Seven mainstream techniques were identified and studied with their pros and cons. The neural networks and regression analysis are observed as the two mostly employed techniques, among others. The review also pointed to the fact that optimization models or simulation can be used to improve the accuracy of forecasting through formulating and optimizing a cost function for the fitting of the predictions to data.

One key finding from reviewing the existing literature was that there is a very limited research conducted on the applications of BDA in CLSC and reverse logistics. There are key benefits in adopting a data-driven approach for design and management of CLSCs. Due to increasing environmental awareness and incentives from the government, nowadays a vast quantity of returned (used) products are collected, which are of various types and conditions, received and sorted in many collection points. These uncertainties have a direct impact on the cost-efficiency of remanufacturing processes, the final price of the refurbished products and the demand for these products [ 115 ]. As such, design and operation of CLSCs present a case for big data analytics from both supply and demand forecasting perspectives.

Availability of data and materials

The paper presents a review of the literature extracted from main scientific databases without presenting data.

Abbreviations

Adaptive neural fuzzy inference systems

Auto regressive integrated moving average

Artificial neural network

• Big data analytics

Backpropagation

Closed-loop supply chain

Extreme learning machine

Enterprise resource planning

Genetic algorithms

Growing hierarchical self-organizing map

Holt-winters

Internet of things

K-nearest-neighbor

Mean absolute deviation

Mean absolute error

Mean absolute percentage error

Mean square error

Mean square root error

Radial basis function

Particle swarm optimization

Self-organizing maps

Stock-keeping unit

Supply chain analytics

Supply chain

• Supply chain management

Support vector machine

Support vector regression

Total cost deviation

Theil inequality index

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Seyedan, M., Mafakheri, F. Predictive big data analytics for supply chain demand forecasting: methods, applications, and research opportunities. J Big Data 7 , 53 (2020). https://doi.org/10.1186/s40537-020-00329-2

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Healthcare predictive analytics using machine learning and deep learning techniques: a survey

• Mohammed Badawy   ORCID: orcid.org/0000-0001-9494-1386 1 ,
• Nagy Ramadan 1 &
• Hesham Ahmed Hefny 2  

Journal of Electrical Systems and Information Technology volume  10 , Article number:  40 ( 2023 ) Cite this article

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Healthcare prediction has been a significant factor in saving lives in recent years. In the domain of health care, there is a rapid development of intelligent systems for analyzing complicated data relationships and transforming them into real information for use in the prediction process. Consequently, artificial intelligence is rapidly transforming the healthcare industry, and thus comes the role of systems depending on machine learning and deep learning in the creation of steps that diagnose and predict diseases, whether from clinical data or based on images, that provide tremendous clinical support by simulating human perception and can even diagnose diseases that are difficult to detect by human intelligence. Predictive analytics for healthcare a critical imperative in the healthcare industry. It can significantly affect the accuracy of disease prediction, which may lead to saving patients' lives in the case of accurate and timely prediction; on the contrary, in the case of an incorrect prediction, it may endanger patients' lives. Therefore, diseases must be accurately predicted and estimated. Hence, reliable and efficient methods for healthcare predictive analysis are essential. Therefore, this paper aims to present a comprehensive survey of existing machine learning and deep learning approaches utilized in healthcare prediction and identify the inherent obstacles to applying these approaches in the healthcare domain.

Introduction

Each day, human existence evolves, yet the health of each generation either improves or deteriorates. There are always uncertainties in life. Occasionally encounter many individuals with fatal health problems due to the late detection of diseases. Concerning the adult population, chronic liver disease would affect more than 50 million individuals worldwide. However, if the sickness is diagnosed early, it can be stopped. Disease prediction based on machine learning can be utilized to identify common diseases at an earlier stage. Currently, health is a secondary concern, which has led to numerous problems. Many patients cannot afford to see a doctor, and others are extremely busy and on a tight schedule, yet ignoring recurring symptoms for an extended length of time can have significant health repercussions [ 1 ].

Diseases are a global issue; thus, medical specialists and researchers are exerting their utmost efforts to reduce disease-related mortality. In recent years, predictive analytic models has played a pivotal role in the medical profession because of the increasing volume of healthcare data from a wide range of disparate and incompatible data sources. Nonetheless, processing, storing, and analyzing the massive amount of historical data and the constant inflow of streaming data created by healthcare services has become an unprecedented challenge utilizing traditional database storage [ 2 , 3 , 4 ]. A medical diagnosis is a form of problem-solving and a crucial and significant issue in the real world. Illness diagnosis is the process of translating observational evidence into disease names. The evidence comprises data received from evaluating a patient and substances generated from the patient; illnesses are conceptual medical entities that detect anomalies in the observed evidence [ 5 ].

Healthcare is the collective effort of society to ensure, provide, finance, and promote health. In the twentieth century, there was a significant shift toward the ideal of wellness and the prevention of sickness and incapacity. The delivery of healthcare services entails organized public or private efforts to aid persons in regaining health and preventing disease and impairment [ 6 ]. Health care can be described as standardized rules that help evaluate actions or situations that affect decision-making [ 7 ]. Healthcare is a multi-dimensional system. The basic goal of health care is to diagnose and treat illnesses or disabilities. A healthcare system’s key components are health experts (physicians or nurses), health facilities (clinics and hospitals that provide medications and other diagnostic services), and a funding institution to support the first two [ 8 ].

With the introduction of systems based on computers, the digitalization of all medical records and the evaluation of clinical data in healthcare systems have become widespread routine practices. The phrase "electronic health records" was chosen by the Institute of Medicine, a division of the National Academies of Sciences, Engineering, and Medicine, in 2003 to define the records that continued to enhance the healthcare sector for the benefit of both patients and physicians. Electronic Health Records (EHR) are "computerized medical records for patients that include all information in an individual's past, present, or future that occurs in an electronic system used to capture, store, retrieve, and link data primarily to offer healthcare and health-related services," according to Murphy, Hanken, and Waters [ 8 ].

Daily, healthcare services produce an enormous amount of data, making it increasingly complicated to analyze and handle it in "conventional ways." Using machine learning and deep learning, this data may be properly analyzed to generate actionable insights. In addition, genomics, medical data, social media data, environmental data, and other data sources can be used to supplement healthcare data. Figure  1 provides a visual picture of these data sources. The four key healthcare applications that can benefit from machine learning are prognosis, diagnosis, therapy, and clinical workflow, as outlined in the following section [ 9 ].

Illustration of heterogeneous sources contributing to healthcare data [ 9 ]

The long-term investment in developing novel technologies based on machine learning as well as deep learning techniques to improve the health of individuals via the prediction of future events reflects the increased interest in predictive analytics techniques to enhance healthcare. Clinical predictive models, as they have been formerly referred to, assisted in the diagnosis of people with an increased probability of disease. These prediction algorithms are utilized to make clinical treatment decisions and counsel patients based on some patient characteristics [ 10 ].

The concept of medical care is used to stress the organization and administration of curative care, which is a subset of health care. The ecology of medical care was first introduced by White in 1961. White also proposed a framework for perceiving patterns of health concerning symptoms experienced by populations of interest, along with individuals’ choices in getting medical treatment. In this framework, it is possible to calculate the proportion of the population that used medical services over a specific period of time. The "ecology of medical care" theory has become widely accepted in academic circles over the past few decades [ 6 ].

Medical personnel usually face new problems, changing tasks, and frequent interruptions because of the system's dynamism and scalability. This variability often makes disease recognition a secondary concern for medical experts. Moreover, the clinical interpretation of medical data is a challenging task from an epistemological point of view. This not only applies to professionals with extensive experience but also to representatives, such as young physician assistants, with varied or little experience [ 11 ]. The limited time available to medical personnel, the speedy progression of diseases, and the fluctuating patient dynamics make diagnosis a particularly complex process. However, a precise method of diagnosis is critical to ensuring speedy treatment and, thus, patient safety [ 12 ].

Predictive analytics for health care are critical industry requirements. It can have a significant impact on the accuracy of disease prediction, which can save patients' lives in the case of an accurate and timely prediction but can also endanger patients' lives in the case of an incorrect prediction. Diseases must therefore be accurately predicted and estimated. As a result, dependable and efficient methods for healthcare predictive analysis are required.

The purpose of this paper is to present a comprehensive review of common machine learning and deep learning techniques that are utilized in healthcare prediction, in addition to identifying the inherent obstacles that are associated with applying these approaches in the healthcare domain.

The rest of the paper is organized as follows: Section  " Background " gives a theoretical background on artificial intelligence, machine learning, and deep learning techniques. Section  " Disease prediction with analytics " outlines the survey methodology and presents a literature review of machine learning as well as deep learning approaches employed in healthcare prediction. Section  " Results and Discussion " gives a discussion of the results of previous works related to healthcare prediction. Section  " Challenges " covers the existing challenges related to the topic of this survey. Finally, Section  " Conclusion " concludes the paper.

The extensive research and development of cutting-edge tools based on machine learning and deep learning for predicting individual health outcomes demonstrate the increased interest in predictive analytics techniques to improve health care. Clinical predictive models assisted physicians in better identifying and treating patients who were at a higher risk of developing a serious illness. Based on a variety of factors unique to each individual patient, these prediction algorithms are used to advise patients and guide clinical practice.

Artificial intelligence (AI) is the ability of a system to interpret data, and it makes use of computers and machines to improve humans' capacity for decision-making, problem-solving, and technological innovation [ 13 ]. Figure  2 depicts machine learning and deep learning as subsets of AI.

AI, ML, and DL

Machine learning

Machine learning (ML) is a subfield of AI that aims to develop predictive algorithms based on the idea that machines should have the capability to access data and learn on their own [ 14 ]. ML utilizes algorithms, methods, and processes to detect basic correlations within data and create descriptive and predictive tools that process those correlations. ML is usually associated with data mining, pattern recognition, and deep learning. Although there are no clear boundaries between these areas and they often overlap, it is generally accepted that deep learning is a relatively new subfield of ML that uses extensive computational algorithms and large amounts of data to define complex relationships within data. As shown in Fig.  3 , ML algorithms can be divided into three categories: supervised learning, unsupervised learning, and reinforcement learning [ 15 ].

Different types of machine learning algorithms

Supervised learning

Supervised learning is an ML model for investigating the input–output correlation information of a system depending on a given set of training examples that are paired between the inputs and the outputs [ 16 ]. The model is trained with a labeled dataset. It matches how a student learns fundamental math from a teacher. This kind of learning requires labeled data with predicted correct answers based on algorithm output [ 17 ]. The most widely used supervised learning-based techniques include linear regression, logistic regression, decision trees, random forests, support vector machines, K-nearest neighbor, and naive Bayes.

A. Linear regression

Linear regression is a statistical method commonly used in predictive investigations. It succeeds in forecasting the dependent, output, variable (Y) based on the independent, input, variable (X). The connection between X and Y is represented as shown in Eq.  1 assuming continuous, real, and numeric parameters.

where m indicates the slope and c indicates the intercept. According to Eq.  1 , the association between the independent parameters (X) and the dependent parameters (Y) can be inferred [ 18 ].

The advantage of linear regression is that it is straightforward to learn and easy to-eliminate overfitting through regularization. One drawback of linear regression is that it is not convenient when applied to nonlinear relationships. However, it is not recommended for most practical applications as it greatly simplifies real-world problems [ 19 ]. The implementation tools utilized in linear regression are Python, R, MATLAB, and Excel.

As shown in Fig.  4 , observations are highlighted in red, and random deviations' result (shown in green) from the basic relationship (shown in yellow) between the independent variable (x) and the dependent variable (y) [ 20 ].

Linear regression model

B. Logistic regression

Logistic regression, also known as the logistic model, investigates the correlation between many independent variables and a categorical dependent variable and calculates the probability of an event by fitting the data to a logistic curve [ 21 ]. Discrete mean values must be binary, i.e., have only two outcomes: true or false, 0 or 1, yes or no, or either superscript or subscript. In logistic regression, categorical variables need to be predicted and classification problems should be solved. Logistic regression can be implemented using various tools such as R, Python, Java, and MATLAB [ 18 ]. Logistic regression has many benefits; for example, it shows the linear relationship between dependent and independent variables with the best results. It is also simple to understand. On the other hand, it can only predict numerical output, is not relevant to nonlinear data, and is sensitive to outliers [ 22 ].

C. Decision tree

The decision tree (DT) is the supervised learning technique used for classification. It combines the values of attributes based on their order, either ascending or descending [ 23 ]. As a tree-based strategy, DT defines each path starting from the root using a data-separating sequence until a Boolean conclusion is attained at the leaf node [ 24 , 25 ]. DT is a hierarchical representation of knowledge interactions that contains nodes and links. When relations are employed to classify, nodes reflect purposes [ 26 , 27 ]. An example of DT is presented in Fig.  5 .

Example of a DT

DTs have various drawbacks, such as increased complexity with increasing nomenclature, small modifications that may lead to a different architecture, and more processing time to train data [ 18 ]. The implementation tools used in DT are Python (Scikit-Learn), RStudio, Orange, KNIME, and Weka [ 22 ].

D. Random forest

Random forest (RF) is a basic technique that produces correct results most of the time. It may be utilized for classification and regression. The program produces an ensemble of DTs and blends them [ 28 ].

In the RF classifier, the higher the number of trees in the forest, the more accurate the results. So, the RF has generated a collection of DTs called the forest and combined them to achieve more accurate prediction results. In RF, each DT is built only on a part of the given dataset and trained on approximations. The RF brings together several DTs to reach the optimal decision [ 18 ].

As indicated in Fig.  6 , RF randomly selects a subset of features from the data, and from each subset it generates n random trees [ 20 ]. RF will combine the results from all DTs and provide them in the final output.

Random forest architecture

Two parameters are being used for tuning RF models: mtry —the count of randomly selected features to be considered in each division; and ntree —the model trees count. The mtry parameter has a trade-off: Large values raise the correlation between trees, but enhance the per-tree accuracy [ 29 ].

The RF works with a labeled dataset to do predictions and build a model. The final model is utilized to classify unlabeled data. The model integrates the concept of bagging with a random selection of traits to build variance-controlled DTs [ 30 ].

RF offers significant benefits. First, it can be utilized for determining the relevance of the variables in a regression and classification task [ 31 , 32 ]. This relevance is measured on a scale, based on the impurity drop at each node used for data segmentation [ 33 ]. Second, it automates missing values contained in the data and resolves the overfitting problem of DT. Finally, RF can efficiently handle huge datasets. On the other side, RF suffers from drawbacks; for example, it needs more computing and resources to generate the output results and it requires training effort due to the multiple DTs involved in it. The implementation tools used in RF are Python Scikit-Learn and R [ 18 ].

E. Support vector machine

The supervised ML technique for classification issues and regression models is called the support vector machine (SVM). SVM is a linear model that offers solutions to issues that are both linear and nonlinear. as shown in Fig.  7 . Its foundation is the idea of margin calculation. The dataset is divided into several groups to build relations between them [ 18 ].

Support vector machine

SVM is a statistics-based learning method that follows the principle of structural risk minimization and aims to locate decision bounds, also known as hyperplanes, that can optimally separate classes by finding a hyperplane in a usable N-dimensional space that explicitly classifies data points [ 34 , 35 , 36 ]. SVM indicates the decision boundary between two classes by defining the value of each data point, in particular the support vector points placed on the boundary between the respective classes [ 37 ].

SVM has several advantages; for example, it works perfectly with both semi-structured and unstructured data. The kernel trick is a strong point of SVM. Moreover, it can handle any complex problem with the right functionality and can also handle high-dimensional data. Furthermore, SVM generalization has less allocation risk. On the other hand, SVM has many downsides. The model training time is increased on a large dataset. Choosing the right kernel function is also a difficult process. In addition, it is not working well with noisy data. Implementation tools used in SVM include SVMlight with C, LibSVM with Python, MATLAB or Ruby, SAS, Kernlab, Scikit-Learn, and Weka [ 22 ].

F. K-nearest neighbor

K-nearest neighbor (KNN) is an "instance-based learning" or non-generalized learning algorithm, which is often known as a “lazy learning” algorithm [ 38 ]. KNN is used for solving classification problems. To anticipate the target label of the novel test data, KNN determines the distance of the nearest training data class labels with a new test data point in the existence of a K value, as shown in Fig.  8 . It then calculates the number of nearest data points using the K value and terminates the label of the new test data class. To determine the number of nearest-distance training data points, KNN usually sets the value of K according to (1): k  =  n ^(1/2), where n is the size of the dataset [ 22 ].

K-nearest neighbor

KNN has many benefits; for example, it is sufficiently powerful if the size of the training data is large. It is also simple and flexible, with attributes and distance functions. Moreover, it can handle multi-class datasets. KNN has many drawbacks, such as the difficulty of choosing the appropriate K value, it being very tedious to choose the distance function type for a particular dataset, and the computation cost being a little high due to the distance between all the training data points, the implementation tools used in KNN are Python (Scikit-Learn), WEKA, R, KNIME, and Orange [ 22 ].

G. Naive Bayes

Naive Bayes (NB) focuses on the probabilistic model of Bayes' theorem and is simple to set up as the complex recursive parameter estimation is basically none, making it suitable for huge datasets [ 39 ]. NB determines the class membership degree based on a given class designation [ 40 ]. It scans the data once, and thus, classification is easy [ 41 ]. Simply, the NB classifier assumes that there is no relation between the presence of a particular feature in a class and the presence of any other characteristic. It is mainly targeted at the text classification industry [ 42 ].

NB has great benefits such as ease of implementation, can provide a good result even using fewer training data, can manage both continuous and discrete data, and is ideal to solve the prediction of multi-class problems, and the irrelevant feature does not affect the prediction. NB, on the other hand, has the following drawbacks: It assumes that all features are independent which is not always viable in real-world problems, suffers from zero frequency problems, and the prediction of NB is not usually accurate. Implementation tools are WEKA, Python, RStudio, and Mahout [ 22 ].

To summarize the previously discussed models, Table 1 demonstrates the advantages and disadvantages of each model.

Unsupervised learning

Unlike supervised learning, there are no correct answers and no teachers in unsupervised learning [ 42 ]. It follows the concept that a machine can learn to understand complex processes and patterns on its own without external guidance. This approach is particularly useful in cases where experts have no knowledge of what to look for in the data and the data itself do not include the objectives. The machine predicts the outcome based on past experiences and learns to predict the real-valued outcome from the information previously provided, as shown in Fig.  9 .

Workflow of unsupervised learning [ 23 ]

Unsupervised learning is widely used in the processing of multimedia content, as clustering and partitioning of data in the lack of class labels is often a requirement [ 43 ]. Some of the most popular unsupervised learning-based approaches are k-means, principal component analysis (PCA), and apriori algorithm.

The k-means algorithm is the common portioning method [ 44 ] and one of the most popular unsupervised learning algorithms that deal with the well-known clustering problem. The procedure classifies a particular dataset by a certain number of preselected (assuming k -sets) clusters [ 45 ]. The pseudocode of the K-means algorithm is shown in Pseudocode 1.

K means has several benefits such as being more computationally efficient than hierarchical grouping in case of large variables. It provides more compact clusters than hierarchical ones when a small k is used. Also, the ease of implementation and comprehension of assembly results is another benefit. However, K -means have disadvantages such as the difficulty of predicting the value of K . Also, as different starting sections lead to various final combinations, the performance is affected. It is accurate for raw points and local optimization, and there is no single solution for a given K value—so the average of the K value must be run multiple times (20–100 times) and then pick the results with the minimum J [ 19 ].

B. Principal component analysis

In modern data analysis, principal component analysis (PCA) is an essential tool as it provides a guide for extracting the most important information from a dataset, compressing the data size by keeping only those important features without losing much information, and simplifying the description of a dataset [ 46 , 47 ].

PCA is frequently used to reduce data dimensions before applying classification models. Moreover, unsupervised methods, such as dimensionality reduction or clustering algorithms, are commonly used for data visualizations, detection of common trends or behaviors, and decreasing the data quantity to name a few only [ 48 ].

PCA converts the 2D data into 1D data. This is done by changing the set of variables into new variables known as principal components (PC) which are orthogonal [ 23 ]. In PCA, data dimensions are reduced to make calculations faster and easier. To illustrate how PCA works, let us consider an example of 2D data. When these data are plotted on a graph, it will take two axes. Applying PCA, the data turn into 1D. This process is illustrated in Fig.  10 [ 49 ].

Visualization of data before and after applying PCA [ 49 ]

Apriori algorithm is considered an important algorithm, which was first introduced by R. Agrawal and R. Srikant, and published in [ 50 , 51 ].

The principle of the apriori algorithm is to represent the filter generation strategy. It creates a filter element set ( k  + 1) based on the repeated k element groups. Apriori uses an iterative strategy called planar search, where k item sets are employed to explore ( k  + 1) item sets. First, the set of repeating 1 item is produced by scanning the dataset to collect the number for each item and then collecting items that meet the minimum support. The resulting group is called L1. Then L1 is used to find L2, the recursive set of two elements is used to find L3, and so on until no repeated k element groups are found. Finding every Lk needs a full dataset scan. To improve production efficiency at the level-wise of repeated element groups, a key property called the apriori property is used to reduce the search space. Apriori property states that all non-empty subsets of a recursive element group must be iterative. A two-step technique is used to identify groups of common elements: join and prune activities [ 52 ].

Although it is simple, the apriori algorithm suffers from several drawbacks. The main limitation is the costly wasted time to contain many candidates sets with a lot of redundant item sets. It also suffers from low minimum support or large item sets, and multiple rounds of data are needed for data mining which usually results in irrelevant items, in addition to difficulties in discovering individual elements of events [ 53 , 54 ].

To summarize the previously discussed models, Table 2 demonstrates the advantages and disadvantages of each model.

Reinforcement learning

Reinforcement learning (RL) is different from supervised learning and unsupervised learning. It is a goal-oriented learning approach. RL is closely related to an agent (controller) that takes responsibility for the learning process to achieve a goal. The agent chooses actions, and as a result, the environment changes its state and returns rewards. Positive or negative numerical values are used as rewards. An agent's goal is to maximize the rewards accumulated over time. A job is a complete environment specification that identifies how to generate rewards [ 55 ]. Some of the most popular reinforcement learning-based algorithms are the Q-learning algorithm and the Monte Carlo tree search (MCTS).

A. Q-learning

Q-learning is a type of model-free RL. It can be considered an asynchronous dynamic programming approach. It enables agents to learn how to operate optimally in Markovian domains by exploring the effects of actions, without the need to generate domain maps [ 56 ]. It represented an incremental method of dynamic programming that imposed low computing requirements. It works through the successive improvement of the assessment of individual activity quality in particular states [ 57 ].

In information theory, Q-learning is strongly employed, and other related investigations are underway. Recently, Q-learning combined with information theory has been employed in different disciplines such as natural language processing (NLP), pattern recognition, anomaly detection, and image classification [ 58 , 59 , 60 , 60 ]. Moreover, a framework has been created to provide a satisfying response based on the user’s utterance using RL in a voice interaction system [ 61 ]. Furthermore, a high-resolution deep learning-based prediction system for local rainfall has been constructed [ 62 ].

The advantage of developmental Q-learning is that it is possible to identify the reward value effectively on a given multi-agent environment method as agents in ant Q-learning are interacting with each other. The problem with Q-learning is that its output can be stuck in the local minimum as agents just take the shortest path [ 63 ].

B. Monte Carlo tree search

Monte Carlo tree search (MCTS) is an effective technique for solving sequential selection problems. Its strategy is based on a smart tree search that balances exploration and exploitation. MCTS presents random samples in the form of simulations and keeps activity statistics for better educated choices in each future iteration. MCTS is a decision-making algorithm that is employed in searching tree-like huge complex regions. In such trees, each node refers to a state, which is also referred to as problem configuration, while edges represent transitions from one state to another [ 64 ].

The MCTS is related directly to cases that can be represented by a Markov decision process (MDP), which is a type of discrete-time random control process. Some modifications of the MCTS make it possible to apply it to partially observable Markov decision processes (POMDP) [ 65 ]. Recently, MCTS coupled with deep RL became the base of AlphaGo developed by Google DeepMind and documented in [ 66 ]. The basic MCTS method is conceptually simple, as shown in Fig.  11 .

Basic MCTS process

Tree 1 is constructed progressively and unevenly. The tree policy is utilized to get the critical node of the current tree for each iteration of the method. The tree strategy seeks to strike a balance between exploration and exploitation concerns. Then, from the specified node, simulation 2 is run, and the search tree is then updated according to the obtained results. This comprises adding a child node that matches the specified node's activity and updating its ancestor's statistics. During this simulation, movements are performed based on some default policy, which in its simplest case is to make uniform random movements. The benefit of MCTS is that there is no need to evaluate the values of the intermediate state, which significantly minimizes the amount of required knowledge in the field [ 67 ].

To summarize the previously discussed models, Table 3 demonstrates the advantages and disadvantages of each model.

Deep learning

Over the past decades, ML has had a significant impact on our daily lives with examples including efficient computer vision, web search, and recognition of optical characters. In addition, by applying ML approaches, AI at the human level has also been improved [ 68 , 69 , 70 ]. However, when it comes to the mechanisms of human information processing (such as sound and vision), the performance of traditional ML algorithms is far from satisfactory. The idea of deep learning (DL) was formed in the late 20th inspired by the deep hierarchical structures of human voice recognition and production systems. DL breaks have been introduced in 2006 when Hinton built a deep-structured learning architecture called deep belief network (DBN) [ 71 ].

The performance of classifiers using DL has been extensively improved with the increased complexity of data compared to classical learning methods. Figure  12 shows the performance of classic ML algorithms and DL methods [ 72 ]. The performance of typical ML algorithms becomes stable when they reach the training data threshold, but DL improves its performance as the complexity of data increases [ 73 ].

Performance of deep learning concerning the complexity of data

DL (deep ML, or deep-structured learning) is a subset of ML that involves a collection of algorithms attempting to represent high-level abstractions for data through a model that has complicated structures or is otherwise, composed of numerous nonlinear transformations. The most important characteristic of DL is the depth of the network. Another essential aspect of DL is the ability to replace handcrafted features generated by efficient algorithms for unsupervised or semi-supervised feature learning and hierarchical feature extraction [ 74 ].

DL has significantly advanced the latest technologies in a variety of applications, including machine translation, speech, and visual object recognition, NLP, and text automation, using multilayer artificial neural networks (ANNs) [ 15 ].

Different DL designs in the past two decades give enormous potential for employment in various sectors such as automatic voice recognition, computer vision, NLP, and bioinformatics. This section discusses the most common architectures of DL such as convolutional neural networks (CNNs), long short-term memory (LSTM), and recurrent convolution neural networks (RCNNs) [ 75 ].

A. Convolutional neural network

CNNs are special types of neural networks inspired by the human visual cortex and used in computer vision. It is an automatic feed-forward neural network in which information transfers exclusively in the forward direction [ 76 ]. CNN is frequently applied in face recognition, human organ localization, text analysis, and biological image recognition [ 77 ].

Since CNN was first created in 1989, it has done well in disease diagnosis over the past three decades [ 78 ]. Figure  13 depicts the general architecture of a CNN composed of feature extractors and a classifier. Each layer of the network accepts the output of the previous layer as input and passes it on to the next layer in feature extraction layers. A typical CNN architecture consists of three types of layers: convolution, pooling, and classification. There are two types of layers at the network's low and middle levels: convolutional layers and pooling layers. Even-numbered layers are used for convolutions, while odd-numbered layers are used for pooling operations. The convolution and pooling layers' output nodes are categorized in a two-dimensional plane called feature mapping. Each layer level is typically generated by combining one or more previous layers [ 79 ].

Architecture of CNN [ 79 ]

CNN has a lot of benefits, including a human optical processing system, greatly improved 2D and 3D image processing structure, and is effective in learning and extracting abstract information from 2D information. The max-pooling layer in CNN is efficient in absorbing shape anisotropy. Furthermore, they are constructed from sparse connections with paired weights and contain far fewer parameters than a fully connected network of equal size. CNNs are trained using a gradient-based learning algorithm and are less susceptible to the diminishing gradient problem because the gradient-based approach trains the entire network to directly reduce the error criterion, allowing CNNs to provide highly optimized weights [ 79 ].

B. Long short-term memory

LSTM is a special type of recurrent neural network (RNN) with internal memory and multiplicative gates. Since the original LSTM introduction in 1997 by Sepp Hochrieiter and Jürgen Schmidhuber, a variety of LSTM cell configurations have been described [ 80 ].

LSTM has contributed to the development of well-known software such as Alexa, Siri, Cortana, Google Translate, and Google voice assistant [ 81 ]. LSTM is an implementation of RNN with a special connection between nodes. The special components within the LSTM unit include the input, output, and forget gates. Figure  14 depicts a single LSTM cell.

LSTM unit [ 82 ]

x t  = Input vector at the time t.

h t-1  = Previous hidden state.

c t-1  = Previous memory state.

h t  = Current hidden state.

c t  = Current memory state.

[ x ] = Multiplication operation.

[+] = Addition operation.

LSTM is an RNN module that handles gradient loss problems. In general, RNN uses LSTM to eliminate propagation errors. This allows the RNN to learn over multiple time steps. LSTM is characterized by cells that hold information outside the recurring network. This cell enables the RNN to learn over many time steps. The basic principle of LSTMs is the state of the cell, which contains information outside the recurrent network. A cell is like a memory in a computer, which decides when data should be stored, written, read, or erased via the LSTM gateway [ 82 ]. Many network architectures use LSTM such as bidirectional LSTM, hierarchical and attention-based LSTM, convolutional LSTM, autoencoder LSTM, grid LSTM, cross-modal, and associative LSTM [ 83 ].

Bidirectional LSTM networks move the state vector forward and backward in both directions. This implies that dependencies must be considered in both temporal directions. As a result of inverse state propagation, the expected future correlations can be included in the network's current output [ 84 ]. Bidirectional LSTM investigates and analyzes this because it encapsulates spatially and temporally scattered information and can tolerate incomplete inputs via a flexible cell state vector propagation communication mechanism. Based on the detected gaps in data, this filtering mechanism reidentifies the connections between cells for each data sequence. Figure  15 depicts the architecture. A bidirectional network is used in this study to process properties from multiple dimensions into a parallel and integrated architecture [ 83 ].

(left) Bidirectional LSTM and (right) filter mechanism for processing incomplete data [ 84 ]

Hierarchical LSTM networks solve multi-dimensional problems by breaking them down into subproblems and organizing them in a hierarchical structure. This has the advantage of focusing on a single or multiple subproblems. This is accomplished by adjusting the weights within the network to generate a certain level of interest [ 83 ]. A weighting-based attention mechanism that analyzes and filters input sequences is also used in hierarchical LSTM networks for long-term dependency prediction [ 85 ].

Convolutional LSTM reduces and filters input data collected over a longer period using convolutional operations applied in LSTM networks or the LSTM cell architecture directly. Furthermore, due to their distinct characteristics, convolutional LSTM networks are useful for modeling many quantities such as spatially and temporally distributed relationships. However, many quantities can be expected collectively in terms of reduced feature representation. Decoding or decoherence layers are required to predict different output quantities not as features but based on their parent units [ 83 ].

The LSTM autoencoder solves the problem of predicting high-dimensional parameters by shrinking and expanding the network [ 86 ]. The autoencoder architecture is separately trained with the aim of accurate reconstruction of the input data as reported in [ 87 ]. Only the encoder is used during testing and commissioning to extract the low-dimensional properties that are transmitted to the LSTM. The LSTM was extended to multimodal prediction using this strategy. To compress the input data and cell states, the encoder and decoder are directly integrated into the LSTM cell architecture. This combined reduction improves the flow of information in the cell and results in an improved cell state update mechanism for both short-term and long-term dependency [ 83 ].

Grid long short-term memory is a network of LSTM cells organized into a multi-dimensional grid that can be applied to sequences, vectors, or higher-dimensional data like images [ 88 ]. Grid LSTM has connections to the spatial or temporal dimensions of input sequences. Thus, connections of different dimensions within cells extend the normal flow of information. As a result, grid LSTM is appropriate for the parallel prediction of several output quantities that may be independent, linear, or nonlinear. The network's dimensions and structure are influenced by the nature of the input data and the goal of the prediction [ 89 ].

A novel method for the collaborative prediction of numerous quantities is the cross-modal and associative LSTM. It uses several standard LSTMs to separately model different quantities. To calculate the dependencies of the quantities, these LSTM streams communicate with one another via recursive connections. The chosen layers' outputs are added as new inputs to the layers before and after them in other streams. Consequently, a multimodal forecast can be made. The benefit of this approach is that the correlation vectors that are produced have the same dimensions as the input vectors. As a result, neither the parameter space nor the computation time increases [ 90 ].

C. Recurrent convolution neural network

CNN is a key method for handling various computer vision challenges. In recent years, a new generation of CNNs has been developed, the recurrent convolution neural network (RCNN), which is inspired by large-scale recurrent connections in the visual systems of animals. The recurrent convolutional layer (RCL) is the main feature of RCNN, which integrates repetitive connections among neurons in the normal convolutional layer. With the increase in the number of repetitive computations, the receptive domains (RFs) of neurons in the RCL expand infinitely, which is contrary to biological facts [ 91 ].

The RCNN prototype was proposed by Ming Liang and Xiaolin Hu [ 92 , 93 ], and the structure is illustrated in Fig.  16 , in which both forward and redundant connections have local connectivity and weights shared between distinct sites. This design is quite like the recurrent multilayer perceptron (RMLP) concept which is often used for dynamic control [ 94 , 95 ] (Fig.  17 , middle). Like the distinction between MLP and CNN, the primary distinction is that in RMLP, common local connections are used in place of full connections. For this reason, the proposed model is known as RCNN [ 96 ].

Illustration of the architectures of CNN, RMLP, and RCNN [ 85 ]

Illustration of the total number of reviewed papers

The main unit of RCNN is the RCL. RCLs develop through discrete time steps. RCNN offers three basic advantages. First, it allows each unit to accommodate background information in an arbitrarily wide area in the current layer. Second, recursive connections improve the depth of the network while keeping the number of mutable parameters constant through weight sharing. This is consistent with the trend of modern CNN architecture to grow deeper with a relatively limited number of parameters. The third aspect of RCNN is the time exposed in RCNN which is a CNN with many paths between the input layer and the output layer, which makes learning simple. On one hand, having longer paths makes it possible for the model to learn very complex features. On the other hand, having shorter paths may improve the inverse gradient during training [ 91 ].

To summarize the previously discussed models, Table 4 demonstrates the advantages and disadvantages of each model.

Disease prediction with analytics

The studies discussed in this paper have been presented and published in high-quality journals and international conferences published by IEEE, Springer, and Elsevier, and other major scientific publishers such as Hindawi, Frontiers, Taylor, and MDPI. The search engines used are Google Scholar, Scopus, and Science Direct. All papers selected covered the period from 2019 to 2022. Machine learning, deep learning, health care, surgery, cardiology, radiology, hepatology, and nephrology are some of the terms used to search for these studies. The studies chosen for this survey are concerned with the use of machine learning as well as deep learning algorithms in healthcare prediction. For this survey, empirical and review articles on the topics were considered. This section discusses existing research efforts that healthcare prediction using various techniques in ML and DL. This survey gives a detailed discussion about the methods and algorithms which are used for predictions, performance metrics, and tools of their model.

ML-based healthcare prediction

To predict diabetes patients, the authors of [ 97 ] utilized a framework to develop and evaluate ML classification models like logistic regression, KNN, SVM, and RF. ML method was implemented on the Pima Indian Diabetes Database (PIDD) which has 768 rows and 9 columns. The forecast accuracy delivers 83%. Results of the implementation approach indicate how the logistic regression outperformed other algorithms of ML, in addition only a structured dataset was selected but unstructured data are not considered, also model should be implemented in other healthcare domains like heart disease, and COVID-19, finally other factors should be considered for diabetes prediction, like family history of diabetes, smoking habits, and physical inactivity.

The authors created a diagnosis system in [ 98 ] that uses two different datasets (Frankfurt Hospital in Germany and PIDD provided by the UCI ML repository) and four prediction models (RF, SVM, NB, and DT) to predict diabetes. the SVM algorithm performed with an accuracy of 83.1 percent. There are some aspects of this study that need to be improved; such as, using a DL approach to predict diabetes may lead to achieving better results; furthermore, the model should be tested in other healthcare domains such as heart disease and COVID-19 prediction datasets.

In [ 99 ], the authors proposed three ML methods (logistic regression, DT, and boosted RF) to assess COVID-19 using OpenData Resources from Mexico and Brazil. To predict rescue and death, the proposed model incorporates just the COVID-19 patient's geographical, social, and economic conditions, as well as clinical risk factors, medical reports, and demographic data. On the dataset utilized, the model for Mexico has a 93 percent accuracy, and an F1 score is 0.79. On the other hand, on the used dataset, the Brazil model has a 69 percent accuracy and an F1 score is 0.75. The three ML algorithms have been examined and the acquired results showed that logistic regression is the best way of processing data. The authors should be concerned about the usage of authentication and privacy management of the created data.

A new model for predicting type 2 diabetes using a network approach and ML techniques was presented by the authors in [ 100 ] (logistic regression, SVM, NB, KNN, decision tree, RF, XGBoost, and ANN). To predict the risk of type 2 diabetes, the healthcare data of 1,028 type 2 diabetes patients and 1,028 non-type 2 diabetes patients were extracted from de-identified data. The experimental findings reveal the models’ effectiveness with an area under curve (AUC) varied from 0.79 to 0.91. The RF model achieved higher accuracy than others. This study relies only on the dataset providing hospital admission and discharge summaries from one insurance company. External hospital visits and information from other insurance companies are missing for people with many insurance providers.

The authors of [ 101 ] proposed a healthcare management system that can be used by patients to schedule appointments with doctors and verify prescriptions. It gives support for ML to detect ailments and determine medicines. ML models including DT, RF, logistic regression, and NB classifiers are applied to the datasets of diabetes, heart disease, chronic kidney disease, and liver. The results showed that among all the other models, logistic regression had the highest accuracy of 98.5 percent in the heart dataset. while the least accuracy is of the DT classifier which came out to be 92 percent. In the liver dataset the logistic regression with maximum accuracy of 75.17% among all others. In the chronic renal disease dataset, the logistic regression, RF, and Gaussian NB, all performed well with an accuracy of 1, the accuracy of 100% should be verified by using k-fold cross-validation to test the reliability of the models. In the diabetes dataset random forest with maximum accuracy of 83.67 percent. The authors should include a hospital directory as then various hospitals and clinics can be accessed through a single portal. Additionally, image datasets could be included to allow image processing of reports and the deployment of DL to detect diseases.

In [ 102 ], the authors developed an ML model to predict the occurrence of Type 2 Diabetes in the following year (Y + 1) using factors in the present year (Y). Between 2013 and 2018, the dataset was obtained as an electronic health record from a private medical institute. The authors applied logistic regression, RF, SVM, XGBoost, and ensemble ML algorithms to predict the outcome of non-diabetic, prediabetes, and diabetes. Feature selection was applied to choose the three classes efficiently. FPG, HbA1c, triglycerides, BMI, gamma-GTP, gender, age, uric acid, smoking, drinking, physical activity, and family history were among the features selected. According to the experimental results, the maximum accuracy was 73% from RF, while the lowest was 71% from the logistic regression model. The authors presented a model that used only one dataset. As a result, additional data sources should be applied to verify the models developed in this study.

The authors of [ 103 ] classified the diabetes dataset using SVM and NB algorithms with feature selection to improve the model's accuracy. PIDD is taken from the UCI Repository for analysis. For training and testing purposes the authors employed the k-fold cross-validation model, the SVM classifier was performing better than the NB method it offers around 91% correct predictions; however, the authors acknowledge that they need to extend to the latest dataset that will contain additional attributes and rows.

K-means clustering is an unsupervised ML algorithm that was introduced by the authors of [ 104 ] for the purpose of detecting heart disease in its earliest stages using the UCI heart disease dataset. PCA is used for dimensionality reduction. The outcome of the method demonstrates early cardiac disease prediction with 94.06% accuracy. The authors should apply the proposed technique using more than one algorithm and use more than one dataset.

In [ 105 ], the authors constructed a predictive model for the classification of diabetes data using the logistic regression classification technique. The dataset includes 459 patients for training data and 128 cases for testing data. The prediction accuracy using logistic regression was obtained at 92%. The main limitation of this research is that the authors have not compared the model with other diabetes prediction algorithms, so it cannot be confirmed.

The authors of [ 106 ] developed a prediction model that analyzes the user's symptoms and predicts the disease using ML algorithms (DT classifier, RF classifier, and NB classifier). The purpose of this study was to solve health-related problems by allowing medical professionals to predict diseases at an early stage. The dataset is a sample of 4920 patient records with 41 illnesses diagnosed. A total of 41 disorders were included as a dependent variable. All algorithms achieved the same accuracy score of 95.12%. The authors noticed that overfitting occurred when all 132 symptoms from the original dataset were assessed instead of 95 symptoms. That is, the tree appears to remember the dataset provided and thus fails to classify new data. As a result, just 95 symptoms were assessed during the data-cleansing process, with the best ones being chosen.

In [ 107 ], the authors built a decision-making system that assists practitioners to anticipate cardiac problems in exact classification through a simpler method and will deliver automated predictions about the condition of the patient’s heart. implemented 4 algorithms (KNN, RF, DT, and NB), all these algorithms were used in the Cleveland Heart Disease dataset. The accuracy varies for different classification methods. The maximum accuracy is given when they utilized the KNN algorithm with the Correlation factor which is almost 94 percent. The authors should extend the presented technique to leverage more than one dataset and forecast different diseases.

The authors of [ 108 ] used the Cleveland dataset, which included 303 cases and 76 attributes, to test out three different classification strategies: NB, SVM, and DT in addition to KNN. Only 14 of these 76 characteristics are going to be put through the testing process. The authors performed data preprocessing to remove noisy data. The KNN obtained the greatest accuracy with 90.79 percent. The authors need to use more sophisticated models to improve the accuracy of early heart disease prediction.

The authors of [ 109 ] proposed a model to predict heart disease by making use of a cardiovascular dataset, which was then classified through the application of supervised machine learning algorithms (DT, NB, logistic regression, RF, SVM, and KNN). The results reveal that the DT classification model predicted cardiovascular disorders better than other algorithms with an accuracy of 73 percent. The authors highlighted that the ensemble ML techniques employing the CVD dataset can generate a better illness prediction model.

In [ 110 ], the authors attempted to increase the accuracy of heart disease prediction by applying a logistic regression using a healthcare dataset to determine whether patients have heart illness problems or not. The dataset was acquired from an ongoing cardiovascular study on people of the town of Framingham, Massachusetts. The model reached an accuracy prediction of 87 percent. The authors acknowledge the model could be improved with more data and the use of more ML models.

Because breast cancer affects one in every 28 women in India, the author of [ 111 ] presented an accurate classification technique to examine the breast cancer dataset containing 569 rows and 32 columns. Similarly employing a heart disease dataset and Lung cancer dataset, this research offered A novel way to function selection. This method of selection is based on genetic algorithms mixed with the SVM classification. The classifier results are Lung cancer 81.8182, Diabetes 78.9272. noticed that the size, kind, and source of data used are not indicated.

In [ 112 ], the authors predicted the risk factors that cause heart disease using the K-means clustering algorithm and analyzed with a visualization tool using a Cleveland heart disease dataset with 76 features of 303 patients, holds 209 records with 8 attributes such as age, chest pain type, blood pressure, blood glucose level, ECG in rest, heart rate as well as four types of chest pain. The authors forecast cardiac diseases by taking into consideration the primary characteristics of four types of chest discomfort solely and K-means clustering is a common unsupervised ML technique.

The aim of the article [ 113 ] was to report the advantages of using a variety of data mining (DM) methods and validated heart disease survival prediction models. From the observations, the authors proposed that logistic regression and NB achieved the highest accuracy when performed on a high-dimensional dataset on the Cleveland hospital dataset and DT and RF produce better results on low-dimensional datasets. RF delivers more accuracy than the DT classifier as the algorithm is an optimized learning algorithm. The author mentioned that this work can be extended to other ML algorithms, the model could be developed in a distributed environment such as Map–Reduce, Apache Mahout, and HBase.

In [ 114 ], the authors proposed a single algorithm named hybridization to predict heart disease that combines used techniques into one single algorithm. The presented method has three phases. Preprocessing phase, classification phase, and diagnosis phase. They employed the Cleveland database and algorithms NB, SVM, KNN, NN, J4.8, RF, and GA. NB and SVM always perform better than others, whereas others depend on the specified features. results attained an accuracy of 89.2 percent. The authors need to is the key goal. Notice that the dataset is little; hence, the system was not able to train adequately, so the accuracy of the method was bad.

Using six algorithms (logistic regression, KNN, DT, SVM, NB, and RF), the authors of [ 115 ] explored different data representations to better understand how to use clinical data for predicting liver disease. The original dataset was taken from the northeast of Andhra Pradesh, India. includes 583 liver patient data, whereas 75.64 percent are male, and 24.36 percent are female. The analysis result indicated that the logistic regression classifier delivers the most increased order exactness of 75 percent depending on the f1 measure to forecast the liver illness and NB gives the least precision of 53 percent. The authors merely studied a few prominent supervised ML algorithms; more algorithms can be picked to create an increasingly exact model of liver disease prediction and performance can be steadily improved.

In [ 116 ], the authors aimed to predict coronary heart disease (CHD) based on historical medical data using ML technology. The goal of this study is to use three supervised learning approaches, NB, SVM, and DT, to find correlations in CHD data that could aid improve prediction rates. The dataset contains a retrospective sample of males from KEEL, a high-risk heart disease location in the Western Cape of South Africa. The model utilized NB, SVM, and DT. NB achieved the most accurate among the three models. SVM and DT J48 outperformed NB with a specificity rate of 82 percent but showed an inadequate sensitivity rate of less than 50 percent.

With the help of DM and network analysis methods, the authors of [ 117 ] created a chronic disease risk prediction framework that was created and evaluated in the Australian healthcare system to predict type 2 diabetes risk. Using a private healthcare funds dataset from Australia that spans six years and three different predictive algorithms (regression, parameter optimization, and DT). The accuracy of the prediction ranges from 82 to 87 percent. The hospital admission and discharge summary are the dataset's source. As a result, it does not provide information about general physician visits or future diagnoses.

DL-based healthcare prediction

With the help of DL algorithms such as CNN for autofeature extraction and illness prediction, the authors of [ 118 ] proposed a system for predicting patients with the more common inveterate diseases, and they used KNN for distance calculation to locate the exact matching in the dataset and the outcome of the final sickness prediction. A combination of disease symptoms was made for the structure of the dataset, the living habits of a person, and the specific attaches to doctor consultations which are acceptable in this general disease prediction. In this study, the Indian chronic kidney disease dataset was utilized that comprises 400 occurrences, 24 characteristics, and 2 classes were restored from the UCI ML store. Finally, a comparative study of the proposed system with other algorithms such as NB, DT, and logistic regression has been demonstrated in this study. The findings showed that the proposed system gives an accuracy of 95% which is higher than the other two methods. So, the proposed technique should be applied using more than one dataset.

In [ 119 ], the authors developed a DL approach that uses chest radiography images to differentiate between patients with mild, pneumonia, and COVID-19 infections, providing a valid mechanism for COVID-19 diagnosis. To increase the intensity of the chest X-ray image and eliminate noise, image-enhancing techniques were used in the proposed system. Two distinct DL approaches based on a pertained neural network model (ResNet-50) for COVID-19 identification utilizing chest X-ray (CXR) pictures are proposed in this work to minimize overfitting and increase the overall capabilities of the suggested DL systems. The authors emphasized that tests using a vast and hard dataset encompassing several COVID-19 cases are necessary to establish the efficacy of the suggested system.

Diabetes disease prediction was the topic of the article [ 120 ], in which the authors presented a cuckoo search-based deep LSTM classifier for prediction. The deep convLSTM classifier is used in cuckoo search optimization, which is a nature-inspired method for accurately predicting disease by transferring information and therefore reducing time consumption. The PIMA dataset is used to predict the onset of diabetes. The National Institute of Diabetes and Digestive and Kidney Diseases provided the data. The dataset is made up of independent variables including insulin level, age, and BMI index, as well as one dependent variable. The new technique was compared to traditional methods, and the results showed that the proposed method achieved 97.591 percent accuracy, 95.874 percent sensitivity, and 97.094 percent specificity, respectively. The authors noticed more datasets are needed, as well as new approaches to improve the classifier's effectiveness.

In [ 121 ], the authors presented a wavelet-based convolutional neural network to handle data limitations in this time of COVID-19 fast emergence. By investigating the influence of discrete wavelet transform decomposition up to 4 levels, the model demonstrated the capability of multi-resolution analysis for detecting COVID-19 chest X-rays. The wavelet sub-bands are CNN’s inputs at each decomposition level. COVID-19 chest X-ray-12 is a collection of 1,944 chest X-ray pictures divided into 12 groups that were compiled from two open-source datasets (National Institute Health containing several X-rays of pneumonia-related diseases, whereas the COVID-19 dataset is collected from Radiology Society North America). COVID-Neuro wavelet, a suggested model, was trained alongside other well-known ImageNet pre-trained models on COVID-CXR-12. The authors acknowledge they hope to investigate the effects of other wavelet functions besides the Haar wavelet.

A CNN framework for COVID-19 identification was suggested in [ 122 ] it made use of computed tomography images that was developed by the authors. The proposed framework employs a public CT dataset of 2482 CT images from patients of both classifications. the system attained an accuracy of 96.16 percent and recall of 95.41 percent after training using only 20 percent of the dataset. The authors stated that the use of the framework should be extended to multimodal medical pictures in the future.

Using an LSTM network enhanced by two processes to perform multi-label classification based on patients' clinical visit records, the authors of [ 123 ] performed multi-disease prediction for intelligent clinical decision support. A massive dataset of electronic health records was collected from a prominent hospital in southeast China. The suggested LSTM approach outperforms several standard and DL models in predicting future disease diagnoses, according to model evaluation results. The F1 score rises from 78.9 to 86.4 percent, respectively, with the state-of-the-art conventional and DL models, to 88.0 percent with the suggested technique. The authors stated that the model prediction performance may be enhanced further by including new input variables and that to reduce computational complexity, the method only uses one data source.

In [ 124 ], the authors introduced an approach to creating a supervised ANN structure based on the subnets (the group of neurons) instead of layers, in the cases of low datasets, this effectively predicted the disease. The model was evaluated using textual data and compared to multilayer perceptrons (MLPs) as well as LSTM recurrent neural network models using three small-scale publicly accessible benchmark datasets. On the Iris dataset, the experimental findings for classification reached 97% accuracy, compared to 92% for RNN (LSTM) with three layers, and the model had a lower error rate, 81, than RNN (LSTM) and MLP on the diabetic dataset, while RNN (LSTM) has a high error rate of 84. For larger datasets, however, this method is useless. This model is useless because it has not been implemented on large textual and image datasets.

The authors of [ 125 ] presented a novel AI and Internet of Things (IoT) convergence-based disease detection model for a smart healthcare system. Data collection, reprocessing, categorization, and parameter optimization are all stages of the proposed model. IoT devices, such as wearables and sensors, collect data, which AI algorithms then use to diagnose diseases. The forest technique is then used to remove any outliers found in the patient data. Healthcare data were used to assess the performance of the CSO-LSTM model. During the study, the CSO-LSTM model had a maximum accuracy of 96.16% on heart disease diagnoses and 97.26% on diabetes diagnoses. This method offered a greater prediction accuracy for heart disease and diabetes diagnosis, but there was no feature selection mechanism; hence, it requires extensive computations.

The global health crisis posed by coronaviruses was a subject of [ 126 ]. The authors aimed at detecting disease in people whose X-ray had been selected as potential COVID-19 candidates. Chest X-rays of people with COVID-19, viral pneumonia, and healthy people are included in the dataset. The study compared the performance of two DL algorithms, namely CNN and RNN. DL techniques were used to evaluate a total of 657 chest X-ray images for the diagnosis of COVID-19. VGG19 is the most successful model, with a 95% accuracy rate. The VGG19 model successfully categorizes COVID-19 patients, healthy individuals, and viral pneumonia cases. The dataset's most failing approach is InceptionV3. The success percentage can be improved, according to the authors, by improving data collection. In addition to chest radiography, lung tomography can be used. The success ratio and performance can be enhanced by creating numerous DL models.

In [ 127 ], the authors developed a method based on the RNN algorithm for predicting blood glucose levels for diabetics a maximum of one hour in the future, which required the patient's glucose level history. The Ohio T1DM dataset for blood glucose level prediction, which included blood glucose level values for six people with type 1 diabetes, was used to train and assess the approach. The distribution features were further honed with the use of studies that revealed the procedure's certainty estimate nature. The authors point out that they can only evaluate prediction goals with enough glucose level history; thus, they cannot anticipate the beginning levels after a gap, which does not improve the prediction's quality.

To build a new deep anomaly detection model for fast, reliable screening, the authors of [ 128 ] used an 18-layer residual CNN pre-trained on ImageNet with a different anomaly detection mechanism for the classification of COVID-19. On the X-ray dataset, which contains 100 images from 70 COVID-19 persons and 1431 images from 1008 non-COVID-19 pneumonia subjects, the model obtains a sensitivity of 90.00 percent specificity of 87.84 percent or sensitivity of 96.00 percent specificity of 70.65 percent. The authors noted that the model still has certain flaws, such as missing 4% of COVID-19 cases and having a 30% false positive rate. In addition, more clinical data are required to confirm and improve the model's usefulness.

In [ 129 ], the authors developed COVIDX-Net, a novel DL framework that allows radiologists to diagnose COVID-19 in X-ray images automatically. Seven algorithms (MobileNetV2, ResNetV2, VGG19, DenseNet201, InceptionV3, Inception, and Xception) were evaluated using a small dataset of 50 photographs (MobileNetV2, ResNetV2, VGG19, DenseNet201, InceptionV3, Inception, and Xception). Each deep neural network model can classify the patient's status as a negative or positive COVID-19 case based on the normalized intensities of the X-ray image. The f1-scores for the VGG19 and dense convolutional network (DenseNet) models were 0.89 and 0.91, respectively. With f1-scores of 0.67, the InceptionV3 model has the weakest classification performance.

The authors of [ 130 ] designed a DL approach for delivering 30-min predictions about future glucose levels based on a Dilated RNN (DRNN). The performance of the DRNN models was evaluated using data from two electronic health records datasets: OhioT1DM from clinical trials and the in silicon dataset from the UVA-Padova simulator. It outperformed established glucose prediction approaches such as neural networks (NNs), support vector regression (SVR), and autoregressive models (ARX). The results demonstrated that it significantly improved glucose prediction performance, although there are still some limits, such as the authors' creation of a data-driven model that heavily relies on past EHR. The quality of the data has a significant impact on the accuracy of the prediction. The number of clinical datasets is limited and , however, often restricted. Because certain data fields are manually entered, they are occasionally incorrect.

In [ 131 ], the authors utilized a deep neural network (DNN) to discover 15,099 stroke patients, researchers were able to predict stroke death based on medical history and human behaviors utilizing large-scale electronic health information. The Korea Centers for Disease Control and Prevention collected data from 2013 to 2016 and found that there are around 150 hospitals in the country, all having more than 100 beds. Gender, age, type of insurance, mode of admission, necessary brain surgery, area, length of hospital stays, hospital location, number of hospital beds, stroke kind, and CCI were among the 11 variables in the DL model. To automatically create features from the data and identify risk factors for stroke, researchers used a DNN/scaled principal component analysis (PCA). 15,099 people with a history of stroke were enrolled in the study. The data were divided into a training set (66%) and a testing set (34%), with 30 percent of the samples used for validation in the training set. DNN is used to examine the variables of interest, while scaled PCA is utilized to improve the DNN's continuous inputs. The sensitivity, specificity, and AUC values were 64.32%, 85.56%, and 83.48%, respectively.

The authors of [ 132 ] proposed (GluNet), an approach to glucose forecasting. This method made use of a personalized DNN to forecast the probabilistic distribution of short-term measurements for people with Type 1 diabetes based on their historical data. These data included insulin doses, meal information, glucose measurements, and a variety of other factors. It utilized the newest DL techniques consisting of four components: post-processing, dilated CNN, label recovery/ transform, and data preprocessing. The authors run the models on the subjects from the OhioT1DM datasets. The outcomes revealed significant enhancements over the previous procedures via a comprehensive comparison concerning the and root mean square error (RMSE) having a time lag of 60 min prediction horizons (PH) and RMSE having a small-time lag for the case of prediction horizons in the virtual adult participants. If the PH is properly matched to the lag between input and output, the user may learn the control of the system more frequently and it achieves good performance. Additionally, GluNet was validated on two clinical datasets. It attained an RMSE with a time lag of 60 min PH and RMSE with a time lag of 30-min PH. The authors point out that the model does not consider physiological knowledge, and that they need to test GluNet with larger prediction horizons and use it to predict overnight hypoglycemia.

The authors of [ 133 ] proposed the short-term blood glucose prediction model (VMD-IPSO-LSTM), which is a short-term strategy for predicting blood glucose (VMD-IPSO-LSTM). Initially, the intrinsic modal functions (IMF) in various frequency bands were obtained using the variational modal decomposition (VMD) technique, which deconstructed the blood glucose content. The short- and long-term memory networks then constructed a prediction mechanism for each blood glucose component’s intrinsic modal functions (IMF). Because the time window length, learning rate, and neuron count are difficult to set, the upgraded PSO approach optimized these parameters. The improved LSTM network anticipated each IMF, and the projected subsequence was superimposed in the final step to arrive at the ultimate prediction result. The data of 56 participants were chosen as experimental data among 451 diabetic Mellitus patients. The experiments revealed that it improved prediction accuracy at "30 min, 45 min, and 60 min." The RMSE and MAPE were lower than the "VMD-PSO-LSTM, VMD-LSTM, and LSTM," indicating that the suggested model is effective. The longer time it took to anticipate blood glucose levels and the higher accuracy of the predictions gave patients and doctors more time to improve the effectiveness of diabetes therapy and manage blood glucose levels. The authors noted that they still faced challenges, such as an increase in calculation volume and operation time. The time it takes to estimate glucose levels in the short term will be reduced.

To speed up diagnosis and cut down on mistakes, the authors of [ 134 ] proposed a new paradigm for primary COVID-19 detection based on a radiology review of chest radiography or chest X-ray. The authors used a dataset of chest X-rays from verified COVID-19 patients (408 photographs), confirmed pneumonia patients (4273 images), and healthy people (1590 images) to perform a three-class image classification (1590 images). There are 6271 people in total in the dataset. To fulfill this image categorization problem, the authors plan to use CNN and transfer learning. For all the folds of data, the model's accuracy ranged from 93.90 percent to 98.37 percent. Even the lowest level of accuracy, 93.90 percent, is still quite good. The authors will face a restriction, particularly when it comes to adopting such a model on a large scale for practical usage.

In [ 135 ], the authors proposed DL models for predicting the number of COVID-19-positive cases in Indian states. The Ministry of Health and Family Welfare dataset contains time series data for 32 individual confirmed COVID-19 cases in each of the states (28) and union territories (4) since March 14, 2020. This dataset was used to conduct an exploratory analysis of the increase in the number of positive cases in India. As prediction models, RNN-based LSTMs are used. Deep LSTM, convolutional LSTM, and bidirectional LSTM models were tested on 32 states/union territories, and the model with the best accuracy was chosen based on absolute error. Bidirectional LSTM produced the best performance in terms of prediction errors, while convolutional LSTM produced the worst performance. For all states, daily and weekly forecasts were calculated, and bi-LSTM produced accurate results (error less than 3%) for short-term prediction (1–3 days).

With the goal of increasing the reliability and precision of type 1 diabetes predictions, the authors of [ 136 ] proposed a new method based on CNNs and DL. It was about figuring out how to extract the behavioral pattern. Numerous observations of identical behaviors were used to fill in the gaps in the data. The suggested model was trained and verified using data from 759 people with type 1 diabetes who visited Sheffield Teaching Hospitals between 2013 and 2015. A subject's type 1 diabetes test, demographic data (age, gender, years with diabetes), and the final 84 days (12 weeks) of self-monitored blood glucose (SMBG) measurements preceding the test formed each item in the training set. In the presence of insufficient data and certain physiological specificities, prediction accuracy deteriorates, according to the authors.

The authors of [ 137 ] constructed a framework using the PIDD. PID's participants are all female and at least 21 years old. PID comprises 768 incidences, with 268 samples diagnosed as diabetic and 500 samples not diagnosed as diabetic. The eight most important characteristics that led to diabetes prediction. The accuracy of functional classifiers such as ANN, NB, DT, and DL is between 90 and 98 percent. On the PIMA dataset, DL had the best results for diabetes onset among the four, with an accuracy rate of 98.07 percent. The technique uses a variety of classifiers to accurately predict the disease, but it failed to diagnose it at an early stage.

To summarize all previous works discussed in this section, we will categorize them according to the diseases along with the techniques used to predict each disease, the datasets used, and the main findings, as shown in Table 5 .

Results and discussion

This study conducted a systematic review to examine the latest developments in ML and DL for healthcare prediction. It focused on healthcare forecasting and how the use of ML and DL can be relevant and robust. A total of 41 papers were reviewed, 21 in ML and 20 in DL as depicted in Fig.  17 .

In this study, the reviewed paper were classified by diseases predicted; as a result, 5 diseases were discussed including diabetes, COVID-19, heart, liver, and chronic kidney). Table 6 illustrates the number of reviewed papers for each disease in addition to the adopted prediction techniques in each disease.

Table 6 provides a comprehensive summary of the various ML and DL models used for disease prediction. It indicates the number of studies conducted on each disease, the techniques employed, and the highest level of accuracy attained. As shown in Table 6 , the optimal diagnostic accuracy for each disease varies. For diabetes, the DL model achieved a 98.07% accuracy rate. For COVID-19, the accuracy of the logistic regression model was 98.5%. The CSO-LSTM model achieved an accuracy of 96.16 percent for heart disease. For liver disease, the accuracy of the logistic regression model was 75%. The accuracy of the logistic regression model for predicting multiple diseases was 98.5%. It is essential to note that these are merely the best accuracy included in this survey. In addition, it is essential to consider the size and quality of the datasets used to train and validate the models. It is more likely that models trained on larger and more diverse datasets will generalize well to new data. Overall, the results presented in Table 6 indicate that ML and DL models can be used to accurately predict disease. When selecting a model for a specific disease, it is essential to carefully consider the various models and techniques.

Although ML and DL have made incredible strides in recent years, they still have a long way to go before they can effectively be used to solve the fundamental problems plaguing the healthcare systems. Some of the challenges associated with implementing ML and DL approaches in healthcare prediction are discussed here.

The Biomedical Data Stream is the primary challenge that needs to be handled. Significant amounts of new medical data are being generated rapidly, and the healthcare industry as a whole is evolving rapidly. Some examples of such real-time biological signals include measurements of blood pressure, oxygen saturation, and glucose levels. While some variants of DL architecture have attempted to address this problem, many challenges remain before effective analyses of rapidly evolving, massive amounts of streaming data can be conducted. These include problems with memory consumption, feature selection, missing data, and computational complexity. Another challenge for ML and DL is tackling the complexity of the healthcare domain.

Healthcare and biomedical research present more intricate challenges than other fields. There is still a lot we do not know about the origins, transmission, and cures for many of these incredibly diverse diseases. It is hard to collect sufficient data because there are not always enough patients. A solution to this issue may be found, however. The small number of patients necessitates exhaustive patient profiling, innovative data processing, and the incorporation of additional datasets. Researchers can process each dataset independently using the appropriate DL technique and then represent the results in a unified model to extract patient data.

The use of ML and DL techniques for healthcare prediction has the potential to change the way traditional healthcare services are delivered. In the case of ML and DL applications, healthcare data is deemed the most significant component that contributes to medical care systems. This paper aims to present a comprehensive review of the most significant ML and DL techniques employed in healthcare predictive analytics. In addition, it discussed the obstacles and challenges of applying ML and DL Techniques in the healthcare domain. As a result of this survey, a total of 41 papers covering the period from 2019 to 2022 were selected and thoroughly reviewed. In addition, the methodology for each paper was discussed in detail. The reviewed studies have shown that AI techniques (ML and DL) play a significant role in accurately diagnosing diseases and helping to anticipate and analyze healthcare data by linking hundreds of clinical records and rebuilding a patient's history using these data. This work advances research in the field of healthcare predictive analytics using ML and DL approaches and contributes to the literature and future studies by serving as a resource for other academics and researchers.

Availability of data and materials

Not applicable.

Abbreviations

Artificial Intelligence

Machine Learning

Decision Tree

Electronic Health Records

Random Forest

Support Vector Machine

K-Nearest Neighbor

Naive Bayes

Reinforcement Learning

Natural Language Processing

Monte Carlo Tree Search

Partially Observable Markov Decision Processes

Deep Learning

Deep Belief Network

Artificial Neural Networks

Convolutional Neural Networks

Long Short-Term Memory

Recurrent Convolution Neural Networks

Recurrent Neural Networks

Recurrent Convolutional Layer

Receptive Domains

Recurrent Multilayer Perceptron

Pima Indian Diabetes Database

Coronary Heart Disease

Chest X-Ray

Multilayer Perceptrons

Internet of Things

Dilated RNN

Neural Networks

Support Vector Regression

Principal Component Analysis

Deep Neural Network

Prediction Horizons

Root Mean Square Error

Intrinsic Modal Functions

Variational Modal Decomposition

Self-Monitored Blood Glucose

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Badawy, M., Ramadan, N. & Hefny, H.A. Healthcare predictive analytics using machine learning and deep learning techniques: a survey. Journal of Electrical Systems and Inf Technol 10 , 40 (2023). https://doi.org/10.1186/s43067-023-00108-y

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AI-Driven Intelligent Data Analytics and Predictive Analysis in Industry 4.0: Transforming Knowledge, Innovation, and Efficiency

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In the era of Industry 4.0, integrating digital technologies into industrial processes has become imperative for sustaining growth and fostering innovation. This research paper explores the profound impact of AI-driven intelligent data analytics and predictive analysis on economic efficiency and managerial practices within Industry 4.0. With a focus on knowledge, innovation, technology, and society, this study delves into the transformative potential of these advanced technologies. Intelligent data analytics, powered by artificial intelligence (AI), has revolutionized the way industries harness vast datasets. Uncovering real-time patterns, correlations, and opportunities empowers decision-makers with accurate and timely insights. Predictive analysis, rooted in statistics and machine learning, aids in forecasting trends and managing risks, offering economic stability across sectors. Using a mixed-methods approach, the study combines qualitative interviews with 19 Chinese operations managers and quantitative data from an online survey of 286 managers. The study ranks various Industry 4.0 technologies through ordinal regression based on their impact on environmental sustainability and economic management. Results show that smart sensors, radio-frequency identification, AI, and analytics are the most influential technologies for enhancing economic and environmental outcomes. Conversely, technologies like additive manufacturing and automated robots yield less favorable results. The study also identifies a noticeable gap in professionals’ understanding and adoption of AI and augmented reality. Environmental concerns around the disposal of electronic waste generated by these technologies are also highlighted. The research thus offers significant insights for companies seeking to adopt intelligent data analytics to enhance economic performance and environmental sustainability. On the managerial front, the fusion of these technologies enables agile and responsive frameworks, promoting dynamic strategies in response to changing market dynamics. This culture of continual improvement fosters excellence and foresight in managerial processes. However, challenges exist, including the underutilization of data, data complexity, historical biases, and the need for tailored AI solutions across industries. Ethical considerations, data privacy, and security also pose concerns. Collaborative innovation among stakeholders is crucial to addressing these challenges and seizing opportunities. Governments, academia, and industry players must collaborate to develop technologically advanced, economically viable, and socially responsible solutions. As industries transition to Industry 4.0, this paper advocates a critical approach that embraces technology’s potential while mitigating risks. The future lies in a technologically advanced, economically resilient, and socially inclusive industrial landscape driven by AI-powered knowledge and innovation.

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This work was supported by the Key Research Projects of Humanities and Social Sciences in Universities of Anhui Province (2023AH052850, 2022AH052811), the Social Science Planning Project of Fuyang (FSK2023028), the Research Projects in the Humanities and Social Sciences of College of Information Engineering, Fuyang Normal University (FXG2021SZ01), and the Key Research Project of Talent Fund of College of Information Engineering, Fuyang Normal University (2022xgrcxm03).

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Zong, Z., Guan, Y. AI-Driven Intelligent Data Analytics and Predictive Analysis in Industry 4.0: Transforming Knowledge, Innovation, and Efficiency. J Knowl Econ (2024). https://doi.org/10.1007/s13132-024-02001-z

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DOI : https://doi.org/10.1007/s13132-024-02001-z

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