Neural Computing and Applications (2023) 35:12751–12761

https://doi.org/10.1007/s00521-023-08411-5 (0123456789().,-volV)(0123456789().
,- volV)

ORIGINAL ARTICLE

Performance analysis and comparison of Machine Learning and LoRa-

based Healthcare model
Navneet Verma1 • Sukhdip Singh1 • Devendra Prasad2

Received: 2 August 2022 / Accepted: 13 February 2023 / Published online: 7 March 2023
Ó The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature 2023

Abstract
Diabetes Mellitus (DM) is a widespread condition that is one of the main causes of health disasters around the world, and
health monitoring is one of the sustainable development topics. Currently, the Internet of Things (IoT) and Machine
Learning (ML) technologies work together to provide a reliable method of monitoring and predicting Diabetes Mellitus. In
this paper, we present the performance of a model for patient real-time data collection that employs the Hybrid Enhanced
Adaptive Data Rate (HEADR) algorithm for the Long-Range (LoRa) protocol of the IoT. On the Contiki Cooja simulator,
the LoRa protocol’s performance is measured in terms of high dissemination and dynamic data transmission range
allocation. Furthermore, by employing classification methods for the detection of diabetes severity levels on acquired data
via the LoRa (HEADR) protocol, Machine Learning prediction takes place. For prediction, a variety of Machine Learning
classifiers are employed, and the final results are compared with the already existing models where the Random Forest and
Decision Tree classifiers outperform the others in terms of precision, recall, F-measure, and receiver operating curve
(ROC) in the Python programming language. We also discovered that using k-fold cross-validation on k-neighbors,
Logistic regression (LR), and Gaussian Nave Bayes (GNB) classifiers boosted the accuracy.

Keywords Machine learning
Diabetes mellitus
Internet of Things
LoRa
Contiki Cooja

1 Introduction that make effective long-distance communication possible.

Today, due to TCP/IP protocol suite, billions of Internet of
Things (IoT)-based equipment have been able to link with
the Internet and are working too. IoT protocols are a crucial
part of the IoT knowledge heap because lacking this;
connected devices are meaningless since they only allow
the flow of organized, useful data. Due to the lack of a
standardized architecture in the IoT, using communication
techniques that are appropriate for the applications may be
difficult. Despite being the greatest source of Big Data
today, IoT is useless without analytical power. Low power
wide area network (LPWAN), LoRa (Long Range), and
NB-IoT are a few examples of modern IoT technologies
& Navneet Verma
19001901005navneet@dcrustm.org
1
Computer Science and Engineering Department, DCRUST,
Murthal, Sonipat 131027, India
2
Computer Science and Engineering Department, PIET,
Samalkha, Panipat 132103, India
The LoRa-enabled network, where LoRa-enabled sensors
are located in the network field or on patients’ bodies, is
covered by the LPWAN protocols. Data transmission may
be started by the sensors or by any outside control, as per
the circumstances which are mentioned in Mekki et al.
work [1]. Throughput and collision rate have an impact on
how effective and influential these strategies are. We can
remotely monitor patients and gather data using the IoT-
based sensor. For the amount of insulin in the blood sugar
to be near the normal value, patients and systems will now
need to review a significant number of data sets and engage
in a lot of data interpretation. LoRa Gateways can transport
data from Lora-enabled glucose sensors to a database.
In our paper, the performance of the Hybrid Enhanced
Adaptive Data Rate (HEADR) algorithm for the LoRa
protocol of the Internet of Things (IoT) is analyzed in terms
of improved switching which will boost the data rate, high
dissemination which can handle more end devices means
we can add more IoT devices in this network, and dynamic
data transmission range allocation specifically for

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heterogeneous IoT network. It is designed to cover unsta-
ble frequency conditions in case of rain or bad weather
condition and also the Data rate adaptation by end devices
is specified in this LoRa (HEADR) protocol. In terms of
analysis, monitoring, and other clinical difficulties related
to diagnosis, ML techniques in DM are unquestionably
important. However, there is an optimization approach
based on Scikit Learns that employs train-test splitting and
k-fold cross-validation. ML algorithms are commonly used
to predict diabetes, and they deliver better results.
As the population of various countries grows, so does
the burden of responsibility for the health of this growing
population on hospitals, doctors, and nursing staff. So the
present study has focused on the IoT since it has the
potential to reduce the pressure on health care systems.
According to Verma et al. [2], Diabetes Healthcare Mon-
itoring Systems are crucial right now, particularly for
remote health care monitoring, as visiting hospitals and
standing in line for services is a waste of time for patient
monitoring. It is extremely dangerous for diabetic patients
to wait in line since their life might be in danger at any
moment [3]. In this COVID-19 situation, remote monitor-
ing and ML prediction system such as this one may be
pretty helpful while we are incapable of actively caring for
our elderly guardians and relatives. In Fig. 1, the applica-
tion of IoT sensors and technology in the health care
industry is illustrated.
2 Related work
2.1 Patient monitoring
In terms of applications, the Internet of Things is now more
prevalent than ever in the health care industry. According
Fig. 1 IoT in Healthcare
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Neural Computing and Applications (2023) 35:12751–12761
to Islam et al. [4], they offer a useful analysis and a model
that is appropriate for collecting patient physical health
data from supporting sensors and IoT health care. The IoT
system needs to be adaptable to provide all amenities
during an emergency while also keeping the presence of
medical staff and nursing staff in remote areas. This
technology also automates data collection, making it more
reliable than manual patient data entry. The LoRa network
has been used to turn an interface called my signals into a
health monitoring system that gathers information from a
heart rate, ECG sensor, body temperature, and pulse rate.
The LoRa module’s performance was assessed once it was
integrated into the terminal application, and it showed
promise for gathering information from the patient’s body.
In the work of Lavric [5], to estimate the effectiveness
of the LoRa protocol, more focus is given on measures
including the number of packet collisions and network
performance. Accordingly, this work describes how many
LoRa nodes can connect to the gateway at once while still
abiding by the protocol’s rules. To lessen collision inci-
dence and increase communication channel efficiency,
several factors have been researched, including the
spreading factor, data transmission rate, and duty cycle.
The Adaptive Data Rate (ADR) technique, which will
modify the data rate without human intervention when a
collision is determined, is one of the suggestions made by
the author for decreasing the frequency of collisions [6, 7].
However, this tactic will result in more energy being used
by the LoRa node.
A comparison of short- and long-range communication
protocols is also demonstrated in Table 1.
Neural Computing and Applications (2023) 35:12751–12761 12753

2.2 Machine learning methods
According to Zou et al. [8], information on over 70,000
people—both healthy and diabetes patients—was physi-
cally collected from a hospital in Luzhou, China. Decision
trees, random forests, and neural networks with k-fold
validation were utilized to predict diabetes mellitus, while
PCA and mRMR were employed to minimize dimension-
ality. Last but not least, the random forest generated the
most accurate forecast (0.8084). It is also mentioned that
choosing the right characteristic requires careful consider-
ation of the classifier technique.
In the work of Sneha and Gangil [9], the research goal
has been to use predictive analysis to identify which feature
has the most influence on early diabetes mellitus predic-
tion. Diabetic hyperglycemia is linked to harm to several
organs, including the heart, kidneys, veins, eyes, and
nerves. In this research, the goal is to utilize ML to create a
perfect classifier model whose results are equivalent to
clinical outcomes and a prediction algorithm that considers
important factors. The final results of this model demon-
strated that the decision tree and random forest have given
98.20 percent and 98.00 percent maximum specificity,
respectively, for the interpretation of diabetes data. The
approach with the highest accuracy, NB, has an accuracy of
82.30 percent. The study extends the choice of the top
attributes from the dataset to increase classification
accuracy.
The local hospital in Kano, Nigeria provided the dia-
betes diagnosis dataset that was used in this investigation
by Muhammad et al. [10]. Using this dataset, a model was
created using SVM, k-nn, LR, RF, NB, and GB. Although
the accuracy of the random forest and gradient boosting
predictive learning-based models is 86.28 and 88.76 per-
cent, respectively, for these models, the receiver operating
characteristic (ROC) curve indicates that these are the best
models. The algorithm will help health care workers and
medical experts identify and predict type 2 diabetes in
those who are suspected of having the condition.
As per Letters et al. work [11], using the PIMA Indian
dataset, the SVM model was used to estimate the risk
factor for diabetes after feature scaling, selection, aug-
mentation, and imputation. The accuracy, selection, and
specificity performance parameters for this model were
assessed as follows using a tenfold stratified cross-valida-
tion approach: 83.20 percent accuracy, 87.20 percent

Table 1 Comparison of short- and long-range communication protocols [2]

Long-range protocols
SigFox LoRa NB-IoT

Suitability for Poor Average Good

health care
Deployment 9.5 km 7.2–10 km 15 km
area
Transmission 100bps 0.25–5.5kpbs 250kbps
rate
Security Private key signature Distinctive key distribution, recognized only by 3GPP S3 security, which includes user and
Encryption and the node and base station using the unique key device identity, entity authentication,
scrambling Technique Data encryption confidentiality, and data integrity
Bandwidth 868 MHz (Eu) 868 MHz (Eu) 915 MHz (US) 433 MHz (Asia) LTE bands, in the guard bands of LTE (guard-
915 MHz (US) band mode), or re-farmed GSM bands

Short-range protocols
Bluetooth low energy ZigBee MQTT

Suitability for Good Average Average

health care
Deployment 150 m 30 m M2M
area
Transmission 1Mbps 250kbps 2Mbps
rate
Security Secure pairing before the key exchange, Two keys used to AES-128b, Network key shared across network, TLS/
provide authentication and identity protection, AES-128b Optional link key to secure Application layer SSL
encryption communications
Bandwidth 2.4 GHz 2.4 GHz 2.4 GHz

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selection, and 79 percent specificity. Patients can send data
through smart devices like smartphones and smartwatches,
but it is not defined on which technology it was based. This
suggested strategy might help medical professionals make
judgments at an early stage depending on the threat pre-
dicted by the computer.
3 Proposed work
In Fig. 2, the suggested model is displayed. Two compo-
nents make up the LoRa-based Diabetes Predictive Model
first one is the communication module, and the second is
the processing module whose flowchart is given in Figs. 3
and 4. LoRa-enabled sensors from the patient’s body will
first send the data to the gateway node as explained in
algorithm1, after that this will be stored on a server (i.e.,
Dataset of Patients). Following preprocessing of the data,
normalization, and ML classification algorithms are
applied which is the standard protocol for applying an ML
technique.
3.1 Data gathering
The network’s data are gathered to establish a patient’s
health state. Because LoRa (HEADR) protocol is used for
transmission, sensors with LoRa capability may be able to
identify diabetes patients’ health states. Using a glucose
Fig. 2 LoRa(HEADR) and machine learning-based healthcare model
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Neural Computing and Applications (2023) 35:12751–12761
sensor, we may examine the patient’s blood for the pres-
ence of glucose. Depending on the situation, the glucose
sensor can either be placed internally beneath the skin or
externally on the skin as part of the continuous glucose
monitoring system (CGM).
3.2 Data transmission
The LoRa (HEADR) protocol is used to transmit data from
the patient to the gateway. The dataset unit for the patient
receives this information from the gateway. The discovered
data may be sent regularly or whenever the patient’s
biomedical sensor readings significantly change. This new
Hybrid Enhanced Adaptive Data Rate (HEADR) technique
also enhances LoRa device implementation and resolves
the sensor’s data transmission range distribution issue. To
evaluate network performance, this model shows real-time
data detection and transfer utilizing IoT protocol using the
Contiki Cooja simulator.
3.3 Dataset validation and ML classification
(i) Data preprocessing To complete the processing
module, a table with the data type and range value
of each attribute is created using the data collected
from patients using LoRa-enabled sensors. Fol-
lowing preprocessing, several ML classification
models are used. Our dataset contains the
Neural Computing and Applications (2023) 35:12751–12761
Fig. 4 Flowchart for processing module
Fig. 3 Flowchart for communication module
following variables: age, outcome, BMI, HbA1c,
skin thickness, blood pressure, family history,
glucose value, and insulin unit. The effectiveness
of the used algorithms has been decreased as a
result of the discovery that the data contain 0
values in several places. Since the Contiki is used
to perform the data transmission component of the
proposed HEADR model, real Indian Diabetes
data are gathered from two different hospitals in
the Indian state of Haryana.
(ii) Invalid data values There are numerous ways to
deal with invalid data values, as listed below:
Ignore the following data In the majority of
circumstances, it is not advised because it can
leave some crucial information behind. The
‘‘skin thickness’’ and ‘‘insulin’’ columns in the
dataset supplied include a large number of
incorrect data points, although the ‘‘BMI,’’
‘‘glucose,’’ and ‘‘blood pressure’’ values may
be legitimate.
Employing mean values If a mean value were
used for the blood pressure column in our
dataset, the model would, however, yield
12755
incorrect findings. On various other kinds of
data sets, mean values can also be employed.
(iii) Correlation and Heat map Python is used for
figuring out these correlations and heat maps. By
using correlation, one may comprehend character-
istics more thoroughly, such as how one or more
qualities are reliant on another attribute or serve as
a catalyst for another quality. The heat map is a
two-dimensional graph of data where each value is
represented by a color matrix.
(iv) Cloud storage With the aid of the gateway node,
the data gathered from the patient by the glucose
sensor are saved in the dataset for that patient.
After preprocessing the acquired data, a copy of
the preprocessed data is sent to the cloud. Physi-
cians may utilize the cloud-based database for
upcoming research. The suggested method auto-
matically records diabetic patients’ glucose read-
ings and sends them to a preprocessing unit for
cloud storage.
(v) Normalization We must carry out the normaliza-
tion step following the data cleaning phase, where
we must divide the entire dataset into training and
testing models. We will set aside the test dataset
because the data are in split form and apply the
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training method to the training dataset. Conse-
quently, with the assistance of this training
procedure, a training model will be produced that
will function on the values of the features in the
training data, logic, and algorithm. Bringing all of
the attributes to the same standard is the aim of
normalization.
(vi) Machine learning techniques Only after the data
have been presented appropriately, ML techniques
can be used. Medical diagnostic datasets may be
effectively mined for information using machine
learning (ML) techniques. We may use a variety
of classification and ensemble algorithms as used
by Onan et al. [12], to predict diabetes using the
diabetes dataset. The main goal of employing ML
techniques is to understand how these classifica-
tion methods are implemented to determine their
accuracy, as well as to identify the major charac-
teristic that is crucial for diabetes prediction. ML
methods may be divided into three groups: rein-
forcement learning, unsupervised learning, and
both. In this prototype, we will employ supervised
learning, in which the model is trained and
accurate result predictions are made using a
labeled dataset.
Classification and regression are further divisions of
supervised learning:
(i) Gradient Boosting The name ‘‘gradient boosting’’
refers to the fact that the gradient of the prediction
error determines the target outputs for each case.
In the work of Lai et al. [13], every new prototype
makes predictions in each training example to
reduce error.
(ii) Random Forest Several well-liked ensemble
techniques exist, including ‘‘bagging, boosting,
gradient boosting, ada-boosting, averaging, and
voting, etc., as mentioned in Korukoğlu et al.
research [14].’’ For forecasting diabetes, we
employ a Random Forest of Bagging ensemble
technique. Random Forest may be used for both
classification and regression tasks in the ensemble
learning approach.
(iii) Decision Tree It transforms the data collection
into a roughly sine curve based on basic if–then-
else decision principles. According to Li et al.
[15], for a deeper decision tree, prototype com-
plications will rise and model fitting will get more
difficult.
(iv) k-neighbors We often employed the k-nn
approach, which is a supervised ML algorithm,
to solve the classification and regression issues
[10]. K-nn is a useless prediction method since it
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presupposes that similar objects are close to one
another, which is usually the case with comparable
data points.
(v) Logistic Regression The category of supervised
learning classification techniques includes logistic
regression as well, as mentioned in Butt et al. work
[16]. By presenting the output result in binary
form, which denotes 1 and 0, we can distinguish
between individuals who are positive or negative
for diabetes in this diabetic dataset. Logistic
regression is often used to categorize our distinct
data items.
(vi) Gaussian Naı¨ve Bayes According to Sneha and
Gangil work [9], Naive Bayes Classifiers may be
taught quickly and effectively, especially while
under supervision. Small training data are needed
for Naive Bayes classifiers to approximate the
classification-related parameters. Gaussian Naive
Bayes only supports continuous-valued features
and models that follow a Gaussian (normal)
distribution.
(vii) SVM The Support Vector Machine approach is
one of the supervised machine learning tech-
niques. The SVM-generated hyperplane divides
the data into two categories. In high-dimensional
space, it may also produce one or more hyper-
planes that can be used for classification or
regression also mentioned in Bondre et al.
research [17].
3.4 Execution of the whole process step-by-step
(1) The placement of LoRa (HEADR)-enabled sensors
for the data collection on the bodies of patients in the
network region (Algorithm 1).
(2) The gateway sends the gathered data to the database
system.
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b Fig. 5 a Packets received by 20 nodes in 30 min. b Constant and Table 3 Dataset structure
dynamic data transmission
Our dataset [20]
Attributes Type Values Units

Table 2 ADR vs HEADR Family history Integer {0–6} Count

ADR HEADR Glucose value Integer {80–460} mg/dl
Blood pressure Integer {80–190} mm Hg
The frequency range in ADR is The frequency range in HEADR Skin thickness Integer {7–99} Mm
800–2100 MHz, which can is proposed 24–54 GHz, which
handle tens to thousands of end can handle more end devices Insulin unit Integer {0–20} mu U/ml
devices BMI Floating {12.8–50.0} kg/m2
It is designed for situations with It is designed to cover HbA1c Floating {2.9–9.9} mmol/mol
steady radio channel conditions unstable frequency conditions Age Integer {19–65} Years
in case of rain or bad weather
Outcome Binary {0–1} 0-Negative
condition
1-Positive
The majority of ADR protocols It is designed for heterogeneous
now in use are designed for end devices means dynamic end PIMA dataset [3]
homogeneous end devices devices Attributes Type Values Units
Data rate adaptation by end Data rate adaptation by end Pregnancy Integer 0–17 Count
devices is not specified devices is specified Plasma glucose Real 0–199 mg/dl
Blood pressure Real 0–122 mm Hg
Triceps skin fold Real 0–99 Mm
(3) To determine the relative relevance of various Serum insulin Real 0–846 mu U/ml
characteristics, we create a correlation and heat Body mass index Real 0–67.1 kg/m2
map after preprocessing the data. Diabetes pedigree (ancestors) Real 0.078–2.42 %
(4) Divide the entire dataset into training and testing Age Integer 21–81 Years
datasets at a ratio of 0.75:0.25. Outcome Binary 0, 1 0-Negative
(5) Choose the machine learning algorithm from the list, 1-Positive
which includes the GB, DT, SVM, k-nn, RF, LR, and
GNB algorithms.
(6) Using the training dataset and the aforementioned
ML approaches, build a classification model. steady state. Only the frequency ranges from 800 to
(7) Apply the same ML approach to test the trained 2100 MHz are covered by the current ADR, and these are
model using the test dataset. the bands set aside for LTE.
(8) Compare the performance of each classifier’s pre- The planned HEADR encompasses millimeter waves in
dictions experimentally. different band frequencies from 24 to 54 GHz. Base sta-
(9) Determine the optimum algorithm based on multiple tions for the proposed prototype are linked to routers that
analytical metrics. utilize the Internet and IoT switching devices in the mobile
network through high-speed optical fiber connections. To
adjust the channel and set the device, use the end device. A
4 Simulation results and analysis fixed data rate is scheduled for each HEADR request. With
the allocation of the downlink data transmission range, the
Improved switching, high dissemination, and dynamic data user request is made possible. As seen in Fig. 5a, a certain
transmission range allocation—all of these boost the data amount of LoRa packets were transmitted with a 1% duty
rate—support the proposed HEADR. The hybrid improved cycle. For 30 min, we sent 600 or more packets to 20
switching manages data collision prevention, data trans- nodes. A node must abide by the duty cycle constraint of
mission speed, and range allowance while routing between 1% while taking into account our simulation scenario and
the sensors. According to the user request criteria, the the suggested HEADR model. This suggested solution
HEADR chose the dissemination conditions. The end improves the LoRaWAN device implementation and
device may be given a dynamic data transmission range addresses the device data transmission range allocation
with high dispersion that includes both continuous and issue, as demonstrated in Fig. 5b. Here, we are imple-
dynamic data transfers. Based on the device’s availability, menting the data processing module after gathering the
the allocation of the data transmission range shifted to a patient’s data.

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Fig. 6 ROC curve

Table 4 Evaluation parameters

Classifiers Precision Recall F1- AUC
measure

0 GB 0.935583 0.929878 0.932722 0.953563

2 DT 0.940063 0.908537 0.924031 0.943976
1 RF 0.936508 0.899390 0.917574 0.938861
3 k-nn 0.859589 0.765244 0.809677 0.860412
4 GNB 0.749254 0.765244 0.757164 0.837118
5 LR 0.756944 0.664634 0.707792 0.794397
6 SVC 0.751131 0.506098 0.604736 0.723255

4.1 Comparative analysis and discussion

As per our proposed HEADR algorithm, the instant

switching data transmission range 125, 250, and 500 kHz
are used which will be decided by the end devices. Con-
cerning high band; mid band, and low band, millimeter
waves, quick switching spans a range of 24–54 GHz while
reducing latency and enhancing throughput. As compared
to the LoRa ADR algorithm as mentioned in Lavric and
Popa research [18], the overall performance of the HEADR
algorithm is better. The major difference between ADR and
HEADR is shown in Table 2.
In the work of Sripreethaa [19], by employing several
classifiers, a model for the early prediction of diabetes was
expected, with RF having the best accuracy (94%) but a
lower accuracy than the suggested model (96.48%) without Fig. 7 a Classifier Accuracy. b Accuracy after k-fold validation
k-fold validation. A performance evaluation model incor-
porating classifiers like DT, LR, SVM, k-nn, RF, GB, and with the best accuracy (77.60%) is LR, yet its accuracy is
NB is presented in Mekki et al. research [1]. The classifier lower than that of the suggested model (87.84%).

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Fig. 8 a PIMA Classifier. b PIMA Accuracy after k-fold validation
The ML classification results are shown in Fig. 7a,
whereas after k-fold validation, RF ranks best in Accuracy
(96.28%), Precision (94.56%), Recall (90.24%), F-Measure
(92.35%), and ROC (95%) as shown in Fig. 7b. Even the
results are shown in Fig. 8a and b which are based on the
PIMA dataset are lower than our ML classification results.
Both data structure is shown in the following Table 3. ROC
curve and values of evaluation parameters are shown in
Fig. 6 and Table 4.
5 Conclusion
We have given a healthcare model in this research that is
utilized to track a patient’s health, particularly diabetic
symptoms, as well as determine the severity of the patient’s
illness. Monitoring and diagnosis were done independently
in previous studies. The suggested HEADR method is
utilized to monitor the LoRa protocol from an IoT network,
and its working is assessed on the Contiki Cooja simulator,
where we discovered that data rate is improved by quick
switching and by employing low, mid, and high band
millimeter waves, and for data processing, the
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Neural Computing and Applications (2023) 35:12751–12761
Random Forest approach of ML classification is having the
highest accuracy of 96.28 percent after k-fold cross-vali-
dation as shown in Fig. 7b. Patients’ datasets may be
reserved on the cloud after preprocessing with ML so that
medical professionals may later access more precise data to
research this ailment. On a LoRa network based on
HEADR, the patient monitoring method may also be
physically carried out.
Data availability Data will be made available on reasonable request.
Declarations
Conflict of interest There are no conflicts of interest associated with
this investigation.
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