Background: As an ever-growing popular service, telehealth catered for better access to high-quality healthcare services. It is more valuable and cost-effective, particularly in the middle of the current COVID-19 pandemic. Accordingly, this study aimed to systematically review the features and challenges of telehealth-based services developed to support COVID-19 patients and healthcare providers.Methods: A comprehensive search was done for the English language and peer-reviewed articles published until November 2020 using PubMed and Scopus electronic databases. In this review paper, only studies focusing on the telehealth-based service to support COVID-19 patients and healthcare providers were included. The first author's name, publication year, country of the research, study objectives, outcomes, function type including screening, triage, prevention, diagnosis, treatment or follow-up, target population, media, communication type, guideline-based design, main findings, and challenges were extracted, classified, and tabulated.Results: Of the 5,005 studies identified initially, 64 met the eligibility criteria. The studies came from 18 countries. Most of them were conducted in the United States and China. Phone calls, mobile applications, videoconferencing or video calls, emails, websites, text messages, mixed-reality, and teleradiology software were used as the media for communication. The majority of studies used a synchronous communication. The articles addressed the prevention, screening, triage, diagnosis, treatment, and follow-up aspects of COVID-19 which the most common purpose was the patients' follow-up (34/64, 53%). Thirteen group barriers were identified in the literature, which technology acceptance and user adoption, concerns about the adequacy and accuracy of subjective patient assessment, and technical issues were the most frequent ones.Conclusion: This review revealed the usefulness of telehealth-based services during the COVID-19 outbreak and beyond. The features and challenges identified through the literature can be helpful for a better understanding of current telehealth approaches and pointed out the need for clear guidelines, scientific evidence, and innovative policies to implement successful telehealth projects.
Infertility is a significant health problem and assisted reproductive technologies to treat infertility. Despite all efforts, the success rate of these methods is still low. Also, each of these methods has side effects and costs. Therefore, accurate prediction of treatment success rate is a clinical challenge. This retrospective study aimed to internally validate and compare various machine learning models for predicting the clinical pregnancy rate (CPR) of infertility treatment. For this purpose, data from 1931 patients consisting of in vitro fertilization (IVF) or intra cytoplasmic sperm injection (ICSI) (733) and intra uterine insemination (IUI) (1196) treatments were included. Also, no egg or sperm donation data were used. The performance of machine learning algorithms to predict clinical pregnancy were expressed in terms of accuracy, recall, F-score, positive predictive value (PPV), brier score (BS), Matthew correlation coefficient (MCC), and receiver operating characteristic. The significance of the features with CPR and AUCs was evaluated by Student's t test and DeLong’s algorithm. Random forest (RF) model had the highest accuracy in the IVF/ICSI treatment. The sensitivity, F1 score, PPV, and MCC of the RF model were 0.76, 0.73, 0.80, and 0.5, respectively. These values for IUI treatment were 0.84, 0.80, 0.82, and 0.34, respectively. The BS was 0.13 and 0.15 for IVF/ICS and IUI, respectively. In addition, the estimated AUCs of the RF model for IVF/ICS and IUI were 0.73 and 0.7, respectively. Some essential features were obtained based on RF ranking for the two datasets, including age, follicle stimulation hormone, endometrial thickness, and infertility duration. The results showed a strong relationship between clinical pregnancy and a woman's age. Also, endometrial thickness and the number of follicles decreased with increasing female age in both treatments.
Endometrial thickness in assisted reproductive techniques is one of the essential factors in the success of pregnancy. Despite extensive studies on endometrial thickness prediction, research is still needed. We aimed to analyze the impact of endometrial thickness on the ongoing pregnancy rate in couples with unexplained infertility. A total of 729 couples with unexplained infertility were included in this study. A random forest model (RFM) and logistic regression (LRM) were used to predict pregnancy. Evaluation of the performance of RFM and LRM was based on classification criteria and ROC curve, Odd Ratio for ongoing Pregnancy by EMT categorized. The results showed that RFM outperformed the LRM in IVF/ICSI and IUI treatments, obtaining the highest accuracy. We obtained a 7.7mm cut-off point for IUI and 9.99 mm for IVF/ICSI treatment. The results showed machine learning is a valuable tool in predicting ongoing pregnancy and is trustable via multicenter data for two treatments. In addition, Endometrial thickness was not statistically significantly different from CPR and FHR in both treatments.
Background: Research has shown various influential factors, but a standard for different treatments has not yet been developed. We want to identify principle predictors in IVF/ICSI treatment success rate using a machine learning approach. Methods: We selected the well-known filter, embedded and wrapper methods for selecting features and applied them to the random forest model. In the first step, the best reduce dimension method is selected using hesitant fuzzy sets (HFS). Then, the principle predictors are obtained by the proposed hybrid method. Finally, we evaluated the performance of the proposed method using MCC, runtime, Accuracy, and AUC, PPV, recall, and F-Score. Results: The proposed hybrid feature selection method has the best performance with obtaining the highest ACC (0.795), AUC (0.72), and F-Score (0.8) and lowest number of features (n = 7). Finally, the features selected are included FSH, 16Cells, FAge, Oocytes, GIII, Compact, and Unsuccessful. Conclusion: In the decision-making to select impressive features on success rate of infertility, HFS are suggested for the first time in our proposed method and trusted by multi-center dataset. The HFS utilized the standard deviation among of various criteria which could increase the quality of feature selection and reduce features numbers. The mean of pregnant and non-pregnant groups was significantly different in the Features selected, including FSH, FAge, 16Cells, Oocytes, GIII, and Compact. According to the results, FAge significantly correlated to FHR and CPR, and the highest FSH with 31.87% is obtained for FSH dose in the range of 10 to 13 (mIU/ml).
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