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Sufian MA, Hamzi W, Zaman S, Alsadder L, Hamzi B, Varadarajan J, Azad MAK. Enhancing Clinical Validation for Early Cardiovascular Disease Prediction through Simulation, AI, and Web Technology. Diagnostics (Basel) 2024; 14:1308. [PMID: 38928723 PMCID: PMC11202579 DOI: 10.3390/diagnostics14121308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/10/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
Cardiovascular diseases (CVDs) remain a major global health challenge and a leading cause of mortality, highlighting the need for improved predictive models. We introduce an innovative agent-based dynamic simulation technique that enhances our AI models' capacity to predict CVD progression. This method simulates individual patient responses to various cardiovascular risk factors, improving prediction accuracy and detail. Also, by incorporating an ensemble learning model and interface of web application in the context of CVD prediction, we developed an AI dashboard-based model to enhance the accuracy of disease prediction and provide a user-friendly app. The performance of traditional algorithms was notable, with Ensemble learning and XGBoost achieving accuracies of 91% and 95%, respectively. A significant aspect of our research was the integration of these models into a streamlit-based interface, enhancing user accessibility and experience. The streamlit application achieved a predictive accuracy of 97%, demonstrating the efficacy of combining advanced AI techniques with user-centered web applications in medical prediction scenarios. This 97% confidence level was evaluated by Brier score and calibration curve. The design of the streamlit application facilitates seamless interaction between complex ML models and end-users, including clinicians and patients, supporting its use in real-time clinical settings. While the study offers new insights into AI-driven CVD prediction, we acknowledge limitations such as the dataset size. In our research, we have successfully validated our predictive proposed methodology against an external clinical setting, demonstrating its robustness and accuracy in a real-world fixture. The validation process confirmed the model's efficacy in the early detection of CVDs, reinforcing its potential for integration into clinical workflows to aid in proactive patient care and management. Future research directions include expanding the dataset, exploring additional algorithms, and conducting clinical trials to validate our findings. This research provides a valuable foundation for future studies, aiming to make significant strides against CVDs.
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Affiliation(s)
- Md Abu Sufian
- IVR Low-Carbon Research Institute, Chang’an University, Xi’an 710018, China;
- School of Computing and Mathematical Sciences, University of Leicester, Leicester LE1 7RH, UK
| | - Wahiba Hamzi
- Laboratoire de Biotechnologie Santé et Environnement, Department of Biology, University of Blida, Blida 09000, Algeria;
| | - Sadia Zaman
- Department of Physiology, Queen Mary University, London E1 4NS, UK; (S.Z.); (L.A.)
| | - Lujain Alsadder
- Department of Physiology, Queen Mary University, London E1 4NS, UK; (S.Z.); (L.A.)
| | - Boumediene Hamzi
- Department of Computing and Mathematical Sciences, California Institute of Technology, Caltech, CA 91125, USA;
- The Alan Turing Institute, London NW1 2DB, UK
- Department of Mathematics, Gulf University for Science and Technology (GUST), Mubarak Al-Abdullah 32093, Kuwait
| | - Jayasree Varadarajan
- Centre for Digital Innovation, Manchester Metropolitan University, Manchester M15 6BH, UK;
| | - Md Abul Kalam Azad
- Department of Medicine, Rangpur Medical College and Hospital, Rangpur 5400, Bangladesh
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Khagi B, Belousova T, Short CM, Taylor A, Nambi V, Ballantyne CM, Bismuth J, Shah DJ, Brunner G. A machine learning-based approach to identify peripheral artery disease using texture features from contrast-enhanced magnetic resonance imaging. Magn Reson Imaging 2024; 106:31-42. [PMID: 38065273 DOI: 10.1016/j.mri.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/30/2023] [Accepted: 11/30/2023] [Indexed: 01/12/2024]
Abstract
Diagnosing and assessing the risk of peripheral artery disease (PAD) has long been a focal point for medical practitioners. The impaired blood circulation in PAD patients results in altered microvascular perfusion patterns in the calf muscles which is the primary location of intermittent claudication pain. Consequently, we hypothesized that changes in perfusion and increase in connective tissue could lead to alterations in the appearance or texture patterns of the skeletal calf muscles, as visualized with non-invasive imaging techniques. We designed an automatic pipeline for textural feature extraction from contrast-enhanced magnetic resonance imaging (CE-MRI) scans and used the texture features to train machine learning models to detect the heterogeneity in the muscle pattern among PAD patients and matched controls. CE-MRIs from 36 PAD patients and 20 matched controls were used for preparing training and testing data at a 7:3 ratio with cross-validation (CV) techniques. We employed feature arrangement and selection methods to optimize the number of features. The proposed method achieved a peak accuracy of 94.11% and a mean testing accuracy of 84.85% in a 2-class classification approach (controls vs. PAD). A three-class classification approach was performed to identify a high-risk PAD sub-group which yielded an average test accuracy of 83.23% (matched controls vs. PAD without diabetes vs. PAD with diabetes). Similarly, we obtained 78.60% average accuracy among matched controls, PAD treadmill exercise completers, and PAD exercise treadmill non-completers. Machine learning and imaging-based texture features may be of interest in the study of lower extremity ischemia.
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Affiliation(s)
- Bijen Khagi
- Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Tatiana Belousova
- Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | - Christina M Short
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Addison Taylor
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Vijay Nambi
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Christie M Ballantyne
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Jean Bismuth
- Division of Vascular Surgery, USF Health Morsani School of Medicine, Tampa, FL, USA
| | - Dipan J Shah
- Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | - Gerd Brunner
- Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA, USA; Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
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Ogunpola A, Saeed F, Basurra S, Albarrak AM, Qasem SN. Machine Learning-Based Predictive Models for Detection of Cardiovascular Diseases. Diagnostics (Basel) 2024; 14:144. [PMID: 38248021 PMCID: PMC10813849 DOI: 10.3390/diagnostics14020144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/21/2023] [Accepted: 12/25/2023] [Indexed: 01/23/2024] Open
Abstract
Cardiovascular diseases present a significant global health challenge that emphasizes the critical need for developing accurate and more effective detection methods. Several studies have contributed valuable insights in this field, but it is still necessary to advance the predictive models and address the gaps in the existing detection approaches. For instance, some of the previous studies have not considered the challenge of imbalanced datasets, which can lead to biased predictions, especially when the datasets include minority classes. This study's primary focus is the early detection of heart diseases, particularly myocardial infarction, using machine learning techniques. It tackles the challenge of imbalanced datasets by conducting a comprehensive literature review to identify effective strategies. Seven machine learning and deep learning classifiers, including K-Nearest Neighbors, Support Vector Machine, Logistic Regression, Convolutional Neural Network, Gradient Boost, XGBoost, and Random Forest, were deployed to enhance the accuracy of heart disease predictions. The research explores different classifiers and their performance, providing valuable insights for developing robust prediction models for myocardial infarction. The study's outcomes emphasize the effectiveness of meticulously fine-tuning an XGBoost model for cardiovascular diseases. This optimization yields remarkable results: 98.50% accuracy, 99.14% precision, 98.29% recall, and a 98.71% F1 score. Such optimization significantly enhances the model's diagnostic accuracy for heart disease.
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Affiliation(s)
- Adedayo Ogunpola
- DAAI Research Group, College of Computing and Digital Technology, Birmingham City University, Birmingham B4 7XG, UK; (A.O.); (S.B.)
| | - Faisal Saeed
- DAAI Research Group, College of Computing and Digital Technology, Birmingham City University, Birmingham B4 7XG, UK; (A.O.); (S.B.)
| | - Shadi Basurra
- DAAI Research Group, College of Computing and Digital Technology, Birmingham City University, Birmingham B4 7XG, UK; (A.O.); (S.B.)
| | - Abdullah M. Albarrak
- Computer Science Department, College of Computer and Information Sciences, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 11432, Saudi Arabia; (A.M.A.); (S.N.Q.)
| | - Sultan Noman Qasem
- Computer Science Department, College of Computer and Information Sciences, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 11432, Saudi Arabia; (A.M.A.); (S.N.Q.)
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Gakovic B, Neskovic SA, Vranic I, Grujicic K, Mijatovic S, Ljubojevic A, Stankovic I. The relationship of diagonal earlobe crease (Frank's sign) and obstructive coronary artery disease in patients undergoing coronary angiography. Wien Klin Wochenschr 2023; 135:667-673. [PMID: 37902857 DOI: 10.1007/s00508-023-02297-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/01/2023] [Indexed: 11/01/2023]
Abstract
BACKGROUND Traditional risk factors for cardiovascular disease (CVD) play an important role in the clinical evaluation of patients with symptoms suggestive of coronary artery disease (CAD). The utility of the diagonal earlobe crease (DELC) in predicting the presence of CAD is controversial. PURPOSE To investigate the association between DELC, traditional CVD risk factors, and obstructive CAD. METHODS This prospective study included 1377 patients (mean age 65 ± 10 years, 64% male) who underwent invasive coronary angiography for suspected acute or chronic coronary syndromes. In addition to routine clinical assessment, all patients underwent visual examination of both earlobes for the presence of DELC. All assessments were made by three independent readers, with a majority vote in the case of disagreement. Obstructive CAD was defined by invasive coronary angiography as > 50% stenosis of the left main coronary artery or > 70% stenosis in any other major epicardial coronary artery. RESULTS Bilateral DELC was observed more frequently in patients with obstructive CAD than in those without it (67% vs. 33%, p = 0.022). In the multivariate logistic regression model, bilateral DELC was independently associated with CAD (odds ratio [OR] 1.36, 95% confidence interval [CI] 1.07-1.74), along with smoking (OR 1.86, 95% CI 1.44-2.38), diabetes mellitus (OR 1.67, 95% CI 1.29-2.15), male sex (OR 2.04, 95% CI 1.61-2.58), and dyslipidemia (OR 1.54, 95% CI 1.12-2.30); however, the diagnostic accuracy of DELC was modest and resembled that of traditional CVD risk factors. CONCLUSION Despite being independently associated with obstructive CAD, DELC is not a reliable stand-alone clinical marker of CAD due to modest diagnostic accuracy.
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Affiliation(s)
- Branka Gakovic
- Department of Cardiology, Clinical Hospital Centre Zemun, Belgrade, Serbia.
| | | | - Ivona Vranic
- Department of Cardiology, Clinical Hospital Centre Zemun, Belgrade, Serbia
| | - Katarina Grujicic
- Department of Cardiology, Clinical Hospital Centre Zemun, Belgrade, Serbia
| | - Stefan Mijatovic
- Department of Cardiology, Clinical Hospital Centre Zemun, Belgrade, Serbia
| | | | - Ivan Stankovic
- Department of Cardiology, Clinical Hospital Centre Zemun, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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