A hybrid dense convolutional network and fuzzy inference system for pneumonia diagnosis with dynamic symptom tracking
Year: 2025
Type: article
Abstract: BACKGROUND: Pneumonia is a major cause of mortality among children under five and adults over 65, especially in low-resource settings where access to skilled radiologists is limited. Accurate and early diagnosis is essential, but is often hindered by subjective interpretation and variability in its symptoms. OBJECTIVES: This study aims to develop a hybrid Artificial Intelligence (AI) based pneumonia diagnosis system that integrates Deep Learning (DL) confidence scores, DenseNet201 with Capsule Network (CapsNet), Mamdani-style fuzzy inference, and a dynamic symptom adjustment mechanism to enhance diagnostic accuracy, transparency, and clinical usability. METHODS: The system was evaluated using 17,229 labelled chest X-ray images across multiple cross-validation techniques: Stratified, k-fold, Bootstrap, and Monte Carlo methods, each with five dataset iterations or folds. DenseNet was used to extract spatial features, while CapsNet preserved spatial orientation and hierarchical relationships. A DL based confidence score was generated and used as a fuzzy membership input to support classification in borderline cases, where severity scores were nearly tied, and the confidence score guided the final decision. A dynamic adjustment algorithm further refined symptom severity by incorporating recent trends in patient data. RESULTS: The DenseNet201 + CapsNet architecture achieved the highest performance in the 5th fold of stratified cross-validation, with a test accuracy of 99.01%. The model also demonstrated strong generalization, with a weighted precision, recall and F1-score of 0.9878, 0.9874, and 0.9876, respectively, across all classes. The paired t-test confirmed that the CapsNet-based approach outperformed traditional fully connected layers, and the fuzzy logic system effectively handled ambiguous cases using DL confidence. The dynamic membership mechanism showed strong adaptability for real-time symptom tracking. CONCLUSION: This hybrid model offers a robust, interpretable, and clinically relevant decision-support tool for pneumonia diagnosis. It bridges high-performance AI with real-world medical decision-making, especially in settings with limited radiological expertise.
Source: PLoS ONE
Language: English
Topic: COVID-19 diagnosis using AI
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,382
OpenAlex ID: W4415445339