A Prediction Model for Detecting Developmental Disabilities in Preschool-Age Children Through Digital Biomarker-Driven Deep Learning in Serious Games: Development Study

Comprehensive Assessment and Early Prediction of Gross Motor Performance in Toddlers With Graph Convolutional Networks-Based Deep Learning: Development and Validation Study

BACKGROUND

Accurate and timely assessment of children's developmental status is crucial for early diagnosis and intervention. More accurate and automated developmental assessments are essential due to the lack of trained health care providers and imprecise parental reporting. In various areas of development, gross motor development in toddlers is known to be predictive of subsequent childhood developments.

OBJECTIVE

The purpose of this study was to develop a model to assess gross motor behavior and integrate the results to determine the overall gross motor status of toddlers. This study also aimed to identify behaviors that are important in the assessment of overall gross motor skills and detect critical moments and important body parts for the assessment of each behavior.

METHODS

We used behavioral videos of toddlers aged 18-35 months. To assess gross motor development, we selected 4 behaviors (climb up the stairs, go down the stairs, throw the ball, and stand on 1 foot) that have been validated with the Korean Developmental Screening Test for Infants and Children. In the child behavior videos, we estimated each child's position as a bounding box and extracted human keypoints within the box. In the first stage, the videos with the extracted human keypoints of each behavior were evaluated separately using a graph convolutional networks (GCN)-based algorithm. The probability values obtained for each label in the first-stage model were used as input for the second-stage model, the extreme gradient boosting (XGBoost) algorithm, to predict the overall gross motor status. For interpretability, we used gradient-weighted class activation mapping (Grad-CAM) to identify important moments and relevant body parts during the movements. The Shapley additive explanations method was used for the assessment of variable importance, to determine the movements that contributed the most to the overall developmental assessment.

RESULTS

Behavioral videos of 4 gross motor skills were collected from 147 children, resulting in a total of 2395 videos. The stage-1 GCN model to evaluate each behavior had an area under the receiver operating characteristic curve (AUROC) of 0.79 to 0.90. Keypoint-mapping Grad-CAM visualization identified important moments in each behavior and differences in important body parts. The stage-2 XGBoost model to assess the overall gross motor status had an AUROC of 0.90. Among the 4 behaviors, "go down the stairs" contributed the most to the overall developmental assessment.

CONCLUSIONS

Using movement videos of toddlers aged 18-35 months, we developed objective and automated models to evaluate each behavior and assess each child's overall gross motor performance. We identified the important behaviors for assessing gross motor performance and developed methods to recognize important moments and body parts while evaluating gross motor performance.

Optimization of the game improvement and data analysis model for the early childhood education major via deep learning

An ever-growing portion of the economy is dedicated to the field of education, intensifying the urgency of identifying strategies to secure the sector's enduring prosperity and elevate educational standards universally. This study introduces a model for enhancing games and optimizing data analysis within the context of early childhood education (ECE) majors, hinging on deep learning (DL). This approach aims to enhance the quality of instruction provided to ECE majors and refine the effectiveness of their professional pursuits. This study commences by examining the incorporation of DL technologies within the domain of ECE and delving into their fundamental underpinnings. Subsequently, it expounds upon the design philosophy underpinning ECE games operating within the framework of DL. Finally, it outlines the game improvement and data analysis (GIADA) model tailored to ECE majors. This model is constructed upon DL technology and further refined through the integration of convolutional neural networks (CNN). Empirical findings corroborate that the DL-CNN GIADA model achieves data analysis accuracy ranging from 83 to 93% across four datasets, underscoring the pronounced optimization prowess bestowed by CNN within the DL-based GIADA model. This study stands as an invaluable reference for the application and evolution of artificial intelligence technology within the realm of education, thereby contributing substantively to the broader landscape of educational advancement.

Big data, machine learning, and population health: predicting cognitive outcomes in childhood

The application of machine learning (ML) to address population health challenges has received much less attention than its application in the clinical setting. One such challenge is addressing disparities in early childhood cognitive development-a complex public health issue rooted in the social determinants of health, exacerbated by inequity, characterised by intergenerational transmission, and which will continue unabated without novel approaches to address it. Early life, the period of optimal neuroplasticity, presents a window of opportunity for early intervention to improve cognitive development. Unfortunately for many, this window will be missed, and intervention may never occur or occur only when overt signs of cognitive delay manifest. In this review, we explore the potential value of ML and big data analysis in the early identification of children at risk for poor cognitive outcome, an area where there is an apparent dearth of research. We compare and contrast traditional statistical methods with ML approaches, provide examples of how ML has been used to date in the field of neurodevelopmental disorders, and present a discussion of the opportunities and risks associated with its use at a population level. The review concludes by highlighting potential directions for future research in this area. IMPACT: To date, the application of machine learning to address population health challenges in paediatrics lags behind other clinical applications. This review provides an overview of the public health challenge we face in addressing disparities in childhood cognitive development and focuses on the cornerstone of early intervention. Recent advances in our ability to collect large volumes of data, and in analytic capabilities, provide a potential opportunity to improve current practices in this field. This review explores the potential role of machine learning and big data analysis in the early identification of children at risk for poor cognitive outcomes.

Digital Biomarkers for Well-being Through Exergame Interactions: Exploratory Study

Background

Ecologically valid evaluations of patient states or well-being by means of new technologies is a key issue in contemporary research in health and well-being of the aging population. The in-game metrics generated from the interaction of users with serious games (SG) can potentially be used to predict or characterize a user’s state of health and well-being. There is currently an increasing body of research that investigates the use of measures of interaction with games as digital biomarkers for health and well-being.

Objective

The aim of this paper is to predict well-being digital biomarkers from data collected during interactions with SG, using the values of standard clinical assessment tests as ground truth.

Methods

The data set was gathered during the interaction with patients with Parkinson disease with the webFitForAll exergame platform, an SG engine designed to promote physical activity among older adults, patients, and vulnerable populations. The collected data, referred to as in-game metrics, represent the body movements captured by a 3D sensor camera and translated into game analytics. Standard clinical tests gathered before and after the long-term interaction with exergames (preintervention test vs postintervention test) were used to provide user baselines.

Results

Our results showed that in-game metrics can effectively categorize participants into groups of different cognitive and physical states. Different in-game metrics have higher descriptive values for specific tests and can be used to predict the value range for these tests.

Conclusions

Our results provide encouraging evidence for the value of in-game metrics as digital biomarkers and can boost the analysis of improving in-game metrics to obtain more detailed results.

Deep Learning-Based Mental Health Model on Primary and Secondary School Students’ Quality Cultivation

The purpose was to timely identify the mental disorders (MDs) of students receiving primary and secondary education (PSE) (PSE students) and improve their mental quality. Firstly, this work analyzes the research status of the mental health model (MHM) and the main contents of PSE student-oriented mental health quality cultivation under deep learning (DL). Secondly, an MHM is implemented based on big data technology (BDT) and the convolutional neural network (CNN). Simultaneously, the long short-term memory (LSTM) is introduced to optimize the proposed MHM. Finally, the performance of the MHM before and after optimization is evaluated, and the PSE student-oriented mental health quality training strategy based on the proposed MHM is offered. The results show that the accuracy curve is higher than the recall curve in all classification algorithms. The maximum recall rate is 0.58, and the minimum accuracy rate is 0.62. The decision tree (DT) algorithm has the best comprehensive performance among the five different classification algorithms, with accuracy of 0.68, recall rate of 0.58, and F1-measure of 0.69. Thus, the DT algorithm is selected as the classifier. The proposed MHM can identify 56% of students with MDs before optimization. After optimization, the accuracy is improved by 0.03. The recall rate is improved by 0.19, the F1-measure is improved by 0.05, and 75% of students with MDs can be identified. Diverse behavior data can improve the recognition effect of students' MDs. Meanwhile, from the 60th iteration, the mode accuracy and loss tend to be stable. By comparison, batch_size has little influence on the experimental results. The number of convolution kernels of the first convolution layer has little influence. The proposed MHM based on DL and CNN will indirectly improve the mental health quality of PSE students. The research provides a reference for cultivating the mental health quality of PSE students.

Applications of deep learning methods in digital biomarker research using noninvasive sensing data

Introduction: Noninvasive digital biomarkers are critical elements in digital healthcare in terms of not only the ease of measurement but also their use of raw data. In recent years, deep learning methods have been put to use to analyze these diverse heterogeneous data; these methods include representation learning for feature extraction and supervised learning for the prediction of these biomarkers. Methods: We introduce clinical cases of digital biomarkers and various deep-learning methods applied according to each data type. In addition, deep learning methods for the integrated analysis of multidimensional heterogeneous data are introduced, and the utility of these data as an integrated digital biomarker is presented. The current status of digital biomarker research is examined by surveying research cases applied to various types of data as well as modeling methods. Results: We present a future research direction for using data from heterogeneous sources together by introducing deep learning methods for dimensionality reduction and mode integration from multimodal digital biomarker studies covering related domains. The integration of multimodality has led to advances in research through the improvement of performance and complementarity between modes. Discussion: The integrative digital biomarker will be more useful for research on diseases that require data from multiple sources to be treated together. Since delicate signals from patients are not missed and the interaction effects between signals are also considered, it will be helpful for immediate detection and more accurate prediction of symptoms.

Digital Biomarkers in Living Labs for Vulnerable and Susceptible Individuals: An Integrative Literature Review

PURPOSE

The study aimed to identify which digital biomarkers are collected and which specific devices are used according to vulnerable and susceptible individual characteristics in a living-lab setting.

MATERIALS AND METHODS

A literature search, screening, and appraisal process was implemented using the Web of Science, Pubmed, and Embase databases. The search query included a combination of terms related to "digital biomarkers," "devices that collect digital biomarkers," and "vulnerable and susceptible groups." After the screening and appraisal process, a total of 37 relevant articles were obtained.

RESULTS

In elderly people, the main digital biomarkers measured were values related to physical activity. Most of the studies used sensors. The articles targeting children aimed to predict diseases, and most of them used devices that are simple and can induce some interest, such as wearable device-based smart toys. In those who were disabled, digital biomarkers that measured location-based movement for the purpose of diagnosing disabilities were widely used, and most were measured by easy-to-use devices that did not require detailed explanations. In the disadvantaged, digital biomarkers related to health promotion were measured, and various wearable devices, such as smart bands and headbands were used depending on the purpose and target.

CONCLUSION

As the digital biomarkers and devices that collect them vary depending on the characteristics of study subjects, researchers should pay attention not only to the purpose of the study but also the characteristics of study subjects when collecting and analyzing digital biomarkers from living labs.