Implementation of a Quality Improvement Project to Increase Access to Dietitian Services for Patients With Gastrointestinal Cancer in a Safety-Net Hospital System

Predicting and comparing the long-term impact of lifestyle interventions on individuals with eating disorders in active population: a machine learning evaluation

Objective

This study aims to evaluate and predict the long-term effectiveness of five lifestyle interventions for individuals with eating disorders using machine learning techniques.

Methods

This study, conducted at Dr. Irandoust's Health Center at Qazvin from August 2021 to August 2023, aimed to evaluate the effects of five lifestyle interventions on individuals with eating disorders, initially diagnosed using The Eating Disorder Diagnostic Scale (EDDS). The interventions were: (1) Counseling, exercise, and dietary regime, (2) Aerobic exercises with dietary regime, (3) Walking and dietary regime, (4) Exercise with a flexible diet, and (5) Exercises through online programs and applications. Out of 955 enrolled participants, 706 completed the study, which measured Body Fat Percentage (BFP), Waist-Hip Ratio (WHR), Fasting Blood Sugar (FBS), Low-Density Lipoprotein (LDL) Cholesterol, Total Cholesterol (CHO), Weight, and Triglycerides (TG) at baseline, during, and at the end of the intervention. Random Forest and Gradient Boosting Regressors, following feature engineering, were used to analyze the data, focusing on the interventions' long-term effectiveness on health outcomes related to eating disorders.

Results

Feature engineering with Random Forest and Gradient Boosting Regressors, respectively, reached an accuracy of 85 and 89%, then 89 and 90% after dataset balancing. The interventions were ranked based on predicted effectiveness: counseling with exercise and dietary regime, aerobic exercises with dietary regime, walking with dietary regime, exercise with a flexible diet, and exercises through online programs.

Conclusion

The results show that Machine Learning (ML) models effectively predicted the long-term effectiveness of lifestyle interventions. The current study suggests a significant potential for tailored health strategies. This emphasizes the most effective interventions for individuals with eating disorders. According to the results, it can also be suggested to expand demographics and geographic locations of participants, longer study duration, exploring advanced machine learning techniques, and including psychological and social adherence factors. Ultimately, these results can guide healthcare providers and policymakers in creating targeted lifestyle intervention strategies, emphasizing personalized health plans, and leveraging machine learning for predictive healthcare solutions.

Nutrition care is an integral part of patient-centred medical care: a European consensus

While healthcare is becoming more patient-centred, evidence-based nutrition interventions are still not accessible to all patients with cancer. As nutrition interventions directly improve clinical and socioeconomic outcomes, patient-centred care is not complete without nutrition care. While awareness of the negative impact of malnutrition on clinical outcomes, quality of life, and functional and emotional wellbeing in cancer is growing, there is relatively poor awareness amongst patients, clinicians, policymakers, and payers that nutrition interventions -particularly those begun in the early stages of the disease course- are an effective method for improving such outcomes. The European Beating Cancer Plan recognises the need for a holistic approach to cancer but lacks actionable recommendations to implement integrated nutrition cancer care at member state level. When considering nutrition care as a human right, the impact on quality of life and functional status must be prioritized, as these may be equally as important to patients, especially in advanced cancer where improvements in clinical outcomes such as survival or tumour burden may not be attainable. We formulate actions needed at the regional and the European level to ensure integrated nutrition care for all patients with cancer. The 4 main Take Home Messages are as follows: 1. The goals of Europe's Beating Cancer Plan cannot be achieved without integrating nutrition across the cancer care continuum. 2. Malnutrition negatively impacts clinical outcomes and has socioeconomic consequences for patients and healthcare systems. 3. Championing integrating nutrition care into cancer care is therefore the duty and ethical responsibility of clinicians (Hippocratic Oath-primum non nocere) and 4. Nutrition care is a cost effective, evidence-based therapy.