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Ischemic Stroke Detection using EEG Signals

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 Ischemic Stroke Detection using EEG Signals
Arooj Ahmed Qureshi Canxiu Zhang
Dept. of Computing and Software Dept. of Electrical and Computer Engineering
McMaster University McMaster University
Hamilton, Ontario Hamilton, Ontario
quresa9@mcmaster.ca zhanc3@mcmaster.ca

Rong Zheng Ahmed Elmeligi

Dept. of Computing and Software
McMaster University
Hamilton, Ontario
rzheng@mcmaster.ca
ABSTRACT
Stroke is the second leading cause of death in the United
States of America. 87% of all strokes are ischemic stroke,
which is mainly caused by the blockage of small blood ves-
sels around the brain. Magnetic resonance imaging (MRI)
provides the gold standard for accurate diagnosis of ischemic
strokes, but it is both time-consuming and unsuitable for 24/7
monitoring. In this paper, we propose an ischemic stroke
detection method through the multi-domain analysis of EEG
brain signal from wearable EEG devices and machine learn-
ing. Using 40 healthy and 40 patients’ data, we find that Multi-
Layered Perceptron (MLP) and Bootstrap models (Extra-Tree
and Decision-Tree) can achieve test accuracy of 95% with an
area under the ROC curve 0.85.
HiNT
Hamilton, Ontario
ahmed@hintneuro.com
ACM Reference Format:
Arooj Ahmed Qureshi, Canxiu Zhang, Rong Zheng, and Ahmed
Elmeligi. 2018. Ischemic Stroke Detection using EEG Signals. In
Proceedings of CASCON ’18 (CASCON’18).
1 INTRODUCTION
Stroke is the second leading cause of death worldwide [12],
[22]. One out of twenty deaths in America are due to stroke
and 62,000 strokes that occur each year in Canada affect
all age groups and lead to a lifetime impact on health [12].
According to centers of disease control and prevention, in

CCS CONCEPTS
• Computing methodologies → Machine learning al-
gorithms; Bagging; Neural networks; Representation of math-
ematical functions; Cross-validation;

KEYWORDS
Ischemic Stroke, Multi-Layered Perceptron (MLP), Bootstrap
models (Extra-Tree and Decision-Tree), Multi Domain Fea-
Figure 1: Types of Strokes: Ischemic and Hemorrhagic. In Ischemic
tures.
Brain Stroke (left), a blood clot has blocked the flow of blood to a
specific area of the brain.
Permission to make digital or hard copies of all or part of this work for
personal or classroom use is granted without fee provided that copies are not
made or distributed for profit or commercial advantage and that copies bear the United States, someone suffers from brain stroke in every
this notice and the full citation on the first page. Copyrights for components 40 seconds [4].
of this work owned by others than ACM must be honored. Abstracting with There are two main types of stroke: ischemic and hemor-
credit is permitted. To copy otherwise, or republish, to post on servers or to rhagic. Ischemic stroke occurs when a blockage (obstruction)
redistribute to lists, requires prior specific permission and/or a fee. Request
of small blood vessels occurs around the brain (Fig.1). Magnet
permissions from permissions@acm.org.
CASCON’18, October 2018, Markham, Ontario Canada
Resonance Imaging (MRI) gives accurate results for stroke de-
tection, yet it is an expensive resource, requires several hours
to generate an examination report and is applicable for a
limited time. MRI is used only in situations where there is no
CASCON’18, October 2018, Markham, Ontario Canada
time pressure to offer diagnosis, typically as follow-up imag-
ing. MRI is an expensive and is not available at all healthcare
locations. In comparison, Electroencephalography (EEG) of-
fers a continuous, real-time, non-invasive measure of brain
function [5] and is capable of detecting ischemic stroke due
to variation in cerebral blood flow in the blood vessels. It
has proven to be effective in detecting various other brain-
related activities like Rapid Eye Movement (REM), sleep and
awake stage and other seizure [17].
In this paper, EEG signals data from 40 healthy and 40
ischemic stroke patients datasets are used to detect ischemic
stroke if it occurs in a healthy person. For this purpose, EEG
data have been collected from six channels (two rare and two
at the front side of the brain). It is further bifurcated into EEG
frequency bands to measure the signal fluctuation. Various
features are extracted to detect this fluctuation (in 30 seconds
epoch) in the brain functionality due to ischemic stroke.
Besides frequency domain features, time domain features
are extracted as well to monitor fluctuation trends in the
EEG data due to ischemic stroke. Eventually, these features
are used together to train Multi-Layered Perceptron (MLP)
and Bootstrap (Extra-Tree and Decision-Tree) models.This
approach is shown to be effective as it achieves 95% accuracy
and area under the ROC curve as 0.85 using test data. These
results are promising and may be used to detect the early
onset of Transient Ischemic Acute (TIA) attacks.
There are two main contributions of this paper in the area
of ischemic stroke detection. The first contribution lies in
utilizing multi-domain features for stroke detection using
EEG signal.EEG feature extraction methods are primarily
based on single domain analysis. Conversely, due to the
highly non-stationary and nonlinear characteristics of the
EEG, it is challenging to extract information from a single
domain only. We extract frequency domain (FFT, PSD, Ratio)
and time domain (Root Mean Square, DFA) features. The
second contribution is to deal with imbalanced training data
using Bootstrap models, and achieve an accuracy of 95% and
a greater area under the ROC curve. Imbalanced training
data is common in medical domains as people suffering from
a particular ailment is often a small percentage of the general
population, improving the overall area under the ROC curve
(by reducing false negatives) and an accuracy of 95%.
This paper is organized as follows. Background on EEG
and related work are discussed in Section 2. In Section 3, we
presented the methodology, data pre-processing and feature
extraction methods. In Section 4, performance evaluation
along with results are presented, and finally, conclusion and
future work are discussed in Section 5.
Qureshi,A. Zhang, C. Zheng, R. Elmeligi, A.
2 BACKGROUND AND RELATED WORK
Electroencephalographic (EEG) signals serve as a vital source
of information when it comes to brain function. It is possible
to recognize abnormal activities of the brain functionality
using EEG signals. Most of the cerebral signal observed in
the scalp, EEGs falls in the range of 1 − 20 Hz. Waveforms
are subdivided into bandwidths known as delta (δ ), theta (θ ),
alpha (α), and beta (β) to signify the majority of the EEG
used in clinical practice (Fig.2) [5].
Figure 2: EEG Channel Sub-bands Frequency range.
Ischemic stroke is primarily because of changes in Cere-
bral Blood Flow (CBF), and it can be detected through changes
in EEG signal patterns [9]. Prominent changes include the
reduction of delta (lowest frequency band) or the presence
of high-frequency bands (beta and alpha) [5], [3]. Further-
more, the power density ratio between bands of the differ-
ent hemisphere changes as stroke affects one hemisphere
[5], [3], [10]. The best results for Ischemic stroke detection
so far, are obtained using MRI scans in conjunction with
meta-data like patients’ history, medical prescriptions and
most importantly MRI scan [20]. Omar et.al has implemented
power spectrum density (PSD) ratio between different EEG
bands and channels, as features for ischemic stroke detection,
power spectrum density (PSD) [13], [14]. PSD is used to train
various classifiers such as KNN [14], ANN [13] and Extreme
Learning Machine (ELM) [16] for ischemic stroke detection.
With these settings, they were able to achieve 85% correct
classification with Artificial Neural Network (ANN) [13] and
85% accuracy with KNN classifier [14]. [16] trained (Extreme
Learning Machine) with RPR as well and achieved an accu-
racy of 93%. Moreover, spectrograms are used as features
to train the Convolutional Neural Network (CNN) for map-
ping the changes in the EEG signal due to ischemic stroke
detection[11]. The spectrogram is a visual representation of
a relationship between frequency strength at specific time
step. In[11], the EEG signal is divided into 30 seconds time
windows with 20% overlapping. Spectrogram of each time
window is used as an input for the training of Convolutional
Neural Network.
In EEG signal analysis process, feature extraction is done
by utilizing series of transformations so that the required in-
formation can be studied or observed easily in the transform
domain to provide the best input to the classifier [19].
Ischemic Stroke Detection using EEG Signals
In this paper, we have used a combination of the relative
power ratio (RPR) between hemispheres and channels along
with detrended fluctuation analysis as features to train three
models, multi-layered perceptron (MLP), Decision-Tree (DT)
and Extra-Tree (ET). As we are dealing with imbalance data,
therefore, decision-tree and extra-tree classifiers are used.
These classifiers handle imbalance datasets better than base-
line classifiers [1].
3 METHODOLOGY
The methodology proposed is based on supervised learning.
EEG data signal is analyzed in the time domain as well as
in the frequency domain. To the best of our knowledge, no
previous work has exploited multi-domain features explicitly
for ischemic stroke detection with EEG signals. The process
shown in (Fig.3) involves data cleaning and features extrac-
tion, and training and testing of machine learning models.
Data cleaning comprises of data pre-processing leading to
time and frequency domain features extraction process. The
feature set is used to train and test machine learning models.
More details will be presented in the subsequent sections.
3.1 Data Pre-Processing
The EEG signal is sampled at 256 Hz. Data preprocessing
consists of three steps : data referencing, segmentation and
artifact removal.
3.1.1 Data Referencing. The EEG data were collected by
placing electrodes at six locations, also called six channels:
C3, C4, O1, O2, and two reference channels behind two ears
as illustrated in (Fig.4).
Mean of reference channels is first subtracted from data
C3, C4, O1, O2,
r r e f1 (n) + r r e f2 (n)
x c (n) = r c (n) − (1)
2
where x c (n) representing the referenced EEG signals of chan-
nel c ∈ {C3, C4, O1, O2}, and r c (n) representing the raw EEG
signals in channel c ∈ {C3, C4, O1, O2}, r r e f1 (n) and r r ef2 (n)
refer to raw EEG signals in the two reference channels.
3.1.2 Segmentation. The EEG data in 4 channels collected
from healthy participants and patients may last for hours in
duration. In general, the signals are non-stationary. However,
it is widely accepted that if we divide them into 30-second
epochs, each epoch of the measured EEG data represents a
wide-sense stationary signal. Hence in this paper, the data
are analyzed in 30-second epochs. After data referencing,
the signal in each channel is split into 30-second epochs of
7680 samples each.
CASCON’18, October 2018, Markham, Ontario Canada
3.1.3 Artifact Rejection. Wearable EEG devices are sus-
ceptible to the same sources of artifacts found with tradi-
tional research-grade devices, including eye blinks and eye
movements (electrooculographic, or EOG, artifacts), as well
as artifacts from jaw clenches, facial expressions, and other
muscle activity. The presence of artifacts in EEG signals can
distort the features which represent information of brain
stroke and therefore leads to the false detection result.
The conventional method for artifact rejection for clinical
usage is to identify artifacts by visual inference and then
manually remove the artifact signal. Other methods proposed
to remove artifacts from EEG recordings include a regression
in time/frequency, linear decomposition and reconstruction,
and many more [6].
Since artifact rejection is not the primary focus of this
project, we adopted visual inspection and manual artifact
rejection method. The collected EEG signals are applied man-
ual artifact rejection by experts.
3.2 Feature Extraction
Our experiment demonstrates that both spatial and temporal
features are useful in detecting ischemic stroke. Next, we
provide the detailed description of feature extraction in the
time domain and the frequency domain.
3.2.1 Frequency Domain. According to related medical
literature, occurrences of ischemic strokes affect the signals
in low-frequency range (for example delta, theta and alpha
bands) [3], [13]. An ischemic stroke usually occurs in a spe-
cific area (hemisphere) of the brain,there will be differences
in relative power among different channels [3]. Therefore,
changes in the power of each sub-band of channels and the
relative power ratio between channels provide good indica-
tors when the ischemic stroke occurs.
Sub-band Power Estimation. For each epoch of single chan-
nel EEG signal x(n), n = 0, ..., N − 1, we used the Welch’s
weighted overlapped segment averaging method to estimate
power spectral density, which involves splitting the recorded
signal into overlapped windows of length L, calculating mod-
ified periodograms of these windows, and averaging these
modified periodograms [21].
The resulting modified periodogram for the ith window is
L−1
1 Õ
p̄ i (f ) = | x i (n)w(n)e −j2π f n | 2 , (2)
LU n=0
where U is the normalization factor for the power in the
window function:
L−1
1Õ 2
U = w (n) (3)
L n=0
CASCON’18, October 2018, Markham, Ontario Canada Qureshi,A. Zhang, C. Zheng, R. Elmeligi, A.

Figure 3: Methodology

Relative Band Power. From PSD, frequency bands and their

relative strengths are known. Now for each channel, the
relative power for each sub-band is calculated by (6):
p̄bc / p̄bc ,
Õ
(6)
c ∈C
where c ∈ {C3, C4, O1, O2}, b ∈ {δ, θ, α }, and p̄bc is the av-
erage power of sub-band b recorded by channel c. Since we
have three sub-bands and four channels for each observation,
the total number of relative band power features is twelve.
Relative Hemisphere Power. It shows the difference be-
tween the left hemisphere and the right hemisphere of person
(fig. 4). In our EEG recording device, C3 and C4 channels
located at the front left and the front right hemisphere re-
Figure 4: EEG Channels with blue arrows are C3, C4, O1, O2 in spectively, O1 and O2 channels located at the back left and
front and back hemisphere. the back right hemisphere respectively. We calculate relative
front hemisphere power RPR(b)f h the difference between
C3 and C4 for each sub-band in (7):
and w(n) is the window function. The Welch Power spectrum
is average of these modified periodograms: (|P̄bC3 − P̄bC4 |)/(P̄bC3 + P̄bC4 ), (7)
K −1
1 Õ i where P̄bC3 and P̄bC4 are average power of sub-band b ∈
p̄(f ) = p̄ (f ) (4) {δ, θ, α } in channel C3 and C4 respectively.
K i=0
Similarly, we calculate relative back hemisphere power
In this paper, we used 50% overlapped sliding window with 2 RPR(b)bh the difference between O1 and O2 for each sub
seconds window length, i.e., L = 2sec × fs = 512, to estimate band in (8):
the Power Spectral Density.The number of windows in an (|P̄bO 1 − P̄bO 2 |)/(P̄bO 1 + P̄bO 2 ), (8)
epoch is given by T − 1 = 29. The average power of sub-band
b ∈ {δ, α, θ } for channel c ∈ {C3, C4, O1, O2} is calculated where P̄bO 1 andP̄bO 2are average power of sub-band b ∈
by: {δ, θ, α } in channel O1 and O2 respectively.
Í
fmin ≤f <fmax p̄(f )
Combining (6), (7) and (8), there are 18 features for each
P̄dc = , (5) epoch in the frequency domain.
nb
where fmin and fmax are the lower and upper of frequency 3.2.2 Time Domain Features. EEG signal shows the fluctu-
range of each sub-band shown in (Fig.2) , nb = (fmax − ation of voltages due to specific activities in the brain. These
fmin )/fr is the number of frequency samples for each sub- signals possess a scale-invariant structure which repeats
band range. i.e. fr = fs /L. itself on subintervals of a signal [10].
Ischemic Stroke Detection using EEG Signals
Detrended Fluctuation Analysis (DFA). Detrended fluctua-
tion analysis (DFA) is capable of measuring the intensity of
fluctuation in the brain [11]. DFA can differentiate between
regular and irregular changes. DFA along with Root Mean
Square (RMS) is used to measure the Hurst (h) exponent [7],
which defines specific scale-invariant structure and fluctua-
tion level of each epoch of 30 seconds in health and patient
data. It is a five-step process.
Step 1 Mean Centering. This is the initial calculation to
converts noise like time series data signal into random walk
data (difference signal x̃ ) by subtracting mean x̄ of x(n) from
each data point of x(n),
n
Õ (6)
x̃(n) = (x k − x̄) n = 0, 1, 2, ..., (L − 1) (9)
k =1
Step 2 Split data. Split x̃(n) into Ns = ⌈ Ls ⌉ number of non-
overlapping time windows of size S,
Step 3 Local Linear Regression. Calculate the local linear
trend yv , of each window v, by applying least-square fit,
s ceptron is composed of one input layer, one or more hidden
1 Õ 2
F 2 (v, s) = x̃[(v − 1)s + j] − yv (j) (10)
s j=1
where j = 0, 1, 2, ..s and v = 1, 2, ..., Ns .
Step 4 Local Root Mean Square. RMS fluctuation of x(n) is
calculated from equation below when q = 2:
v
u
t Ns
1 Õ
Fq (s) = [F 2 (v, s)] (11)
Ns v=1
Step 5. Exponent of h(q). Hurst exponent of each epoch is
calculated with RMS values Fq (s) by varying s. It is the power
law relation between the multiple RMS values of different
window sizes.
All features are summarized in (Table 1). Altogether there
are 22 features.
3.3 Recursive Feature Elimination
The Recursive Feature Elimination (or RFE) works by recur-
sively removing attributes(features) and building a model
on those features that remain. It uses the model accuracy
to identify which features (and the combination of features)
contribute the most to predicting the target attribute. The
features which are rank 1 (and True) are the best 14 features
which contribute the most to the model accuracy. All time do-
main features are selected along with ten frequency domain
features mostly related to the Alpha and Delta bands.
CASCON’18, October 2018, Markham, Ontario Canada
Table 1: Total Features
Description Features
Detrended Fluctuation Analysis
h(q)c1 , h(q)c2 ,
(DFA)
h(q)c3 , h(q)c4 ,
(4)
P̄αc1 , P̄θc1 , P̄δc1 ,
Relative Power Ratio
P̄αc2 , P̄θc2 , P̄δc2 ,
(Sub band)
P̄αc3 , P̄θc3 , P̄δc3 ,
(12)
P̄αc4 , P̄θc4 , P̄δc4 ,
Relative Power Ratio RPR(δ )f h , RPR(δ )bh ,
(Hemisphere) RPR(θ )f h , RPR(θ )bh ,
RPR(α)f h , RPR(α)bh ,
3.4 Classifiers
Three classifiers: Multi-layered Perceptron (MLP), and two
bootstrap models -: Decision-Tree and Extra-Tree, are trained
with the multi-domain feature set shown in (Table.1).
3.4.1 Multi-layered Perceptron (MLP). Multi-Layer Per-
layers and a final output layer. Every layer except the out-
put layer is fully connected to the next layer and includes
a bias neuron. This model is sensitive to hyper-parameters,
that is why we used grid-function to identify appropriate
hyper-parameter values of bootstrap models for the project.
3.4.2 Bootstrap Aggregation Techniques (Bagging Method).
Bootstrap aggregation, also known as bagging technique
is a robust ensemble method. It helps to reduce the vari-
ance of all classifiers as per requirement. Random forest,
Decision-Tree,and Extra-Tree are the application of bagging
techniques. Their training is based on several models inde-
pendently and then average the prediction. On average, the
combined estimator is usually better than any of the single
base estimator because its variance is reduced. In this work,
we adopt two bagging techniques.
Decision-Tree Classifier. The purpose of Decision-Trees
(DT) is to create a model that predicts the value of a target
variable by learning simple decision rules inferred from the
data features.
Extra-Tree Classifier. In extremely randomized trees, ran-
domness goes one step further in the way splits are computed.
As in random forests, a random subset of candidate features
is used, but instead of looking for the most discriminative
thresholds, thresholds are drawn at random for each can-
didate feature, and the best of these randomly-generated
thresholds is picked as the splitting rule.
CASCON’18, October 2018, Markham, Ontario Canada
4 RESULTS AND PERFORMANCE
EVALUATION
The dataset used for this project are shared by HiNT (Health-
care Innovation in Neuro Technology). HiNT develops a
wearable point-of-care monitoring device that detects when
patients at high-risk are having a stroke [8]. Dataset consists
of 40 patients who had ischemic stroke history and 40 healthy
people. Patients have an average age of 72 with 13.6 standard
derivation whereas, healthy persons have a mean age of 73
with 7.1 standard derivation. For each person, EEG signals
were recorded from 15 minutes to 4 hours and sampled at
256 Hz.
For this project, data from four channels and two reference
channels are collected, as shown in (fig.4).
Keeping in mind the nature of this project, we consider
accuracy,ROC score, precision, recall and F1-score as evalua-
tion metrices as accuracy and ROC score are not sufficient
for model evaluation [18]. ROC curve is created by plotting
the true positive rate (TPR) against the false positive rate
(FPR) at various threshold settings. The true-positive rate is
also known as sensitivity, recall or probability of detection
in machine learning. Since ischemic stroke detection is a
binary classification problem, we also include the confusion
matrix to gain further insights into the performance of each
algorithm.
Our implementation is base on Python libraries Keras [2]
and scikit-learn [15].
4.1 Classifiers
The parameters of Multi-layered Perceptron, Decision-Tree
and Extra-Tree model are shown in (Table. 2).
4.2 Q-fold cross-validation method
Ideally, the performance accuracy of our EEG classification
algorithm should be measured regarding its probability of
error which necessitates the knowledge of the ground truth
of the patient’s health state. However, since the ground truth
of the health state of a patient measured from the signal
epoch is not known, we, therefore, treat the library of signal
epochs classified by clinical experts as the ground truth. From
the library of collected signal epochs, we randomly selected
some as training signals and some as test signals so that
the validation of our classification methods is carried out as
follows:
(1) For each of the classes Cl , l = {0, 1}, containing Nl
epochs of the patients or healthy person, we randomly
choose NlT matrix curves as the test set and the rest
(Nl − NlT ) as the training (library) set.
(2) Different classifiers were applied on the features ex-
tracted from each epoch.
Qureshi,A. Zhang, C. Zheng, R. Elmeligi, A.
(3) The above steps are repeated Q times (Q-fold cross-
validation), each time choosing different sets of train-
ing and test feature in Cl . The probability of correct
classification for each class can then be estimated by
ÍQ
P̂cl = Q1 q=1 P̂clq where P̂clq denotes the estimated
probability of correct classification of class l at the qth
trial, q = 1, . . . , Q, i.e., P̂clq = NNlT
lc
with Nlc and NlT
being the number of correct classification and total
number of members in class Cl at the qth trial.
We adopted 10-fold cross-validation method in this paper.
Table 2: Parameters of machine learning classifiers.
Classifiers Parameters
Fully connected (dense) model.
Multi-Layered Perceptron Layer 1 : 45 neurons
(MLP) Layer 2: 18 neurons
Layer 3: 1 neuron
Decision-Tree
Number of trees = 675
(DT)
Extra-Tree
Number of trees = 675
(ET)
4.3 Results
For validation of results, 40 different combinations of test
and training datasets were considered for the training and
testing of all classifiers. The 40 healthy and 40 patients’ data
are randomly divided into training and test datasets. 80% of
the healthy and patient data is in the training set, and 20% is
in the test set. There is no common patient in the training
and testing data.
Figure 5: Classifiers Performance regarding accuracy. Blue refers to
the accuracy of the test dataset whereas, grey represents the accuracy
of the training dataset, Black error bar shows the standard deviation.
4.3.1 Accuracy. From fig. 5, it is evident that the perfor-
mance of the bootstrap classifiers is consistent regarding
Ischemic Stroke Detection using EEG Signals
accuracy of training (which is 100%) and test (accuracy is
more than 93%). The accuracy of MLP is lower than the DT
and ET classifiers but still achieves reasonable accuracy. It
is observed that there is no significant change in the per-
formance of MLP accuracy of train and test datasets. This
implies that the MLP model might under-fit the data. A more
in-depth architecture may be adopted.
4.3.2 ROC. For ROC score, it is considered good if it is
close to 1 (or 100 %). Overall, the ROC score of all three
classifiers is higher than 80%. The average ROC score of
these models is higher than 85%. It is evident from fig. 6
that with the MLP classifier, the micro-average ROC score is
higher than the overall ROC curve score (black line), which
reflects that the data is not balanced and has affected the
performance of the MLP classifier.
Figure 6: ROC Curve of MLP Classifier.
The Extra-Tree model shown in (fig 8) is the most promis-
ing and stable so far as compared to the other two models.
Figure 7: ROC Curve of Decision-Tree Classifier.
4.3.3 Confusion Matrix. Confusion matrix provides TPR
and FNR. It validates and verifies the ROC curve score and
accuracy %. A few interesting facts are prominent from con-
fusion matrices of different models shown in (fig. 9, 10).
• Healthy datasets are predicted with 100% accuracy by
the bootstrap models with both healthy and patient
data (fig. 9) whereas, there are variations with test
datasets (fig 10).
CASCON’18, October 2018, Markham, Ontario Canada
Figure 8: ROC Curve of Extra-Tree Classifier.
• The number of epochs for healthy datasets are more
than 8 times higher than the number of epochs of pa-
tients datasets. This leads to the data imbalance prob-
lem. (fig. 9).
Figure 9: Confusion matrix of all three models’ performance with
the training dataset.
Figure 10: Confusion matrix of all three models’ performance with
the test dataset.
It can be concluded that data imbalance has affected all
models’ overall performance. For example, a total number
of the healthy dataset (fig. 9) has 17276 healthy datasets
and 9660 patient datasets where the healthy dataset is quite
significant in number than the patient dataset. ET handles
imbalance datasets slightly better than MLP and DT.
4.3.4 Classification Report. Overall, precision, recall and
F1-score of DT and ET are higher than 90% which reveals
that these two classifiers have predicted accurate results
as compared to MLP. However, MLP precision, recall and
F1-score are reasonable as well.(fig.11).
5 CONCLUSION AND FUTURE WORK
Ischemic stroke detection with multi-domain feature set has
shown promising results for all three selected classifiers
 CASCON’18, October 2018, Markham, Ontario Canada
Figure 11: Average Precision, Recall and F1-Score of all classifiers.
The black line marks 90% benchmark.
(Multi-layered Perceptron, Decision-Tree and Extra-Tree)
when there is no issue of data imbalance. The performance of
all classifiers is triangulated by three different performance
matrices. Bootstrap technique based classifiers (Decision-
Tree and, Extra-Tree) has shown consistency in their perfor-
mance as compared to MLP classifier performance.
For future work, a number of directions will be pursued.
First, we need to improve the classification accuracy of un-
healthy subjects. Currently, the best performing model has
zero FPR but a relatively high FNR. This implies in practice;
unhealthy subjects may be diagnosed as healthy subjects.
This is unacceptable for medical diagnosis. We believe that
this is in part due to different signal characteristics arising
from the locality of strokes. Possible remedies include more
robust features and location-specific models. Another source
of errors may come from unbalanced data between healthy
and unhealthy subjects. Secondly, the application of these
models on wearable devices has its set of challenges like
computation, power drainage, etc. We will investigate how
to reduce the model complexity without sacrificing the per-
formance.
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