Evidence map›Paper›PMID 41124137›Full record

ArticlePloS one2025

A hybrid dense convolutional network and fuzzy inference system for pneumonia diagnosis with dynamic symptom tracking.

Sulav Baral, Rabindra Bista, Sanjog Sigdel, João C Ferreira

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Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Sulav BaralDepartment of Computer Science and Engineering, School of Engineering, Kathmandu University, Dhulikhel, Kavre, Nepal.
Rabindra BistaDepartment of Computer Science and Engineering, School of Engineering, Kathmandu University, Dhulikhel, Kavre, Nepal.
Sanjog SigdelDepartment of Computer Science and Engineering, School of Engineering, Kathmandu University, Dhulikhel, Kavre, Nepal.ORCID https://orcid.org/0000-0002-0470-860X
João C FerreiraFaculty of Logistics, Molde University College, Molde, Norway.ORCID https://orcid.org/0000-0002-6662-0806

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPneumonia 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.

objectivesThis 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.

methodsThe 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.

resultsThe 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.

conclusionThis 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.

Indexed as

Fuzzy LogicPneumoniaAdultAlgorithmsArtificial IntelligenceChildDeep LearningFemaleHumansMaleNeural Networks, Computer

Identifiers

PMID41124137
PMCPMC12543161

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.