一种用于预测个体阿尔茨海默病严重程度的实用计算机化决策支持系统。
A practical computerized decision support system for predicting the severity of Alzheimer's disease of an individual.
作者信息
Bucholc Magda, Ding Xuemei, Wang Haiying, Glass David H, Wang Hui, Prasad Girijesh, Maguire Liam P, Bjourson Anthony J, McClean Paula L, Todd Stephen, Finn David P, Wong-Lin KongFatt
机构信息
Intelligent Systems Research Centre, School of Computing, Engineering & Intelligent Systems, Ulster University, Magee campus, Northern Ireland, United Kingdom.
Cognitive Analytics Research Lab, School of Computing, Engineering & Intelligent Systems, Ulster University, Magee campus, Northern Ireland, United Kingdom.
出版信息
Expert Syst Appl. 2019 Sep 15;130:157-171. doi: 10.1016/j.eswa.2019.04.022. Epub 2019 Apr 10.
Computerized clinical decision support systems can help to provide objective, standardized, and timely dementia diagnosis. However, current computerized systems are mainly based on group analysis, discrete classification of disease stages, or expensive and not readily accessible biomarkers, while current clinical practice relies relatively heavily on cognitive and functional assessments (CFA). In this study, we developed a computational framework using a suite of machine learning tools for identifying key markers in predicting the severity of Alzheimer's disease (AD) from a large set of biological and clinical measures. Six machine learning approaches, namely Kernel Ridge Regression (KRR), Support Vector Regression, and k-Nearest Neighbor for regression and Support Vector Machine (SVM), Random Forest, and k-Nearest Neighbor for classification, were used for the development of predictive models. We demonstrated high predictive power of CFA. Predictive performance of models incorporating CFA was shown to consistently have higher accuracy than those based solely on biomarker modalities. We found that KRR and SVM were the best performing regression and classification methods respectively. The optimal SVM performance was observed for a set of four CFA test scores (FAQ, ADAS13, MoCA, MMSE) with multi-class classification accuracy of 83.0%, 95%CI = (72.1%, 93.8%) while the best performance of the KRR model was reported with combined CFA and MRI neuroimaging data, i.e., = 0.874, 95%CI = (0.827, 0.922). Given the high predictive power of CFA and their widespread use in clinical practice, we then designed a data-driven and self-adaptive computerized clinical decision support system (CDSS) prototype for evaluating the severity of AD of an individual on a continuous spectrum. The system implemented an automated computational approach for data pre-processing, modelling, and validation and used exclusively the scores of selected cognitive measures as data entries. Taken together, we have developed an objective and practical CDSS to aid AD diagnosis.
计算机化临床决策支持系统有助于提供客观、标准化且及时的痴呆症诊断。然而,当前的计算机化系统主要基于群体分析、疾病阶段的离散分类或昂贵且不易获取的生物标志物,而当前的临床实践相对严重依赖认知和功能评估(CFA)。在本研究中,我们开发了一个计算框架,使用一套机器学习工具,从大量生物和临床测量中识别预测阿尔茨海默病(AD)严重程度的关键标志物。六种机器学习方法,即核岭回归(KRR)、支持向量回归以及用于回归的k近邻算法,和支持向量机(SVM)、随机森林以及用于分类的k近邻算法,被用于开发预测模型。我们证明了CFA具有较高的预测能力。包含CFA的模型的预测性能始终显示出比仅基于生物标志物模式的模型具有更高的准确性。我们发现KRR和SVM分别是性能最佳的回归和分类方法。对于一组四个CFA测试分数(FAQ、ADAS13、MoCA、MMSE),观察到最优的SVM性能,多类分类准确率为83.0%,95%置信区间 = (72.1%,93.8%),而KRR模型的最佳性能是在CFA和MRI神经影像数据相结合的情况下报告的,即 = 0.874,95%置信区间 = (0.827,0.922)。鉴于CFA的高预测能力及其在临床实践中的广泛应用,我们随后设计了一个数据驱动且自适应的计算机化临床决策支持系统(CDSS)原型,用于在连续范围内评估个体AD的严重程度。该系统实现了一种自动化计算方法用于数据预处理、建模和验证,并且仅使用选定认知测量的分数作为数据输入。综上所述,我们开发了一个客观且实用的CDSS来辅助AD诊断。