Jammeh Emmanuel A, Carroll Camille B, Pearson Stephen W, Escudero Javier, Anastasiou Athanasios, Zhao Peng, Chenore Todd, Zajicek John, Ifeachor Emmanuel
Research Fellow, School of Computing, Electronics and Mathematics, Faculty of Science and Engineering, Plymouth University, Plymouth, UK.
Honorary Consultant Neurologist, Faculty of Medicine and Dentistry, University of Plymouth, Plymouth, UK.
BJGP Open. 2018 Jun 13;2(2):bjgpopen18X101589. doi: 10.3399/bjgpopen18X101589. eCollection 2018 Jul.
Up to half of patients with dementia may not receive a formal diagnosis, limiting access to appropriate services. It is hypothesised that it may be possible to identify undiagnosed dementia from a profile of symptoms recorded in routine clinical practice.
The aim of this study is to develop a machine learning-based model that could be used in general practice to detect dementia from routinely collected NHS data. The model would be a useful tool for identifying people who may be living with dementia but have not been formally diagnosed.
DESIGN & SETTING: The study involved a case-control design and analysis of primary care data routinely collected over a 2-year period. Dementia diagnosed during the study period was compared to no diagnosis of dementia during the same period using pseudonymised routinely collected primary care clinical data.
Routinely collected Read-encoded data were obtained from 18 consenting GP surgeries across Devon, for 26 483 patients aged >65 years. The authors determined Read codes assigned to patients that may contribute to dementia risk. These codes were used as features to train a machine-learning classification model to identify patients that may have underlying dementia.
The model obtained sensitivity and specificity values of 84.47% and 86.67%, respectively.
The results show that routinely collected primary care data may be used to identify undiagnosed dementia. The methodology is promising and, if successfully developed and deployed, may help to increase dementia diagnosis in primary care.
多达一半的痴呆症患者可能未得到正式诊断,这限制了他们获得适当服务的机会。据推测,从常规临床实践中记录的症状概况中有可能识别出未被诊断的痴呆症。
本研究的目的是开发一种基于机器学习的模型,该模型可用于全科医疗,从常规收集的英国国家医疗服务体系(NHS)数据中检测痴呆症。该模型将成为识别可能患有痴呆症但尚未得到正式诊断的人群的有用工具。
该研究采用病例对照设计,并对2年期间常规收集的初级保健数据进行分析。使用假名形式的常规收集的初级保健临床数据,将研究期间诊断出的痴呆症与同期未诊断出痴呆症的情况进行比较。
从德文郡18个同意参与的全科医生诊所获取了26483名年龄大于65岁患者的常规读取编码数据。作者确定了分配给可能导致痴呆风险的患者的读取编码。这些编码被用作特征来训练机器学习分类模型,以识别可能患有潜在痴呆症的患者。
该模型的灵敏度和特异度值分别为84.47%和86.67%。
结果表明,常规收集的初级保健数据可用于识别未被诊断的痴呆症。该方法很有前景,如果成功开发和应用,可能有助于提高初级保健中痴呆症的诊断率。