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Fulltext Classification of Human Daily Activities Using Ensemble Methods Based on Smartphone Inertial Sensors

Ku Abd Rahim KN, Elamvazuthi I, Izhar LI, Capi G

Sensors (Basel), 2018 Nov 26;18(12).
PMID: 30486242 DOI: 10.3390/s18124132

Increasing interest in analyzing human gait using various wearable sensors, which is known as Human Activity Recognition (HAR), can be found in recent research. Sensors such as accelerometers and gyroscopes are widely used in HAR. Recently, high interest has been shown in the use of wearable sensors in numerous applications such as rehabilitation, computer games, animation, filmmaking, and biomechanics. In this paper, classification of human daily activities using Ensemble Methods based on data acquired from smartphone inertial sensors involving about 30 subjects with six different activities is discussed. The six daily activities are walking, walking upstairs, walking downstairs, sitting, standing and lying. It involved three stages of activity recognition; namely, data signal processing (filtering and segmentation), feature extraction and classification. Five types of ensemble classifiers utilized are Bagging, Adaboost, Rotation forest, Ensembles of nested dichotomies (END) and Random subspace. These ensemble classifiers employed Support vector machine (SVM) and Random forest (RF) as the base learners of the ensemble classifiers. The data classification is evaluated with the holdout and 10-fold cross-validation evaluation methods. The performance of each human daily activity was measured in terms of precision, recall, F-measure, and receiver operating characteristic (ROC) curve. In addition, the performance is also measured based on the comparison of overall accuracy rate of classification between different ensemble classifiers and base learners. It was observed that overall, SVM produced better accuracy rate with 99.22% compared to RF with 97.91% based on a random subspace ensemble classifier.
From Evidence to Policy: Economic Evaluations of Healthcare in Malaysia: A Systematic Review

Ku Abd Rahim KN, Kamaruzaman HF, Dahlui M, Wan Puteh SE

Value Health Reg Issues, 2020 May;21:91-99.
PMID: 31698173 DOI: 10.1016/j.vhri.2019.09.002

OBJECTIVE: To identify and describe the various economic evaluation studies in Malaysia and to determine the range of incremental cost-effectiveness ratios (ICERs) as reported in these studies.
METHODS: A comprehensive search of the scientific electronic databases was conducted (Medline, EBM Reviews, Embase, and hand search) to identify all published economic evaluation studies related to Malaysian healthcare. Two researchers assessed the quality of selected studies using the Critical Appraisal Skills Programme (CASP) checklist and Quality of Health Economic Studies instrument. The assessment was also reviewed by expert members of the Technical Advisory Committee of Health Technology Economic Evaluations (TACHTEE).
RESULTS: A total of 64 full-text articles were assessed for eligibility and included in this systematic review. Thirty studies were partial economic evaluations; the full economic evaluations included 17 cost-effectiveness analyses and 17 cost-utility analyses. From all the reported ICERs, the majority (68%) were categorized as highly cost-effective (ICER of less than 1 gross domestic product (GDP) per capita per quality-adjusted life-years or disability-adjusted life-years gained).
CONCLUSION: This review identifies information gaps and loopholes in health economics research in Malaysia. Additionally, this study provides the information that the majority of published interventions in Malaysia fell within the cost-effectiveness threshold of 1 GDP per capita per quality-adjusted life-years or disability-adjusted life-years gained.
A voice to be heard: patient and public involvement in health technology assessment and clinical practice guidelines in Malaysia

Kamaruzaman HF, Ku Abd Rahim KN, Mohamed Ghazali IM, Mohd Yusof MA

Int J Technol Assess Health Care, 2021 Mar 22;37:e47.
PMID: 33745482 DOI: 10.1017/S0266462321000118

Patient and public involvement (PPI) in health technology assessment (HTA) is widely promoted to ensure that all health-related decisions are made after taking into consideration the viewpoints of important stakeholders. In Malaysia, patients or their representatives have been involved in the development of HTA and Clinical Practice Guidelines (CPG) since 2009 and their influences have been growing steadily over the years. This paper aimed to describe the journey, achievements, challenges, and future direction of the PPI throughout all stages of the development and implementation of HTA and CPG in Malaysia. Currently, in Malaysia, patients or their representatives are mainly involved during the initial development of HTA and CPG drafts as well as during the internal and external reviews. Additionally, they are also encouraged to be involved during the implementation of HTA and CPG recommendations. Although their involvement in this aspect has slowly increased over time, challenges remain in the form of limited representativeness of selected patients or carers, uncertainty on the level of patient involvement allowed during the HTA/CPG development processes, and limited health literacy, which affect their ability to contribute meaningfully throughout the processes. Continuous improvement in these processes is important as patients or their representatives play a pivotal role in ensuring transparency, accountability, and credibility throughout the HTA/CPG development and decision-making processes.
Development of an MCDA Framework for Rare Disease Reimbursement Prioritization in Malaysia

Ku Abd Rahim KN, Muhammad Lattepi N, Sarimin R, Foo SS, Akmal S, Lee SW, et al.

Int J Technol Assess Health Care, 2024 Sep 04.
PMID: 39228212 DOI: 10.1017/S026646232400031X
Stakeholders' perspectives on disinvestment of low-value healthcare interventions and practices in Malaysia: an online survey

Kamaruzaman HF, Grieve E, Ku Abd Rahim KN, Izzuna M, Sit Wai L, Romli EZ, et al.

Int J Technol Assess Health Care, 2024 Nov 15;40(1):e57.
PMID: 39544076 DOI: 10.1017/S0266462324004665

OBJECTIVES: Healthcare disinvestment requires multi-level decision-making, and early stakeholder engagement is essential to facilitate implementation and acceptance. This study aimed to explore the perceptions of Malaysian healthcare stakeholders to disinvestment initiatives as well as identify disinvestment activities in the country.
METHODS: A cross-sectional online survey was conducted from February to March 2023 among Malaysian healthcare stakeholders involved in resource allocation and decision-making at various levels of governance. Response frequencies were analyzed descriptively and cross-tabulation was performed for specific questions to compare the responses of different groups of stakeholders. For free-text replies, content analysis was used with each verbatim response examined and assigned a theme.
RESULTS: A total of 153 complete responses were analyzed and approximately 37 percent of participants had prior involvement in disinvestment initiatives. Clinical effectiveness and cost-effectiveness ranked as the most important criteria in assessment for disinvestment. Surprisingly, equity was rated the lowest priority despite its crucial role in healthcare decision-making. Almost 90 percent of the respondents concurred that a formal disinvestment framework is necessary and the importance of training for the program's successful implementation. Key obstacles to the adoption of disinvestment include insufficient stakeholder support and political will as well as a lack of expertise in executing the process.
CONCLUSIONS: While disinvestment is perceived as a priority for efficient resource allocation in Malaysian healthcare, there is a lack of a systematic framework for its implementation. Future research should prioritize methodological analysis in healthcare disinvestment and strategies for integrating equity considerations in evaluating disinvestment candidates.