A fuzzy logic diagnosis system for classification of pharyngeal dysphagia

Abstract

Identification and classification of the dysphagic patient at risk of aspiration is important from a clinical point of view. Recently, we have developed techniques to quantify various biomechanical parameters that characterize the dysphagic patient, and have developed an expert system to classify patients based on these measurements. The purpose of the present investigation was to develop a fuzzy logic diagnosis system for classification of the patient with pharyngeal dysphagia into four categories of risk for aspiration. Non-invasive acceleration and swallow pressure measurements were obtained and five parameters were extracted from these measurements. A set of membership functions were defined for each parameter. The measured parameter values were fuzzified and fed to a rule base which provided a set of output membership values corresponding to each of the categories. The set of output values were defuzzified to obtain a continuous measure of classification. The fuzzy system was evaluated using the data obtained from 22 subjects. There was a complete agreement between the fuzzy system classification and the clinician's classification in 18 of the 22 patients. The fuzzy system overestimated the risk by half a category in two patients and underestimated by half a category in two patients. The fuzzy logic diagnosis system, together with the biomechanical measures, provides a tool for continued patient assessment on a daily basis to identify the patient who needs further videofluorography examination.