Department of Emergency Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Department of Geriatrics and Gerontology, Chi Mei Medical Center, Tainan, Taiwan.
Medicine (Baltimore). 2023 Jan 27;102(4):e32670. doi: 10.1097/MD.0000000000032670.
Dementia is a progressive disease that worsens over time as cognitive abilities deteriorate. Effective preventive interventions require early detection. However, there are no reports in the literature concerning apps that have been developed and designed to predict patient dementia classes (DCs). This study aimed to develop an app that could predict DC automatically and accurately for patients responding to the clinical dementia rating (CDR) instrument.
A CDR was applied to 366 outpatients in a hospital in Taiwan, with assessments on 25 and 49 items endorsed by patients and family members, respectively. The 2 models of convolutional neural networks (CNN) and artificial neural networks (ANN) were applied to examine the prediction accuracy based on 5 classes (i.e., no cognitive decline, very mild, mild, moderate, and severe) in 4 scenarios, consisting of 74 (items) in total, 25 in patients, 49 in family, and a combination strategy to select the best in the aforementioned scenarios using the forest plot. Using CDR scores in patients and their families on both axes, patients were dispersed on a radar plot. An app was developed to predict patient DC.
We found that ANN had higher accuracy rates than CNN with a ratio of 3:1 in the 4 scenarios. The highest accuracy rate (=93.72%) was shown in the combination scenario of ANN. A significant difference was observed between the CNN and ANN in terms of the accuracy rate. An available ANN-based app for predicting DC in patients was successfully developed and demonstrated in this study.
On the basis of a combination strategy and a decision rule, a 74-item ANN model with 285 estimated parameters was developed and included. The development of an app that will assist clinicians in predicting DC in clinical settings is required in the near future.
痴呆是一种进行性疾病,随着认知能力的恶化,病情会逐渐加重。有效的预防干预措施需要早期发现。然而,目前尚无文献报道开发和设计用于预测患者痴呆等级(DC)的应用程序。本研究旨在开发一种能够自动准确预测对临床痴呆评定量表(CDR)做出反应的患者 DC 的应用程序。
对台湾一家医院的 366 名门诊患者进行 CDR 评估,患者和家属分别对 25 项和 49 项进行评估。应用卷积神经网络(CNN)和人工神经网络(ANN)两种模型,根据 5 个等级(即无认知下降、轻度、中度、重度和极重度)和 4 种情况(共 74 项)评估预测准确率,分别为患者 25 项、家属 49 项和在上述场景中使用森林图选择最佳组合策略。使用患者及其家属在两个坐标轴上的 CDR 评分,将患者在雷达图上分散开来。开发了一个应用程序来预测患者的 DC。
我们发现,在 4 种情况下,ANN 的准确率均高于 CNN,比例为 3:1。ANN 的最高准确率(=93.72%)出现在 ANN 的组合场景中。CNN 和 ANN 在准确率方面存在显著差异。本研究成功开发并展示了一种基于 ANN 预测 DC 的可用应用程序。
在组合策略和决策规则的基础上,开发了一个包含 285 个估计参数的 74 项 ANN 模型。需要在不久的将来开发一种可以帮助临床医生在临床环境中预测 DC 的应用程序。