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基于足底压力参数的社区老年人跌倒风险分类:一种机器学习和可解释人工智能方法。

Fall risk classification with posturographic parameters in community-dwelling older adults: a machine learning and explainable artificial intelligence approach.

机构信息

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan, ROC.

Department of Information Management, National Yunlin University of Science and Technology, Douliu, Taiwan, ROC.

出版信息

J Neuroeng Rehabil. 2024 Jan 29;21(1):15. doi: 10.1186/s12984-024-01310-3.


DOI:10.1186/s12984-024-01310-3
PMID:38287415
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10826018/
Abstract

BACKGROUND: Computerized posturography obtained in standing conditions has been applied to classify fall risk for older adults or disease groups. Combining machine learning (ML) approaches is superior to traditional regression analysis for its ability to handle complex data regarding its characteristics of being high-dimensional, non-linear, and highly correlated. The study goal was to use ML algorithms to classify fall risks in community-dwelling older adults with the aid of an explainable artificial intelligence (XAI) approach to increase interpretability. METHODS: A total of 215 participants were included for analysis. The input information included personal metrics and posturographic parameters obtained from a tracker-based posturography of four standing postures. Two classification criteria were used: with a previous history of falls and the timed-up-and-go (TUG) test. We used three meta-heuristic methods for feature selection to handle the large numbers of parameters and improve efficacy, and the SHapley Additive exPlanations (SHAP) method was used to display the weights of the selected features on the model. RESULTS: The results showed that posturographic parameters could classify the participants with TUG scores higher or lower than 10 s but were less effective in classifying fall risk according to previous fall history. Feature selections improved the accuracy with the TUG as the classification label, and the Slime Mould Algorithm had the best performance (accuracy: 0.72 to 0.77, area under the curve: 0.80 to 0.90). In contrast, feature selection did not improve the model performance significantly with the previous fall history as a classification label. The SHAP values also helped to display the importance of different features in the model. CONCLUSION: Posturographic parameters in standing can be used to classify fall risks with high accuracy based on the TUG scores in community-dwelling older adults. Using feature selection improves the model's performance. The results highlight the potential utility of ML algorithms and XAI to provide guidance for developing more robust and accurate fall classification models. Trial registration Not applicable.

摘要

背景:在站立状态下获取的计算机体描记术已被用于对老年人或疾病群体的跌倒风险进行分类。与传统回归分析相比,机器学习(ML)方法具有处理复杂数据的能力,因为它具有高维性、非线性和高度相关性等特点。本研究的目的是使用 ML 算法,借助可解释人工智能(XAI)方法来提高可解释性,对社区居住的老年人进行跌倒风险分类。

方法:共有 215 名参与者被纳入分析。输入信息包括个人指标和基于跟踪器的四种站立姿势的体描记术获得的姿势参数。使用了两种分类标准:既往有跌倒史和计时起立行走(TUG)测试。我们使用了三种元启发式方法进行特征选择,以处理大量参数并提高功效,并且使用 SHapley Additive exPlanations(SHAP)方法来显示模型中所选特征的权重。

结果:结果表明,姿势参数可以对 TUG 评分高于或低于 10 秒的参与者进行分类,但在根据既往跌倒史进行跌倒风险分类方面效果较差。特征选择提高了以 TUG 为分类标签的准确性,而 Slime Mould Algorithm 的性能最佳(准确性:0.72 至 0.77,曲线下面积:0.80 至 0.90)。相比之下,以既往跌倒史为分类标签时,特征选择并未显著提高模型性能。SHAP 值还有助于显示模型中不同特征的重要性。

结论:基于社区居住的老年人的 TUG 评分,站立时的姿势参数可以高精度地用于分类跌倒风险。使用特征选择可提高模型性能。结果突出了 ML 算法和 XAI 的潜在效用,可为开发更稳健和准确的跌倒分类模型提供指导。

试验注册:不适用。

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引用本文的文献

[1]
A machine learning approach to evaluate the impact of virtual balance/cognitive training on fall risk in older women.

Front Comput Neurosci. 2024-5-14

本文引用的文献

[1]
New onset delirium prediction using machine learning and long short-term memory (LSTM) in electronic health record.

J Am Med Inform Assoc. 2022-12-13

[2]
Deep Neural Networks for Human's Fall-risk Prediction using Force-Plate Time Series Signal.

Expert Syst Appl. 2021-11-15

[3]
World guidelines for falls prevention and management for older adults: a global initiative.

Age Ageing. 2022-9-2

[4]
Mutational Slime Mould Algorithm for Gene Selection.

Biomedicines. 2022-8-22

[5]
The Use of Static Posturography Cut-Off Scores to Identify the Risk of Falling in Older Adults.

Int J Environ Res Public Health. 2022-5-26

[6]
Mobility screening for fall prediction in the Canadian Longitudinal Study on Aging (CLSA): implications for fall prevention in the decade of healthy ageing.

Age Ageing. 2022-5-1

[7]
Predictive validity of the Stopping Elderly Accidents, Deaths & Injuries (STEADI) program fall risk screening algorithms among community-dwelling Thai elderly.

BMC Med. 2022-3-14

[8]
Comparative analysis of explainable machine learning prediction models for hospital mortality.

BMC Med Res Methodol. 2022-2-27

[9]
Early identification of older individuals at risk of mobility decline with machine learning.

Arch Gerontol Geriatr. 2022

[10]
A Pilot Study Quantifying Center of Mass Trajectory during Dynamic Balance Tasks Using an HTC Vive Tracker Fixed to the Pelvis.

Sensors (Basel). 2021-12-1

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