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i
ng
R
e
lie
f
F
a
n
d
H
e
u
r
is
tic
R
o
u
g
h
S
e
ts
a
l
g
o
r
ith
m
s
.
T
h
e
s
t
u
d
y
h
a
s
a
n
u
m
b
e
r
o
f
w
e
a
k
n
e
s
s
e
s
.
F
ir
s
t,
t
h
e
a
ttr
ib
u
te
s
ge
ne
r
a
t
e
d
i
n t
he
d
i
m
e
n
s
i
o
na
l
r
e
d
uc
t
i
o
n p
r
o
c
e
s
s
,
w
he
n r
e
f
e
r
r
i
ng t
o
t
he
c
o
s
t
i
n
g gr
o
up
i
ng
s
o
f
F
e
s
hk
i
a
nd
S
hi
j
a
ni
'
s
[2
]
r
es
ear
ch
r
es
u
l
t
s
,
t
h
er
e
ar
e
t
w
o
co
s
t
l
y
c
h
ec
k
s
,
n
a
m
e
l
y
s
ci
n
t
i
g
r
ap
h
y
an
d
f
l
u
o
r
o
s
co
p
y
.
A
s
i
m
i
l
ar
r
es
u
l
t
i
s
al
s
o
m
ad
e b
y
A
h
m
ad
i
et
.
al
[3
]
,
a co
m
b
i
n
at
i
o
n
m
o
d
el
o
f
C
5
.
0
w
i
t
h
a
n
eu
r
a
l
ne
t
w
o
r
k,
w
hi
c
h d
o
e
s
no
t
r
e
du
c
e
bot
h
t
h
e
c
os
t
l
y
a
t
t
r
i
bu
t
e
s
.
S
e
c
on
d,
di
m
e
n
s
i
o
n
a
l
r
e
du
c
t
i
on
pr
oc
e
s
s
doe
s
n
ot
t
a
ke
i
n
t
o a
c
c
oun
t
t
h
e
cl
i
n
i
cal
p
r
o
ced
u
r
es
t
h
at
cl
i
n
i
c
i
an
s
n
o
r
m
al
l
y
p
er
f
o
r
m
.
A
s
y
s
te
m
o
f
d
ia
g
n
o
s
tic
s
w
it
h
c
o
s
t
-
ba
s
e
d di
m
e
ns
i
on r
e
du
c
t
i
on
h
a
s
be
e
n
pe
r
fo
rm
e
d
b
y
A
r
j
en
ak
i
et
.
al
[4
]
a
nd
a
l
s
o
b
y
F
e
s
h
ki
a
nd
S
hi
j
a
ni
[2
]
.
B
ot
h
of
t
h
e
s
e
s
t
u
di
e
s
i
n di
m
e
ns
i
on
a
l
r
e
du
c
t
i
on
u
s
i
n
g a
g
e
n
e
t
ic
a
l
g
o
r
ith
m
a
n
d
p
a
r
tic
le
s
w
a
r
m
o
p
ti
m
iz
a
tio
n
w
i
th
its
f
i
tn
e
s
s
f
u
n
c
tio
n
i
s
a
c
o
s
t
f
u
n
c
tio
n
.
B
o
th
s
tu
d
ie
s
a
r
e
cap
ab
l
e o
f
r
ed
u
ci
n
g
co
s
t
l
y
at
t
r
i
b
u
t
es
.
U
n
f
o
r
t
u
n
at
el
y
t
h
e
m
o
d
el
d
o
es
n
o
t
c
o
n
s
id
e
r
th
e
s
ta
g
e
s
o
f
e
x
a
m
in
a
tio
n
a
ttr
ib
u
te
s
,
c
o
n
s
e
q
u
e
n
tl
y
a
t t
h
e
ti
m
e
o
f
th
e
d
ia
g
n
o
s
is
p
r
o
c
e
s
s
r
e
q
u
ir
e
s
e
x
a
m
i
n
a
tio
n
o
f
a
ll a
ttr
ib
u
te
s
d
i
m
e
n
s
io
n
a
l
r
e
d
uc
t
i
o
n r
e
s
ul
t
s
.
T
hi
s
m
a
ke
s
t
he
a
b
s
e
nc
e
o
f
a
r
e
d
uc
t
i
o
n p
r
o
c
e
s
s
a
ga
i
n
w
h
e
n t
he
d
i
a
gno
s
i
s
i
s
d
o
ne
.
D
i
me
n
s
i
o
n
al
r
ed
u
c
t
i
o
n
m
o
d
el
s
cap
ab
l
e o
f
r
ed
u
ci
n
g
co
s
t
l
y
at
t
r
i
b
u
t
es
h
a
v
e al
s
o
b
e
en
u
n
d
er
t
a
k
en
b
y
W
ih
a
r
to
e
t.
a
l
[5
]
.
T
h
e s
t
u
d
y
u
s
ed
a co
m
b
i
n
at
i
o
n
o
f
t
i
er
ed
ap
p
r
o
ach
es
w
it
h
lo
g
i
s
tic
r
e
g
r
e
s
s
io
n
a
lg
o
r
it
h
m
s
,
u
n
f
o
r
t
u
n
at
el
y
,
t
h
e t
i
er
ed
ap
p
r
o
ach
i
s
o
n
l
y
u
s
ed
i
n
d
i
m
en
s
i
o
n
al
r
ed
u
ct
i
o
n
p
r
o
ces
s
,
b
u
t
at
t
h
e t
i
m
e o
f
t
h
e
di
a
g
n
os
i
s
pr
oc
e
s
s
i
s
n
ot
u
s
e
d,
s
o n
o di
m
e
ns
i
on
a
l
r
e
du
c
t
i
on
o
c
c
u
r
s
w
he
n
t
h
e
di
a
gn
os
i
s
s
y
s
t
e
m
i
s
u
s
e
d.
T
he
us
e
o
f
t
i
e
r
ed
co
n
cep
t
s
h
a
s
al
s
o
b
een
d
o
n
e
b
y
W
i
h
ar
t
o
et
.
al
[6
]
.
T
he
s
t
ud
y
gr
o
up
e
d
t
he
a
t
t
r
i
b
ut
e
s
a
c
c
o
r
d
i
ng t
o
t
he
s
t
a
ge
s
i
n t
he
p
r
o
c
e
s
s
o
f
d
i
a
gno
s
i
s
,
b
ut
i
n e
a
c
h s
t
a
ge
w
i
t
ho
ut
di
m
e
n
s
i
o
n
a
l
r
e
du
c
t
i
on
pr
oc
e
s
s
.
D
i
m
e
ns
i
o
na
l
r
e
d
uc
t
i
o
n
p
r
o
c
e
s
s
o
c
c
ur
s
o
nl
y
w
he
n
t
he
d
i
a
gn
o
s
t
i
c
p
r
o
c
e
s
s
i
s
d
o
ne
,
i
e
i
f
t
h
e
d
i
a
gno
s
i
s
i
n
t
h
e
ear
l
y
s
t
a
g
es
h
a
s
b
een
d
ecl
ar
ed
n
eg
at
i
v
e,
n
o
f
u
r
t
h
er
ex
a
m
i
n
at
i
o
n
o
f
t
h
e at
t
r
i
b
u
t
es
at
t
h
e n
e
x
t
s
t
ag
e i
s
r
eq
u
i
r
ed
.
T
he
s
am
e co
n
cep
t
h
a
s
al
s
o
b
een
u
s
ed
b
y
W
i
h
ar
t
o
et
.
al
[7
]
,
th
e
s
tu
d
y
u
s
e
d
th
e
C
4
.
5
a
lg
o
r
ith
m
f
o
r
in
d
u
c
tio
n
o
f
th
e
r
u
le
a
s
w
e
ll a
s
d
i
m
e
n
s
io
n
a
l r
e
d
u
c
tio
n
.
U
n
f
o
r
tu
na
t
e
l
y
,
i
n t
he
d
i
m
e
n
s
i
o
n r
e
d
uc
t
i
o
n r
e
s
ul
t
s
ge
ne
r
a
t
e
d
w
he
n
u
s
i
n
g
t
h
e
C
4
.
5
,
o
n
l
y
o
n
e at
t
r
i
b
u
t
e i
s
r
ed
u
ced
.
T
h
i
s
m
ak
e
s
t
h
e
m
o
d
el
l
e
s
s
ab
l
e t
o
r
ed
u
ce t
h
e co
s
t
o
f
t
h
e
e
xa
m
i
na
t
i
o
n,
e
s
p
e
c
i
a
l
l
y a
t
t
r
i
b
ut
e
s
t
ha
t
c
o
s
t
l
y i
n t
he
e
xa
m
i
na
t
i
o
n.
A
no
t
he
r
d
i
s
a
d
v
a
nt
a
ge
i
s
t
ha
t
t
he
pe
r
f
or
m
a
n
c
e
m
e
a
s
u
r
e
m
e
n
t
i
s
on
l
y
popu
l
a
t
i
on
-
b
as
ed
,
w
h
e
r
eas
i
n
d
i
v
i
d
u
al
-
b
as
ed
[8
]
w
it
h
li
k
e
li
h
o
o
d
r
a
tio
p
ar
am
et
er
s
h
as
n
o
t
b
een
d
o
n
e,
b
u
t
t
h
e t
es
t
i
n
g
m
et
h
o
d
d
o
es
n
o
t
u
s
e k
-
f
ol
ds
c
r
os
s
-
v
a
l
id
a
tio
n
.
R
e
f
e
r
r
i
n
g
t
o a
num
be
r
of
s
t
u
d
i
es
t
h
at
h
av
e b
een
d
e
v
el
o
p
ed
,
m
o
s
t
d
i
m
e
n
s
i
o
n
al
r
ed
u
ct
i
o
n
o
ccu
r
s
o
n
l
y
w
h
e
n
p
r
io
r
to
c
la
s
s
i
f
ic
a
tio
n
,
w
h
ile
t
h
e
d
i
m
e
n
s
io
n
a
l r
e
d
u
c
t
io
n
a
t t
h
e
ti
m
e
o
f
t
h
e
d
ia
g
n
o
s
tic
s
y
s
te
m
w
h
ic
h
u
s
e
d
w
a
s
s
till
m
i
n
i
m
a
l.
I
n
a
d
d
itio
n
,
th
e
s
e
s
t
u
d
ie
s
o
f
r
e
d
u
c
e
d
a
ttr
ib
u
te
s
w
e
r
e
s
till s
m
a
ll,
r
e
s
u
lti
n
g
in
c
o
s
tl
y
co
n
s
eq
u
e
n
ces
t
h
at
m
u
s
t
b
e i
n
cu
r
r
ed
i
n
t
h
e d
i
ag
n
o
s
t
i
c p
r
o
ces
s
.
F
u
r
t
h
er
m
o
r
e,
p
r
ev
i
o
u
s
s
t
u
d
i
es
h
av
e
m
o
s
t
l
y
c
on
du
c
t
e
d
m
e
a
s
u
r
e
m
e
n
t
s
o
f
popu
l
a
t
i
on
-
b
as
ed
o
n
p
er
f
o
r
m
a
n
ce.
T
h
er
e w
a
s
s
t
i
l
l
m
i
n
i
m
al
i
n
d
i
v
i
d
u
al
-
ba
s
e
d on
p
er
f
o
r
m
a
n
ce
m
ea
s
u
r
e
m
e
n
t,
th
a
t
lik
e
l
ih
o
o
d
r
a
tio
p
a
r
a
m
e
t
e
r
.
B
a
s
e
d
o
n
th
is
,
in
th
i
s
s
tu
d
y
p
r
o
p
o
s
e
d
a
di
m
e
ns
i
on
a
l
r
e
du
c
t
i
on
m
ode
l
t
h
a
t
oc
c
u
r
r
e
d
w
h
e
n
di
m
e
ns
i
ona
l
r
e
du
c
t
i
on pr
oc
e
s
s
a
n
d di
a
gn
os
t
i
c
pr
oc
e
s
s
.
T
h
i
s
m
ode
l
c
a
n
m
a
k
e
t
h
e
s
y
s
t
e
m
m
ode
l
m
or
e
pr
ov
i
de
c
os
t
s
a
v
i
n
gs
i
n
t
h
e
di
a
g
n
o
si
s
o
f
CH
D
.
2.
R
ES
EA
R
C
H
M
ETH
O
D
2.
1
M
at
e
r
i
al
an
d
D
at
a
T
h
e
s
t
u
d
y
w
a
s
de
v
e
l
ope
d u
s
i
ng
t
h
e
C
l
e
v
e
l
a
n
d a
n
d H
ung
a
r
i
a
n
da
t
a
s
e
t
s
of
t
h
e
U
C
I
r
e
pos
i
t
or
y
,
w
hi
c
h
can
b
e acces
s
ed
o
n
l
i
n
e
[9
]
.
T
h
e
da
t
a
s
e
t
u
s
e
d c
ons
i
s
t
s
of
14 a
t
t
r
i
bu
t
e
s
,
w
hi
c
h
c
o
n
s
i
s
t
of
13 i
n
de
pe
n
de
n
t
a
ttr
ib
u
te
s
a
n
d
1
d
e
p
e
n
d
e
n
t
a
ttr
ib
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t
e.
T
h
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m
p
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e at
t
r
i
b
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t
es
ar
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s
h
o
w
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i
n
T
ab
l
e 1
.
T
h
e n
u
m
b
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o
f
t
h
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C
l
ev
e
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an
d
d
at
as
et
s
w
a
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3
0
3
,
w
h
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e t
h
e H
u
n
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ar
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2
9
4
.
T
h
e d
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w
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,
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e
d by
0,
a
n
d s
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e
d b
y
1.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
nd
o
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s
i
a
n J
E
l
e
c
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ng
&
C
o
m
p
S
c
i
I
SSN
:
2502
-
4752
A
T
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d A
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I
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I
I
G
)
,
a
s
a
c
r
i
t
e
r
i
o
n
f
o
r
s
ep
ar
at
i
o
n
[
14]
.
I
I
G
w
a
s
c
a
lc
u
la
te
d
f
o
r
a
ll c
a
n
d
id
a
te
a
ttr
ib
u
te
s
.
T
h
e
a
ttr
ib
u
te
w
it
h
t
h
e
h
i
g
h
e
s
t I
I
G
v
a
l
u
e
w
i
ll
b
e s
el
ect
ed
as
t
h
e r
o
o
t
n
o
d
e.
Data
colle
ction
The process of grouping Attribute
s
based on the
inspe
ction stage
Data proce
ssing
Missing Value
Data
Testing
Data
Training
5
-
Fold
Cross
-
Validation
Data collection
(
Scintigraphy
&
Fluoroscopy
)
N
on
-
black
-
box
classification
approach algorithm
Rule
Collection
Fuzzy Rule
Base
d
K
nowle
dge Base
Scintigraphy
&
fluoroscopy
Collection of
e
xamination
results Chest
pain
&
ECG
N
on
-
black
-
box
classification
approach algorithm
Rule
Collection
Fuzzy Rule
Base
d
K
nowle
dge Base
Chest pain
&
ECG
Collection
of risk
factor data
Framingham Risk
Score Study
FRS
K
nowle
dge
Base
Fuzzyfication
continuous
data
?
Fuzzy Infe
rence
Engine
Yes
Defuzzification
>
Thre
shold
?
Performance
Fuzzy Infe
rence
Engine
Yes
Defuzzyfication
Fuzzy Infe
rence
Engine
Sure
?
Defuzzyfication
N
o
Performance
e
valuation
Performance
e
valuation
Performance
e
valuation
Performance
Performance
K
nowle
dge Base Modeling
K
nowle
dge Base Modeling
Fuzzy Rule
Base
d
K
nowle
dge Base Modeling
T
he
f
ir
s
P
lev
el
T
he
s
ec
ond
lev
el
T
he
P
hir
d
lev
el
F
i
gu
r
e
1.
T
h
e
pr
opos
e
d
of
m
e
t
h
od
Evaluation Warning : The document was created with Spire.PDF for Python.
I
nd
o
ne
s
i
a
n J
E
l
e
c
E
ng
&
C
o
m
p
S
c
i
I
SSN
:
2502
-
4752
A
T
i
e
r
e
d A
ppr
oac
h
on D
i
m
e
ns
i
onal
R
e
d
uc
t
i
on P
r
oc
e
s
s
f
or
P
r
e
di
c
t
i
on of
…
(
W
i
har
t
o W
i
har
t
o
)
491
T
he
C
A
R
T
a
l
go
r
i
t
h
m
w
a
s
a cl
as
s
i
f
i
cat
i
o
n
al
g
o
r
i
t
h
m
b
as
ed
o
n
t
h
e d
eci
s
i
o
n
t
r
ee,
i
n
t
r
o
d
u
c
ed
b
y
L
eo
B
r
e
im
a
n
e
t a
l.
in
1
9
8
4
[
15
]
.
C
A
R
T
p
r
o
d
u
ces
a cl
as
s
i
f
i
cat
i
o
n
t
r
ee i
f
t
h
e r
es
p
o
n
s
e v
ar
i
ab
l
e
w
a
s
cat
eg
o
r
i
cal
,
an
d
p
r
o
d
u
ces
a r
eg
r
es
s
i
o
n
t
r
ee i
f
t
h
e r
es
p
o
n
s
e v
ar
i
ab
l
e
w
as
co
n
t
i
n
u
o
u
s
.
T
h
e C
A
R
T
al
g
o
r
i
t
h
m
h
as
t
h
e
f
o
llo
w
in
g
st
e
p
s:
a.
P
r
ep
ar
e t
h
e b
r
an
ch
can
d
i
d
at
es
f
o
r
al
l
p
r
ed
i
ct
o
r
v
ar
i
ab
l
es
,
eac
h
d
i
v
i
d
ed
i
n
t
o
2
,
t
h
e
l
ef
t
an
d
t
h
e r
i
g
h
t
b
r
a
n
ch
can
d
i
d
at
es
.
b.
A
s
s
es
s
t
h
e
o
v
er
al
l
p
r
o
s
p
ect
i
v
e b
r
an
c
h
t
h
at
i
s
o
n
t
h
e
l
i
s
t
o
f
ca
n
d
i
d
at
es
f
o
r
t
h
e l
a
t
es
t
b
r
an
ch
e
s
.
T
h
e
p
er
f
o
r
m
a
n
ce o
f
eac
h
b
r
an
ch
c
an
d
i
d
at
e
w
i
l
l
b
e
m
eas
u
r
ed
b
y
a
m
eas
u
r
e cal
l
ed
co
n
f
o
r
m
i
t
y
.
c.
D
et
er
m
i
n
e
w
h
i
ch
b
r
an
c
h
can
d
i
d
at
e
w
i
l
l
act
u
al
l
y
b
e a b
r
an
ch
.
d.
I
f
n
o
m
o
r
e
d
e
c
is
io
n
n
o
d
e
s
,
th
e
i
m
p
le
m
e
n
ta
t
io
n
o
f
t
h
e
C
A
R
T
a
lg
o
r
ith
m
w
ill b
e
te
r
m
in
a
te
d
.
H
o
w
e
v
e
r
,
i
f
th
e
r
e
is
s
t
ill a
d
e
c
is
io
n
n
ode
,
g
o ba
c
k
t
o t
h
e
s
e
c
on
d s
t
e
p,
b
y
f
i
r
s
t
t
h
r
o
w
i
ng
t
h
e
br
a
n
c
h
c
a
ndi
da
t
e
w
h
o h
a
s
s
u
cce
s
s
f
u
l
l
y
b
eco
m
e a b
r
an
c
h
.
T
h
e m
ai
n
co
n
cep
t
o
f
t
h
e f
u
zz
y
l
o
g
i
c t
h
eo
r
y
w
as
t
o
p
l
ace an
i
n
p
u
t
s
p
ace i
n
t
o
t
h
e o
u
t
p
u
t
s
p
ace u
s
i
n
g
IF
-
T
H
E
N
r
u
l
es
,
a
n
d
t
h
e co
n
c
ep
t
can
b
e u
s
ed
t
o
s
o
l
ve
t
he
unc
e
r
t
a
i
nt
y p
r
o
b
l
e
m
[
16]
.
M
a
p
p
i
ng
w
a
s
d
o
ne
b
y
us
i
n
g F
uz
z
y I
n
f
e
r
e
nc
e
S
ys
t
e
m
(
F
I
S
)
.
F
I
S
e
v
a
lu
a
te
s
a
ll r
u
le
s
s
i
m
u
lta
n
e
o
u
s
l
y
to
g
e
n
e
r
a
te
c
o
n
c
lu
s
io
n
s
.
F
I
S
h
a
s
a
c
om
pon
e
n
t
c
ons
i
s
t
i
n
g
o
f
f
u
z
zi
f
i
cat
i
o
n
,
m
e
m
b
er
s
h
i
p
f
u
n
ct
i
o
n
,
i
n
f
er
en
ce p
r
o
ces
s
an
d
d
ef
u
zzi
f
i
cat
i
o
n
[
17]
.
3.
RE
S
U
L
T
S
AND D
I
S
CU
S
S
I
O
N
3.
1
R
e
su
l
t
s
T
h
e d
i
m
e
n
s
i
o
n
al
r
ed
u
ct
i
o
n
m
o
d
el
w
i
t
h
a t
i
er
ed
ap
p
r
o
ach
i
n
t
h
e cas
e o
f
p
r
ed
i
ct
i
o
n
o
f
co
r
o
n
ar
y
h
ear
t
d
is
e
a
s
e
w
a
s
d
iv
id
e
d
in
to
th
r
e
e
le
v
e
l
s
,
as
s
h
o
w
n
i
n
F
i
g
u
r
e 1
.
T
h
e p
r
o
ces
s
o
f
t
h
e d
i
ag
n
o
s
i
s
w
a
s
d
o
n
e b
y
t
i
er
ed
m
o
d
e
l,
i
f
a
t t
h
e
le
v
e
l o
f
1
d
e
c
la
r
e
d
p
r
e
d
ic
tio
n
r
e
s
u
lt
s
h
a
v
e
a
h
ig
h
r
is
k
,
t
h
e
n
g
o
to
th
e
le
v
e
l
o
f
2
,
b
u
t if
n
o
t th
e
n
t
h
e d
i
ag
n
o
s
i
s
w
as
co
m
p
l
et
e.
I
f
t
h
e d
i
ag
n
o
s
i
s
r
es
u
l
t
s
at
t
h
e
s
eco
n
d
le
v
e
l,
it is
p
o
s
s
ib
le
to
m
a
k
e
a
d
ia
g
n
o
s
tic
d
e
c
is
io
n
f
o
r
th
e
c
lin
ic
ia
n
,
th
e
r
e
is
n
o
n
e
e
d
f
o
r
a
d
ia
g
n
o
s
is
a
t th
e
th
ir
d
le
v
e
l,
b
u
t i
f
n
o
t,
t
h
e
n
th
e
th
ir
d
le
v
e
l
d
i
a
gno
s
i
s
i
s
d
o
ne
.
A
t
l
e
ve
l
1
,
gi
ve
s
t
he
o
ut
p
ut
o
f
t
he
p
e
r
c
e
n
t
a
ge
o
f
c
o
r
o
na
r
y he
a
r
t
d
i
s
e
a
s
e
e
ve
nt
s
i
n
t
he
ne
x
t
10
y
e
a
r
s
.
A
f
ol
l
o
w
-
u
p
d
i
ag
n
o
s
i
s
t
o
t
h
e
s
eco
n
d
l
e
v
el
w
i
l
l
b
e p
er
f
o
r
m
ed
i
f
t
h
e
g
e
n
er
at
ed
p
r
o
ces
s
i
o
n
p
as
s
e
s
a
c
e
r
ta
in
th
r
e
s
h
o
ld
.
F
i
g
u
r
e 2
.
T
h
e p
er
f
o
r
m
an
ce o
f
t
h
e d
i
ag
n
o
s
t
i
c s
y
s
t
e
m
a
t
t
h
e l
e
v
el
s
1
,
2
an
d
3
D
e
te
r
m
i
n
a
tio
n
o
f
th
r
e
s
h
o
ld
,
w
h
ic
h
w
as
t
h
e
p
er
cen
t
a
g
e
o
f
t
h
e p
r
ed
i
ct
i
o
n
o
f
co
r
o
n
ar
y
h
e
ar
t
d
i
s
eas
e
r
ef
er
s
t
o
s
ev
er
al
co
n
s
i
d
er
at
i
o
n
s
t
h
at
w
er
e:
a.
t
h
e i
n
f
l
u
e
n
ce o
f
a t
h
r
e
s
h
o
l
d
v
a
l
u
e o
n
t
h
e p
er
f
o
r
m
a
n
ce at
l
ev
e
l
1
,
l
ev
el
2
an
d
l
ev
el
3
,
b.
A
t
t
he
f
i
r
s
t
s
t
a
ge
i
s
t
he
s
c
r
e
e
ni
ng
s
t
a
ge
,
t
h
us
e
m
p
ha
s
i
z
i
n
g t
h
e
s
en
s
i
t
i
v
i
t
y
p
er
f
o
r
m
an
ce p
ar
a
m
et
er
[8
]
,
c.
r
ef
er
s
t
o
t
h
e p
er
cen
t
ag
e p
r
ed
i
ct
ed
i
n
ci
d
en
ce o
f
co
r
o
n
ar
y
h
e
ar
t
d
i
s
eas
e i
n
t
h
e
n
ex
t
1
0
y
ear
s
,
i
f
v
al
u
es
ar
e
<1
0
%
s
ai
d
t
o
h
av
e l
o
w
r
i
s
k
[1
8
]
.
A
num
be
r
o
f
t
h
e
s
e
co
n
s
i
d
er
at
i
o
n
s
u
s
ed
t
o
a
n
al
y
ze t
h
e r
es
u
l
t
s
o
f
t
es
t
i
n
g
at
l
e
v
el
1
.
T
es
t
i
n
g
t
o
d
et
er
m
i
n
e t
h
r
es
h
o
l
d
i
s
d
o
n
e b
y
u
s
i
n
g
t
r
ai
n
i
n
g
d
at
a.
T
h
e r
es
u
l
t
i
n
g
p
er
f
o
r
m
a
n
ce as
s
h
o
w
n
i
n
F
i
g
u
r
e 2
, r
ef
er
r
i
n
g
t
o
a n
u
m
b
er
o
f
t
h
e
s
e co
n
s
i
d
er
at
i
o
n
s
a
n
d
t
h
e p
er
f
o
r
m
a
n
ce o
f
t
h
e t
es
t
r
es
u
l
t
s
,
t
h
e p
er
cen
t
a
g
e v
al
u
e o
f
co
r
o
n
ar
y
h
ear
t
d
i
s
eas
e
ev
e
n
t
s
,
w
h
i
ch
w
a
s
u
s
ed
as
a
t
h
r
e
s
h
o
l
d
w
as
>
7
%
.
T
h
is
v
a
lu
e
in
d
ic
a
te
s
th
a
t i
f
t
h
e
p
r
e
d
ic
te
d
o
u
tp
u
t a
t le
v
e
l 1
w
a
s
>
7
%
,
th
e
n
th
e
d
ia
g
n
o
s
is
w
a
s
r
e
q
u
ir
e
d
a
t th
e
s
e
c
o
n
d
le
v
e
l.
5
5
6
0
6
5
7
0
7
5
8
0
8
5
9
0
9
5
1
0
0
1
2
3
4
5
6
7
8
9
1
0
1
1
1
2
1
3
1
4
1
5
1
6
1
7
1
8
1
9
2
0
%
(
P
ercen
t
)
%
P
red
i
ct
ed
I
n
ci
d
en
ce O
f
C
o
ro
n
a
ry
H
ea
rt
D
i
s
ea
s
e
S
e
n
s
i
t
i
vi
t
y-
1
AUC
-
2
AUC
-
3
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SSN
:
25
02
-
4752
I
nd
o
ne
s
i
a
n J
E
l
e
c
E
ng
&
C
o
m
p
S
c
i
,
V
o
l.
11
, N
o
.
2
,
A
ug
us
t
2018
:
4
87
–
495
492
T
ie
r
e
d
s
y
s
te
m
m
o
d
e
l te
s
t w
a
s
don
e
by
us
i
n
g
5
-
f
ol
d
c
r
os
s
-
v
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[
19]
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T
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20]
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A
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e
c
o
n
d
le
v
e
l,
a
ll a
lg
o
r
ith
m
s
f
o
r
in
d
u
c
tio
n
r
u
le
c
a
n
r
e
d
u
c
e
s
o
m
e
a
ttr
ib
u
te
s
.
T
he
C
A
R
T
a
l
go
r
i
t
h
m
c
a
n
p
r
o
vi
d
e
t
he
hi
ghe
s
t
d
i
m
en
s
i
o
n
al
r
ed
u
ct
i
o
n
,
co
m
p
ar
ed
t
o
o
t
h
er
al
g
o
r
i
t
h
m
s
.
T
h
e C
A
R
T
al
g
o
r
i
t
h
m
i
s
al
s
o
cap
ab
l
e o
f
d
el
i
v
er
i
n
g
pe
r
f
or
m
a
n
c
e
f
or
t
h
e
h
i
gh
e
s
t
pos
t
-
t
e
s
t
pr
oba
bi
l
i
t
y
pa
r
a
m
e
t
e
r
s
c
o
m
pa
r
e
d t
o C
4.
5 a
n
d F
D
T
,
i
e
b
y
u
s
i
ng
o
n
l
y
on
e
cp
a
ttr
ib
u
te
a
t
le
v
e
l
2
.
I
n
p
o
p
u
la
tio
n
-
b
as
ed
p
er
f
o
r
m
a
n
ce
p
ar
a
m
et
er
s
,
t
h
e
p
er
f
o
r
m
an
ce
o
f
C
4
.
5
an
d
F
D
T
i
s
r
e
la
tiv
e
l
y
b
e
tte
r
th
a
n
th
e
C
A
R
T
.
A
t t
h
e
le
v
e
l 3
,
th
e
u
s
e
o
f
C
4
.
5
,
C
A
R
T
,
a
n
d
F
D
T
a
lg
o
r
ith
m
s
is
n
o
t c
a
p
a
b
le
o
f
r
e
d
u
c
in
g
a
ttr
ib
u
te
s
.
T
h
e ab
s
en
ce o
f
r
ed
u
ced
at
tr
ib
u
te
s
i
n
d
ic
a
te
s
th
a
t
b
o
th
a
ttr
ib
u
te
s
a
t t
h
e
th
ir
d
le
v
e
l
h
a
v
e
a
h
ig
h
c
o
n
tr
ib
u
tio
n
to
t
h
e r
es
u
l
t
o
f
t
h
e d
i
ag
n
o
s
i
s
,
s
o
t
h
at
i
t
can
n
o
t
b
e r
ed
u
ced
.
T
h
e r
es
u
l
t
i
n
g
p
er
f
o
r
m
a
n
ce at
t
h
e 3
r
d
l
ev
el
,
f
o
r
popu
l
a
t
i
on
-
b
as
ed
p
er
f
o
r
m
a
n
ce
p
ar
am
et
er
s
i
s
t
h
e C
4
.
5
i
n
d
u
ct
i
o
n
a
l
go
r
i
t
h
m
p
r
o
vi
d
i
n
g t
he
hi
ghe
s
t
p
e
r
f
o
r
m
a
nc
e
,
w
h
ile
f
o
r
in
d
iv
id
u
a
l
-
b
a
s
e
d
i
s
a
C
A
R
T
.
D
i
m
e
n
s
io
n
a
l r
e
d
u
c
tio
n
r
e
s
u
lts
o
f
t
h
e
th
r
e
e
a
lg
o
r
ith
m
s
,
C
A
R
T
a
lg
o
r
ith
m
a
b
le
to
r
e
d
u
c
e
th
e
a
t
tr
ib
u
te
in
t
h
e
n
u
m
b
e
r
o
f
th
e
m
o
s
t.
R
e
f
e
r
r
i
n
g
to
t
h
e
n
u
m
b
e
r
o
f
a
ttr
ib
u
te
s
th
a
t c
a
n
be
r
e
du
c
e
d,
pos
t
-
te
ts
a
n
d
p
r
e
-
te
s
t p
r
o
b
a
b
ilit
y
,
a
n
d
A
U
C
,
th
e
F
R
S
+
C
A
R
T
-
b
as
ed
f
u
zz
y
r
u
l
e b
as
ed
co
m
b
i
n
at
i
o
n
s
ca
n
p
r
o
v
i
d
e b
et
t
er
p
er
f
o
r
m
a
n
ce t
h
a
n
F
R
S
+ C
4
.
5
an
d
F
R
S
+ F
D
T
.
T
h
e
pr
o
pos
e
d di
m
e
n
s
i
on r
e
duc
t
i
on
m
ode
l
i
s
a
l
s
o c
a
pa
bl
e
of
r
e
du
c
i
ng
c
h
e
c
k
i
n
g c
os
t
s
.
T
h
e
a
b
ilit
y
i
s
d
i
v
i
d
ed
i
n
t
o
t
w
o
ap
p
r
o
ach
es
.
F
i
r
s
t
,
t
h
e o
v
er
al
l
ap
p
r
o
ach
t
o
t
h
e s
y
s
t
e
m
i
s
d
y
n
a
m
i
c.
S
eco
n
d
,
co
s
t
r
ed
u
ct
i
o
n
at
ev
er
y
l
e
v
el
,
es
p
eci
al
l
y
t
h
e s
ec
o
n
d
an
d
t
h
i
r
d
l
ev
el
.
F
es
h
k
i
an
d
S
h
i
j
an
i
[2
]
cl
as
s
i
f
y
t
h
e r
eq
u
i
r
ed
i
n
s
p
ect
i
o
n
f
ee
s
f
o
r
e
a
c
h
a
ttr
ib
u
te
i
n
to
4
,
in
o
r
d
e
r
f
r
o
m
t
h
e
lo
w
-
c
o
s
t
t
o
t
he
e
xp
e
ns
i
ve
.
G
r
o
up
i
n
g t
he
s
e
a
t
t
r
i
b
ut
e
s
c
a
n b
e
s
ho
w
n
a
s f
o
l
l
o
w
s:
1.
s
e
x,
a
ge
2.
ch
o
l
,
r
es
t
b
p
s
,
f
b
s
,
r
es
t
ecg
3.
cp
,
t
h
al
ac,
ex
an
g
,
o
l
d
p
eak
,
s
l
o
p
e.
4.
th
a
l,
c
a
R
ef
er
r
i
n
g
t
o
t
h
e cl
as
s
i
f
i
cat
i
o
n
o
f
i
n
s
p
ect
i
o
n
f
ees
,
t
h
e co
s
t
o
f
t
h
e ex
a
m
i
n
at
i
o
n
l
ev
e
l
1
<l
ev
el
2
<l
ev
el
3
.
I
n
th
e
p
r
o
p
o
s
e
d
s
y
s
te
m
m
o
d
e
l
,
if
t
h
e
e
x
a
m
i
n
a
tio
n
o
f
a
p
a
tie
n
t a
t le
v
e
l 1
w
a
s
s
ta
te
d
t
h
a
t t
h
e
r
is
k
o
f
c
o
r
o
n
a
r
y
h
ear
t
d
i
s
eas
e i
s
l
o
w
,
t
h
er
e i
s
n
o
n
eed
f
o
r
ex
a
m
i
n
a
t
i
o
n
at
l
e
v
e
l
2
an
d
l
ev
el
3
.
D
o
n
o
t
d
o
t
h
e
ex
a
m
i
n
at
i
o
n
at
t
h
e
l
ev
el
2
a
n
d
l
e
v
el
3
,
m
a
k
i
n
g
t
h
e co
s
t
t
o
b
e r
ed
u
ced
.
W
h
er
e
as
,
i
f
at
t
h
e
f
i
r
s
t
s
t
ag
e
i
t
i
s
s
t
at
ed
t
h
at
i
t
n
eed
s
a
f
ur
t
he
r
d
i
a
g
no
s
i
s
,
i
t
c
a
n b
e
ex
a
m
i
n
ed
at
l
ev
el
2
,
an
d
i
f
at
t
h
at
l
ev
el
i
s
e
n
o
u
g
h
t
o
m
a
k
e a co
n
cl
u
s
i
o
n
,
t
h
en
t
h
e
l
ev
el
3
ex
a
m
i
n
at
i
o
n
w
a
s
n
o
t
n
eed
ed
an
y
m
o
r
e.
T
h
e
s
eco
n
d
co
s
t
r
ed
u
ct
i
o
n
co
n
cep
t
,
w
a
s
t
h
e
co
s
t
r
ed
u
ct
i
o
n
t
h
at
o
ccu
r
s
a
t
each
l
e
v
el
,
es
p
eci
al
l
y
at
le
v
e
l 2
a
n
d
le
v
e
l 3
.
T
h
is
is
d
u
e t
o
t
h
e s
eco
n
d
an
d
t
h
i
r
d
l
ev
el
t
h
er
e
w
as
a r
ed
u
ct
i
o
n
i
n
t
h
e
n
u
m
b
er
o
f
at
t
r
i
b
u
t
es
,
r
e
s
ul
t
i
n
g i
n r
e
d
uc
e
d
c
o
s
t
s
.
F
o
r
e
xa
m
p
l
e
,
w
he
n
us
i
n
g t
he
C
A
R
T
r
ul
e
i
nd
uc
t
i
o
n a
l
go
r
i
t
h
m
,
a
t
t
he
s
e
c
o
nd
l
e
ve
l
i
t
w
a
s
ab
l
e t
o
r
ed
u
ce t
h
e at
t
r
i
b
u
t
es
o
f
E
C
G
e
x
a
m
i
n
at
i
o
n
at
r
e
s
t
an
d
ex
er
ci
s
e,
i
e r
es
t
ec
g
,
e
x
an
g
,
t
h
a
l
ac,
o
l
d
p
eak
,
a
nd
s
l
o
p
e
.
R
e
f
e
r
r
i
n
g t
o
t
he
gr
o
up
i
n
gs
b
y F
e
s
h
ki
a
nd
S
hi
j
a
ni
[2
]
,
th
e
s
e
a
ttr
ib
u
te
s
b
e
lo
n
g
to
t
he
s
e
c
o
nd
a
nd
t
he
t
h
i
r
d
g
r
o
u
p
s
,
o
r
co
s
t
i
n
r
el
at
i
v
el
y
ex
p
en
s
i
v
e cat
eg
o
r
i
es
.
T
h
e l
ar
g
e n
u
m
b
er
o
f
at
t
r
i
b
u
t
e
s
t
h
at
can
b
e r
ed
u
ced
b
y
t
he
C
A
R
T
i
nd
uc
t
i
o
n a
l
go
r
i
t
h
m
r
ul
e
,
m
a
ki
ng
t
he
t
o
t
a
l
c
o
s
t
o
f
e
xa
m
i
na
t
i
o
n a
t
l
e
ve
l
2
i
s
r
e
l
a
t
i
ve
l
y c
he
a
p
,
c
om
pa
r
e
d t
o u
s
i
ng
C
4.
5
a
n
d
F
D
T
a
lg
o
r
ith
m
s
.
T
h
e
di
m
e
ns
i
on
a
l
r
e
du
c
t
i
on
w
i
t
h
c
os
t
c
ons
i
de
r
a
t
i
on
h
a
s
a
l
s
o be
e
n
don
e
i
n
s
o
m
e
pr
e
v
i
ous
s
t
u
di
e
s
,
on
l
y
i
n
pr
e
v
i
o
u
s
s
t
u
di
e
s
di
d not
u
s
e
a
t
i
e
r
e
d a
ppr
oa
c
h
.
F
e
s
hk
i
a
n
d S
h
i
j
a
n
i
[2
]
r
es
ear
ch
,
u
s
i
n
g
p
ar
t
i
cl
e s
w
ar
m
o
p
tim
iz
a
tio
n
w
it
h
f
it
n
e
s
s
f
u
n
c
tio
n
s
,
c
o
n
s
id
e
r
c
o
s
t,
s
o
a
s
to
r
e
d
u
c
e
t
h
e
t
w
o
c
o
s
tl
y
a
ttr
ib
u
te
s
,
c
a
a
n
d
t
h
a
l.
T
h
e
s
a
m
e i
s
d
o
n
e b
y
A
r
j
en
ak
i
et
.
al
[4
]
,
o
nl
y
t
ha
t
t
he
s
t
ud
y
u
s
e
s
a
ge
ne
t
i
c
a
l
go
r
i
t
h
m
.
B
o
t
h
s
t
ud
i
e
s
ha
ve
s
o
m
e
d
i
s
ad
v
an
t
a
g
es
,
n
a
m
el
y
t
h
e
u
s
e
o
f
cl
as
s
i
f
i
cat
i
o
n
al
g
o
r
i
t
h
m
s
w
i
t
h
t
h
e b
l
ac
k
-
box a
ppr
oa
c
h
,
m
a
k
i
ng
i
t
di
f
f
i
c
u
l
t
t
o
und
e
r
s
t
a
n
d t
h
e
pr
oc
e
s
s
of
di
a
g
n
os
i
s
b
y
c
l
i
n
i
c
i
a
n
s
.
S
e
c
on
d,
do n
ot
us
e
a
t
i
e
r
e
d a
ppr
oa
c
h
,
s
o i
n t
h
e
pr
oc
e
s
s
o
f
d
ia
g
n
o
s
i
s
m
u
s
t c
h
e
c
k
a
ll a
ttr
ib
u
te
s
o
f
th
e
r
e
d
u
c
tio
n
r
e
s
u
lts
,
b
e
f
o
r
e
b
e
in
g
u
s
e
d
f
o
r
in
p
u
t d
ia
g
n
o
s
is
s
y
s
te
m
.
T
h
e r
es
u
l
t
o
f
co
m
p
ar
i
s
o
n
o
f
s
y
s
t
e
m
m
o
d
el
p
er
f
o
r
m
an
ce d
i
a
g
n
o
s
i
s
o
f
co
r
o
n
ar
y
h
ear
t
d
i
s
ea
s
e
w
i
t
h
t
h
e
t
i
er
ed
an
d
n
o
n
-
t
i
er
ed
ap
p
r
o
ach
i
n
d
i
m
e
n
s
i
o
n
r
ed
u
ct
i
o
n
p
r
o
ces
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1
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