The high incidence and prevalence of chronic kidney disease (CKD), often caused by late diagnoses, is a critical public health problem, especially in developing countries such as Brazil. CKD treatment therapies, such as dialysis and kidney transplantation, increase the morbidity and mortality rates, besides the public health costs. This study analyses the usage of machine learning techniques to assist in the early diagnosis of CKD in developing countries. Qualitative and quantitative comparative analyses are, respectively, conducted using a systematic literature review and an experiment with machine learning techniques, with the k-fold cross-validation method based on the Weka© software and a CKD dataset. These analyses enable a discussion on the suitability of machine learning techniques for screening for CKD risk, focusing on low-income and hard-to-reach settings of developing countries, due to the specific problems faced by them, e.g., inadequate primary health care. The study results show that the J48 decision tree is a suitable machine learning technique for such screening in developing countries, due to the easy interpretation of its classification results, with 95.00% accuracy, reaching a nearly perfect agreement with an experienced nephrologist‘s opinion. Conversely, random forest, naive Bayes, support vector machine, multilayer perceptron, and k-nearest neighbor techniques, respectively, yield 93.33%, 88.33%, 76.66%, 75.00%, and 71.67% accuracy, presenting at least moderate agreement with the nephrologist, at the cost of a more difficult interpretation of the classification results.

Chronic kidney disease (CKD) is a worldwide public health problem, usually diagnosed in the late stages of the disease. To alleviate such issue, investment in early prediction is necessary. The purpose of this study is to assist the early prediction of CKD, addressing problems related to imbalanced and limited-size datasets. We used data from medical records of Brazilians with or without a diagnosis of CKD, containing the following attributes: hypertension, diabetes mellitus, creatinine, urea, albuminuria, age, gender, and glomerular filtration rate. We present an oversampling approach based on manual and automated augmentation. We experimented with the synthetic minority oversampling technique (SMOTE), Borderline-SMOTE, and Borderline-SMOTE SVM. We implemented models based on the algorithms: decision tree (DT), random forest, and multi-class AdaBoosted DTs. We also applied the overall local accuracy and local class accuracy methods for dynamic classifier selection; and the k-nearest oracles-union, k-nearest oracles-eliminate, and META-DES for dynamic ensemble selection. We analyzed the models’ performances using the hold-out validation, multiple stratified cross-validation (CV), and nested CV. The DT model presented the highest accuracy score (98.99%) using the manual augmentation and SMOTE. Our approach can assist in designing systems for the early prediction of CKD using imbalanced and limited-size datasets.

Internet of Things (IoT) resources cooperate with themselves for requesting and providing services. In heterogeneous and complex environments, those resources must trust each other. On-Off attacks threaten the IoT trust security through nodes performing good and bad behaviors randomly, to avoid being rated as a menace. Some countermeasures demand prior levels of trust knowledge and time to classify a node behavior. In some cases, a malfunctioning node can be mismatched as an attacker. In this paper, we introduce a smart trust management method, based on machine learning and an elastic slide window technique that automatically assesses the IoT resource trust, evaluating service provider attributes. In simulated and real-world data, this method was able to identify On-Off attackers and fault nodes with a precision up to 96% and low time consumption.

The chronic kidney disease (CKD) is a worldwide critical problem, especially in developing countries. CKD patients usually begin their treatment in advanced stages, which requires dialysis and kidney transplantation, and consequently, affects mortality rates. This issue is faced by a mobile health (mHealth) application (app) that aims to assist the early diagnosis and self-monitoring of the disease progression. A user-centered design (UCD) approach involving health professionals (nurse and nephrologists) and target users guided the development process of the app between 2012 and 2016. In-depth interviews and prototyping were conducted along with healthcare professionals throughout the requirements elicitation process. Elicited requirements were translated into a native mHealth app targeting the Android platform. Afterward, the Cohen’s Kappa coefficient statistics was applied to evaluate the agreement between the app and three nephrologists who analyzed test results collected from 60 medical records. Finally, eight users tested the app and were interviewed about usability and user perceptions. A mHealth app was designed to assist the CKD early diagnosis and self-monitoring considering quality attributes such as safety, effectiveness, and usability. A global Kappa value of 0.7119 showed a substantial degree of agreement between the app and three nephrologists. Results of face-to-face interviews with target users indicated a good user satisfaction. However, the task of CKD self-monitoring proved difficult because most of the users did not fully understand the meaning of specific biomarkers (e.g., creatinine). The UCD approach provided mechanisms to develop the app based on the real needs of users. Even with no perfect Kappa degree of agreement, results are satisfactory because it aims to refer patients to nephrologists in early stages, where they may confirm the CKD diagnosis.