Institute for Biomedical Informatics, University of Kentucky, Lexington, KY, USA.
Department of Computer Science and Engineering, Qingdao University, Shandong, China.
J Alzheimers Dis. 2022;90(2):891-903. doi: 10.3233/JAD-220590.
The progression of Alzheimer's disease (AD) varies in different patients at different stages, which makes predicting the time of disease conversions challenging.
We established an algorithm by leveraging machine learning techniques to predict the probability of the conversion time to next stage for different subjects during a given period.
Firstly, we used Kaplan-Meier (KM) estimation to get the transition curves of different AD stages, and calculated Log-rank statistics to test whether the progression rate between different stages was identical. This quantitatively confirmed the progression rates known in the literature. Then, we developed an approach based on deep learning model, DeepSurv, to predict the probabilities of time-to-conversion. Finally, to help interpret the deep learning model in our approach, we identified important variables contributing the most to the DeepSurv prediction, whose significance were validated with the analysis of variance (ANOVA).
Our machine learning approach predicted the time to conversion with a high accuracy. For each of the different stages, the concordance index (CI) of our approach was at least 86%, and the integrated Brier score (IBS) was less than 0.1. To facilitate interpretability of the prediction results, our approach identified the top 10 variables for each disease conversion scenario, which were clinicopathologically meaningful, and most of them were also statistically significant.
Our study has the potential to provide individualized prediction for future time course of AD conversions years before their actual occurrence, thus facilitating personalized prevention and intervention strategies to slow down the progression of AD.
阿尔茨海默病(AD)在不同患者和不同阶段的进展情况各不相同,这使得预测疾病转变时间具有挑战性。
我们利用机器学习技术建立了一种算法,以预测在给定时间段内不同受试者转换为下一阶段的时间概率。
首先,我们使用 Kaplan-Meier(KM)估计得到不同 AD 阶段的转换曲线,并计算对数秩统计量以检验不同阶段之间的进展速度是否相同。这从定量上证实了文献中已知的进展速度。然后,我们开发了一种基于深度学习模型 DeepSurv 的方法来预测转换时间的概率。最后,为了帮助解释我们方法中的深度学习模型,我们确定了对 DeepSurv 预测贡献最大的重要变量,并通过方差分析(ANOVA)验证了它们的显著性。
我们的机器学习方法对转换时间的预测具有很高的准确性。对于每个不同的阶段,我们方法的一致性指数(CI)至少为 86%,综合 Brier 得分(IBS)小于 0.1。为了便于解释预测结果,我们的方法为每种疾病转换情况确定了前 10 个重要变量,这些变量在临床病理上有意义,其中大多数变量在统计学上也有意义。
我们的研究有可能在 AD 实际发生前数年为未来的 AD 转换时间提供个体化预测,从而促进个性化预防和干预策略,减缓 AD 的进展。