Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan.
Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Sci Rep. 2024 Sep 11;14(1):21273. doi: 10.1038/s41598-024-72206-4.
This study investigated whether machine learning (ML) has better predictive accuracy than logistic regression analysis (LR) for gait independence at discharge in subacute stroke patients (n = 843) who could not walk independently at admission. We developed prediction models using LR and five ML algorithms-specifically, the decision tree (DT), support vector machine, artificial neural network, ensemble learning, and k-nearest neighbor methods. Functional Independence Measure sub-items were used to evaluate the ability to walk independently. Model predictive accuracies were evaluated using areas under receiver operating characteristic curves (AUCs) as well as accuracy, precision, recall, F1 score, and specificity. The AUC for DT (0.812) was significantly lower than those for the other algorithms (p < 0.01); however, the AUC for LR (0.895) did not differ significantly from those for the other models (0.893-0.903). Other performance metrics showed no substantial differences between LR and ML algorithms. In conclusion, the DT algorithm had significantly low predictive accuracy, and LR showed no significant difference in predictive accuracy compared with the other ML algorithms. As its predictive accuracy is similar to that of ML, LR can continue to be used for predicting the prognosis of gait independence, with additional advantages of being easily understandable and manually computable.
本研究旨在探讨在不能独立行走入院的亚急性脑卒中患者(n=843)中,机器学习(ML)是否比逻辑回归分析(LR)在出院时步态独立性方面具有更好的预测准确性。我们使用 LR 和五种 ML 算法(决策树(DT)、支持向量机、人工神经网络、集成学习和 K 最近邻方法)开发了预测模型。使用功能独立性测量的子项来评估独立行走的能力。使用接收者操作特征曲线下的面积(AUC)以及准确性、精度、召回率、F1 得分和特异性来评估模型的预测准确性。DT(0.812)的 AUC 明显低于其他算法(p<0.01);然而,LR(0.895)的 AUC 与其他模型(0.893-0.903)没有显著差异。其他性能指标在 LR 和 ML 算法之间没有显示出显著差异。总之,DT 算法的预测准确性明显较低,而 LR 与其他 ML 算法相比,在预测准确性方面没有显著差异。由于其预测准确性与 ML 相似,LR 可以继续用于预测步态独立性的预后,并且具有易于理解和手动计算的额外优势。