Learning from Clinical Consensus Diagnosis in India to Facilitate Automatic Classification of Dementia: Machine Learning Study (Preprint)

2021 ◽  
Author(s):  
Haomiao Jin ◽  
Sandy Chien ◽  
Erik Meijer ◽  
Pranali Khobragade ◽  
Jinkook Lee
Keyword(s):  
Machine Learning ◽  
Learning Model ◽  
Diagnostic Process ◽  
Support Vector ◽  
Substantial Agreement ◽  
Discriminative Ability ◽  
Machine Learning Model ◽  
Diagnosis Of Dementia ◽  
Consensus Diagnosis

BACKGROUND The Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD) is the first and only nationally representative study on late-life cognition and dementia in India (N=4,096). LASI-DAD obtained clinical consensus diagnosis of dementia for a subsample of 2,528 respondents. OBJECTIVE This study develops a machine learning model that uses data from the clinical consensus diagnosis in LASI-DAD to support the classification of dementia status. METHODS Clinicians were presented with the extensive data collected from LASI-DAD, including sociodemographic information and health history of respondents, results from the screening tests of cognitive status, and information obtained from informant interviews. Based on the Clinical Dementia Rating (CDR®) and using an online platform, clinicians individually evaluated each case and then reached a consensus diagnosis. A two-step procedure was implemented to train several candidate machine learning models, which were evaluated using a separate test set for predictive accuracy measurement, including the area under receiver-operating curve (AUROC), accuracy, sensitivity, specificity, precision, F1 score, and Kappa statistic. The ultimate model was selected based on overall agreement as measured by Kappa. We further examined the overall accuracy and agreement with the final consensus diagnoses between the selected machine learning model and individual clinicians who participated in the clinical consensus diagnostic process. Finally, we applied the selected model to a subgroup of LASI-DAD participants for whom the clinical consensus diagnosis was not obtained to predict their dementia status. RESULTS Among the 2,528 individuals who received clinical consensus diagnosis, 192 (6.7% after adjusting for sampling weight) were diagnosed with dementia. All candidate machine learning models achieved outstanding discriminative ability as indicated by AUROC>0.9 and had similar accuracy and specificity (both around 0.95). The support vector machine model outperformed other models with the highest sensitivity (0.81), F1 score (0.72), and Kappa (0.70, indicating substantial agreement) and the second highest precision (0.65). As a result, the support vector machine was selected as the ultimate model. Further examination revealed that overall accuracy and agreement were similar between the selected model and individual clinicians. Application of the prediction model on 1,568 individuals without clinical consensus diagnosis classified 127 individuals as living with dementia. After applying sampling weight, we can estimate the prevalence of dementia in the population as 7.4%. CONCLUSIONS The selected machine learning model has outstanding discriminative ability and substantial agreement with clinical consensus diagnosis of dementia. The model can serve as a computer model of the clinical knowledge and experience encoded in the clinical consensus diagnostic process and has many potential applications, including predicting missed dementia diagnoses and serving as a clinical decision-support tool or virtual rater to assist diagnosis of dementia.

A Machine Learning Model for Automated Classification of Sleep Stages Using Polysomnography Signals

2021 ◽  
pp. 209-222
Author(s):  
Santosh Kumar Satapathy ◽  
Hari Kishan Kondaveeti ◽  
D. Loganathan ◽  
S. Sharathkumar
Keyword(s):  
Machine Learning ◽  
Learning Model ◽  
Sleep Stages ◽  
Automated Classification ◽  
Machine Learning Model

scholarly journals MEWS++: Enhancing the Prediction of Clinical Deterioration in Admitted Patients through a Machine Learning Model

2020 ◽  
Vol 9 (2) ◽  
pp. 343 ◽  
Author(s):  
Arash Kia ◽  
Prem Timsina ◽  
Himanshu N. Joshi ◽  
Eyal Klang ◽  
Rohit R. Gupta ◽  
...  
Keyword(s):  
Machine Learning ◽  
At Risk ◽  
Area Under The Curve ◽  
Learning Model ◽  
Clinical Deterioration ◽  
Early Warning Score ◽  
Support Vector ◽  
Adult Age ◽  
Machine Learning Model ◽  
Patients At Risk

Early detection of patients at risk for clinical deterioration is crucial for timely intervention. Traditional detection systems rely on a limited set of variables and are unable to predict the time of decline. We describe a machine learning model called MEWS++ that enables the identification of patients at risk of escalation of care or death six hours prior to the event. A retrospective single-center cohort study was conducted from July 2011 to July 2017 of adult (age > 18) inpatients excluding psychiatric, parturient, and hospice patients. Three machine learning models were trained and tested: random forest (RF), linear support vector machine, and logistic regression. We compared the models’ performance to the traditional Modified Early Warning Score (MEWS) using sensitivity, specificity, and Area Under the Curve for Receiver Operating Characteristic (AUC-ROC) and Precision-Recall curves (AUC-PR). The primary outcome was escalation of care from a floor bed to an intensive care or step-down unit, or death, within 6 h. A total of 96,645 patients with 157,984 hospital encounters and 244,343 bed movements were included. Overall rate of escalation or death was 3.4%. The RF model had the best performance with sensitivity 81.6%, specificity 75.5%, AUC-ROC of 0.85, and AUC-PR of 0.37. Compared to traditional MEWS, sensitivity increased 37%, specificity increased 11%, and AUC-ROC increased 14%. This study found that using machine learning and readily available clinical data, clinical deterioration or death can be predicted 6 h prior to the event. The model we developed can warn of patient deterioration hours before the event, thus helping make timely clinical decisions.

scholarly journals Automatic subtyping of individuals with Primary Progressive Aphasia

2020 ◽  
Author(s):  
Charalambos Themistocleous ◽  
Bronte Ficek ◽  
Kimberly Webster ◽  
Dirk-Bart den Ouden ◽  
Argye E. Hillis ◽  
...  
Keyword(s):  
Machine Learning ◽  
Classification Accuracy ◽  
Primary Progressive Aphasia ◽  
Support Vector ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Machine Learning Model ◽  
Machine Learning Approach ◽  
Automated Machine Learning

AbstractBackgroundThe classification of patients with Primary Progressive Aphasia (PPA) into variants is time-consuming, costly, and requires combined expertise by clinical neurologists, neuropsychologists, speech pathologists, and radiologists.ObjectiveThe aim of the present study is to determine whether acoustic and linguistic variables provide accurate classification of PPA patients into one of three variants: nonfluent PPA, semantic PPA, and logopenic PPA.MethodsIn this paper, we present a machine learning model based on Deep Neural Networks (DNN) for the subtyping of patients with PPA into three main variants, using combined acoustic and linguistic information elicited automatically via acoustic and linguistic analysis. The performance of the DNN was compared to the classification accuracy of Random Forests, Support Vector Machines, and Decision Trees, as well as expert clinicians’ classifications.ResultsThe DNN model outperformed the other machine learning models with 80% classification accuracy, providing reliable subtyping of patients with PPA into variants and it even outperformed auditory classification of patients into variants by clinicians.ConclusionsWe show that the combined speech and language markers from connected speech productions provide information about symptoms and variant subtyping in PPA. The end-to-end automated machine learning approach we present can enable clinicians and researchers to provide an easy, quick and inexpensive classification of patients with PPA.

scholarly journals Preoperative prediction of complicated appendicitis using machine learning method

2020 ◽  
Author(s):  
Chunbo Kang ◽  
Xubin Li ◽  
Xiaoqian Chi ◽  
Yabin Yang ◽  
Haifeng Shan ◽  
...  
Keyword(s):  
Machine Learning ◽  
Clinical Symptoms ◽  
Laboratory Data ◽  
Learning Model ◽  
Complicated Appendicitis ◽  
Support Vector ◽  
Training Set ◽  
Preoperative Prediction ◽  
Machine Learning Model ◽  
Testing Set

Abstract BACKGROUND Accurate preoperative prediction of complicated appendicitis (CA) could help selecting optimal treatment and reducing risks of postoperative complications. The study aimed to develop a machine learning model based on clinical symptoms and laboratory data for preoperatively predicting CA.METHODS 136 patients with clinicopathological diagnosis of acute appendicitis were retrospectively included in the study. The dataset was randomly divided (94: 42) into training and testing set. Predictive models using individual and combined selected clinical and laboratory data features were built separately. Three combined models were constructed using logistic regression (LR), support vector machine (SVM) and random forest (RF) algorithms. The CA prediction performance was evaluated with Receiver Operating Characteristic (ROC) analysis, using the area under the curve (AUC), sensitivity, specificity and accuracy factors.RESULTS The features of the abdominal pain time, nausea and vomiting, the highest temperature, high sensitivity-CRP (hs-CRP) and procalcitonin (PCT) had significant differences in the CA prediction (P<0.001). The ability to predict CA by individual feature was low (AUC<0.8). The prediction by combined features was significantly improved. The AUC of the three models (LR, SVM and RF) in the training set and the testing set were 0.805, 0.888, 0.908 and 0.794, 0.895, 0.761, respectively. The SVM-based model showed a better performance for CA prediction. RF had a higher AUC in the training set, but its poor efficiency in the testing set indicated a poor generalization ability.CONCLUSIONS The SVM machine learning model applying clinical and laboratory data can well predict CA preoperatively which could assist diagnosis in resource limited settings.

scholarly journals Moderate to severe OSA screening based on support vector machine of the Chinese population faciocervical measurements dataset: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e048482
Author(s):  
Liu Zhang ◽  
Ya Ru Yan ◽  
Shi Qi Li ◽  
Hong Peng Li ◽  
Ying Ni Lin ◽  
...  
Keyword(s):  
Machine Learning ◽  
Chinese Population ◽  
Learning Model ◽  
Cross Sectional Study ◽  
Neck Circumference ◽  
Secondary Outcome ◽  
Support Vector ◽  
Sectional Study ◽  
Cross Sectional ◽  
Machine Learning Model

ObjectivesObstructive sleep apnoea (OSA) has received much attention as a risk factor for perioperative complications and 68.5% of OSA patients remain undiagnosed before surgery. Faciocervical characteristics may screen OSA for Asians due to smaller upper airways compared with Caucasians. Thus, our study aimed to explore a machine-learning model to screen moderate to severe OSA based on faciocervical and anthropometric measurements.DesignA cross-sectional study.SettingData were collected from the Shanghai Jiao Tong University School of Medicine affiliated Ruijin Hospital between February 2019 and August 2020.ParticipantsA total of 481 Chinese participants were included in the study.Primary and secondary outcome(1) Identification of moderate to severe OSA with apnoea–hypopnoea index 15 events/hour and (2) Verification of the machine-learning model.ResultsSex-Age-Body mass index (BMI)-maximum Interincisal distance-ratio of Height to thyrosternum distance-neck Circumference-waist Circumference (SABIHC2) model was set up. The SABIHC2 model could screen moderate to severe OSA with an area under the curve (AUC)=0.832, the sensitivity of 0.916 and specificity of 0.749, and performed better than the STOP-BANG (snoring, tiredness, observed apnea, high blood pressure, BMI, age, neck circumference, and male gender) questionnaire, which showed AUC=0.631, the sensitivity of 0.487 and specificity of 0.772. Especially for asymptomatic patients (Epworth Sleepiness Scale <10), the SABIHC2 model demonstrated better predictive ability compared with the STOP-BANG questionnaire, with AUC (0.824 vs 0.530), sensitivity (0.892 vs 0.348) and specificity (0.755 vs 0.809).ConclusionThe SABIHC2 machine-learning model provides a simple and accurate assessment of moderate to severe OSA in the Chinese population, especially for those without significant daytime sleepiness.

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