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Hossain MZ, Daskalaki E, Brüstle A, Desborough J, Lueck CJ, Suominen H. The role of machine learning in developing non-magnetic resonance imaging based biomarkers for multiple sclerosis: a systematic review. BMC Med Inform Decis Mak 2022; 22:242. [PMID: 36109726 PMCID: PMC9476596 DOI: 10.1186/s12911-022-01985-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 09/02/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Multiple sclerosis (MS) is a neurological condition whose symptoms, severity, and progression over time vary enormously among individuals. Ideally, each person living with MS should be provided with an accurate prognosis at the time of diagnosis, precision in initial and subsequent treatment decisions, and improved timeliness in detecting the need to reassess treatment regimens. To manage these three components, discovering an accurate, objective measure of overall disease severity is essential. Machine learning (ML) algorithms can contribute to finding such a clinically useful biomarker of MS through their ability to search and analyze datasets about potential biomarkers at scale. Our aim was to conduct a systematic review to determine how, and in what way, ML has been applied to the study of MS biomarkers on data from sources other than magnetic resonance imaging.
Methods
Systematic searches through eight databases were conducted for literature published in 2014–2020 on MS and specified ML algorithms.
Results
Of the 1, 052 returned papers, 66 met the inclusion criteria. All included papers addressed developing classifiers for MS identification or measuring its progression, typically, using hold-out evaluation on subsets of fewer than 200 participants with MS. These classifiers focused on biomarkers of MS, ranging from those derived from omics and phenotypical data (34.5% clinical, 33.3% biological, 23.0% physiological, and 9.2% drug response). Algorithmic choices were dependent on both the amount of data available for supervised ML (91.5%; 49.2% classification and 42.3% regression) and the requirement to be able to justify the resulting decision-making principles in healthcare settings. Therefore, algorithms based on decision trees and support vector machines were commonly used, and the maximum average performance of 89.9% AUC was found in random forests comparing with other ML algorithms.
Conclusions
ML is applicable to determining how candidate biomarkers perform in the assessment of disease severity. However, applying ML research to develop decision aids to help clinicians optimize treatment strategies and analyze treatment responses in individual patients calls for creating appropriate data resources and shared experimental protocols. They should target proceeding from segregated classification of signals or natural language to both holistic analyses across data modalities and clinically-meaningful differentiation of disease.
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Brew-Sam N, Parkinson A, Lueck C, Brown E, Brown K, Bruestle A, Chisholm K, Collins S, Cook M, Daskalaki E, Drew J, Ebbeck H, Elisha M, Fanning V, Henschke A, Herron J, Matthews E, Murugappan K, Neshev D, Nolan CJ, Pedley L, Phillips C, Suominen H, Tricoli A, Wright K, Desborough J. The current understanding of precision medicine and personalised medicine in selected research disciplines: study protocol of a systematic concept analysis. BMJ Open 2022; 12:e060326. [PMID: 36691172 PMCID: PMC9454080 DOI: 10.1136/bmjopen-2021-060326] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 08/08/2022] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION The terms 'precision medicine' and 'personalised medicine' have become key terms in health-related research and in science-related public communication. However, the application of these two concepts and their interpretation in various disciplines are heterogeneous, which also affects research translation and public awareness. This leads to confusion regarding the use and distinction of the two concepts. Our aim is to provide a snapshot of the current understanding of these concepts. METHODS AND ANALYSIS Our study will use Rodgers' evolutionary concept analysis to systematically examine the current understanding of the concepts 'precision medicine' and 'personalised medicine' in clinical medicine, biomedicine (incorporating genomics and bioinformatics), health services research, physics, chemistry, engineering, machine learning and artificial intelligence, and to identify their respective attributes (clusters of characteristics) and surrogate and related terms. A systematic search of the literature will be conducted for 2016-2022 using databases relevant to each of these disciplines: ACM Digital Library, CINAHL, Cochrane Library, F1000Research, IEEE Xplore, PubMed/Medline, Science Direct, Scopus and Web of Science. These are among the most representative databases for the included disciplines. We will examine similarities and differences in definitions of 'precision medicine' and 'personalised medicine' in the respective disciplines and across (sub)disciplines, including attributes of each term. This will enable us to determine how these two concepts are distinguished. ETHICS AND DISSEMINATION Following ethical and research standards, we will comprehensively report the methodology for a systematic analysis following Rodgers' concept analysis method. Our systematic concept analysis will contribute to the clarification of the two concepts and distinction in their application in given settings and circumstances. Such a broad concept analysis will contribute to non-systematic syntheses of the concepts, or occasional systematic reviews on one of the concepts that have been published in specific disciplines, in order to facilitate interdisciplinary communication, translational medical research and implementation science.
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Affiliation(s)
- Nicola Brew-Sam
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Anne Parkinson
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Christian Lueck
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
- Department of Neurology, Canberra Health Services, Canberra, Australian Capital Territory, Australia
| | - Ellen Brown
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Karen Brown
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
- The Centenary Hospital for Women and Children, Canberra Health Services, Canberra, Australian Capital Territory, Australia
| | - Anne Bruestle
- The John Curtin School of Medical Research, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Katrina Chisholm
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Simone Collins
- The Centenary Hospital for Women and Children, Canberra Health Services, Canberra, Australian Capital Territory, Australia
| | - Matthew Cook
- The John Curtin School of Medical Research, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Eleni Daskalaki
- School of Computing, College of Engineering and Computer Science, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Janet Drew
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Harry Ebbeck
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Mark Elisha
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Vanessa Fanning
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Adam Henschke
- Department of Philosophy, University of Twente, Enschede, Overijssel, The Netherlands
| | - Jessica Herron
- The Centenary Hospital for Women and Children, Canberra Health Services, Canberra, Australian Capital Territory, Australia
| | - Emma Matthews
- The Centenary Hospital for Women and Children, Canberra Health Services, Canberra, Australian Capital Territory, Australia
| | - Krishnan Murugappan
- Nanotechnology Research Lab, Research School of Chemistry, College of Science, Australian National University, Canberra, Australian Capital Territory, Australia
- CSIRO, Mineral Resources, Clayton South, Victoria, Australia
| | - Dragomir Neshev
- Department of Electronic Materials Engineering, Research School of Physics, College of Science, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Christopher J Nolan
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
- The John Curtin School of Medical Research, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
- Department of Endocrinology and Diabetes, Canberra Health Services, Canberra, Australian Capital Territory, Australia
| | - Lachlan Pedley
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Christine Phillips
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Hanna Suominen
- School of Computing, College of Engineering and Computer Science, Australian National University, Canberra, Australian Capital Territory, Australia
- Department of Computing, University of Turku, Turku, Finland
| | - Antonio Tricoli
- Nanotechnology Research Lab, Research School of Chemistry, College of Science, Australian National University, Canberra, Australian Capital Territory, Australia
- Nanotechnology Research Laboratory, Faculty of Engineering, The University of Sydney, Sydney, New South Wales, Australia
| | - Kristine Wright
- The Centenary Hospital for Women and Children, Canberra Health Services, Canberra, Australian Capital Territory, Australia
| | - Jane Desborough
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
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