Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea.
Mobile Doctor, Seoul, Republic of Korea.
J Med Internet Res. 2020 Oct 29;22(10):e21369. doi: 10.2196/21369.
Screening for influenza in primary care is challenging due to the low sensitivity of rapid antigen tests and the lack of proper screening tests.
The aim of this study was to develop a machine learning-based screening tool using patient-generated health data (PGHD) obtained from a mobile health (mHealth) app.
We trained a deep learning model based on a gated recurrent unit to screen influenza using PGHD, including each patient's fever pattern and drug administration records. We used meteorological data and app-based surveillance of the weekly number of patients with influenza. We defined a single episode as the set of consecutive days, including the day the user was diagnosed with influenza or another disease. Any record a user entered 24 hours after his or her last record was considered to be the start of a new episode. Each episode contained data on the user's age, gender, weight, and at least one body temperature record. The total number of episodes was 6657. Of these, there were 3326 episodes within which influenza was diagnosed. We divided these episodes into 80% training sets (2664/3330) and 20% test sets (666/3330). A 5-fold cross-validation was used on the training set.
We achieved reliable performance with an accuracy of 82%, a sensitivity of 84%, and a specificity of 80% in the test set. After the effect of each input variable was evaluated, app-based surveillance was observed to be the most influential variable. The correlation between the duration of input data and performance was not statistically significant (P=.09).
These findings suggest that PGHD from an mHealth app could be a complementary tool for influenza screening. In addition, PGHD, along with traditional clinical data, could be used to improve health conditions.
由于快速抗原检测的灵敏度低以及缺乏适当的筛查检测方法,初级保健中的流感筛查具有挑战性。
本研究旨在使用从移动健康(mHealth)应用程序获得的患者生成的健康数据(PGHD)开发一种基于机器学习的筛查工具。
我们基于门控循环单元训练了一个深度学习模型,使用 PGHD 筛查流感,包括每位患者的发热模式和药物管理记录。我们使用气象数据和基于应用程序的每周流感患者人数监测。我们将单个发作定义为连续几天的集合,包括用户被诊断患有流感或其他疾病的那一天。用户在最后一次记录后 24 小时内输入的任何记录都被视为新发作的开始。每个发作都包含用户的年龄、性别、体重和至少一条体温记录的数据。发作总数为 6657 次。其中,有 3326 次发作被诊断为流感。我们将这些发作分为 80%的训练集(2664/3330)和 20%的测试集(666/3330)。在训练集上使用了 5 折交叉验证。
我们在测试集中实现了可靠的性能,准确率为 82%,灵敏度为 84%,特异性为 80%。在评估了每个输入变量的影响后,发现基于应用程序的监测是最具影响力的变量。输入数据的持续时间与性能之间的相关性没有统计学意义(P=.09)。
这些发现表明,mHealth 应用程序的 PGHD 可能是流感筛查的补充工具。此外,PGHD 可以与传统的临床数据一起用于改善健康状况。