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Gómez-Valadés A, Martínez R, Rincón M. Designing an effective semantic fluency test for early MCI diagnosis with machine learning. Comput Biol Med 2024; 180:108955. [PMID: 39153392 DOI: 10.1016/j.compbiomed.2024.108955] [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: 04/11/2024] [Revised: 07/04/2024] [Accepted: 07/26/2024] [Indexed: 08/19/2024]
Abstract
Semantic fluency tests are one of the key tests used in batteries for the early detection of Mild Cognitive Impairment (MCI) as the impairment in speech and semantic memory are among the first symptoms, attracting the attention of a large number of studies. Several new semantic categories and variables capable of providing complementary information of clinical interest have been proposed to increase their effectiveness. However, this also extends the time required to complete all tests and get the overall diagnosis. Therefore, there is a need to reduce the number of tests in the batteries and thus the time spent on them while maintaining or increasing their effectiveness. This study used machine learning methods to determine the smallest and most efficient combination of semantic categories and variables to achieve this goal. We utilized a database containing 423 assessments from 141 subjects, with each subject having undergone three assessments spaced approximately one year apart. Subjects were categorized into three diagnostic groups: Healthy (if diagnosed as healthy in all three assessments), stable MCI (consistently diagnosed as MCI), and heterogeneous MCI (when exhibiting alternations between healthy and MCI diagnoses across assessments). We obtained that the most efficient combination to distinguish between these categories of semantic fluency tests included the animals and clothes semantic categories with the variables corrects, switching, clustering, and total clusters. This combination is ideal for scenarios that require a balance between time efficiency and diagnosis capability, such as population-based screenings.
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Affiliation(s)
- Alba Gómez-Valadés
- Universidad Nacional de Educación a Distancia, Madrid, 28040, Comunidad Autónoma de Madrid, Spain(1).
| | - Rafael Martínez
- Universidad Nacional de Educación a Distancia, Madrid, 28040, Comunidad Autónoma de Madrid, Spain(1).
| | - Mariano Rincón
- Universidad Nacional de Educación a Distancia, Madrid, 28040, Comunidad Autónoma de Madrid, Spain(1).
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2
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Leiser F, Rank S, Schmidt-Kraepelin M, Thiebes S, Sunyaev A. Medical informed machine learning: A scoping review and future research directions. Artif Intell Med 2023; 145:102676. [PMID: 37925206 DOI: 10.1016/j.artmed.2023.102676] [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: 12/16/2022] [Revised: 06/15/2023] [Accepted: 10/02/2023] [Indexed: 11/06/2023]
Abstract
Combining domain knowledge (DK) and machine learning is a recent research stream to overcome multiple issues like limited explainability, lack of data, and insufficient robustness. Most approaches applying informed machine learning (IML), however, are customized to solve one specific problem. This study analyzes the status of IML in medicine by conducting a scoping literature review based on an existing taxonomy. We identified 177 papers and analyzed them regarding the used DK, the implemented machine learning model, and the motives for performing IML. We find an immense role of expert knowledge and image data in medical IML. We then provide an overview and analysis of recent approaches and supply five directions for future research. This review can help develop future medical IML approaches by easily referencing existing solutions and shaping future research directions.
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Affiliation(s)
- Florian Leiser
- Department of Economics and Management, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Sascha Rank
- Department of Economics and Management, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | | | - Scott Thiebes
- Department of Economics and Management, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Ali Sunyaev
- Department of Economics and Management, Karlsruhe Institute of Technology, Karlsruhe, Germany.
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3
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Differential disease diagnoses of epistaxis based on dynamic uncertain causality graph. Eur Arch Otorhinolaryngol 2023; 280:1731-1740. [PMID: 36271164 DOI: 10.1007/s00405-022-07674-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/21/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Epistaxis is a common symptom and can be caused by various diseases, including nasal diseases, systemic diseases, etc. Many misdiagnosis and missed diagnosis of epistaxis are caused by lack of clinical knowledge and experience, especially some interns and the clinicans in primary hospitals. To help inexperienced clinicans improve their diagnostic accuracies of epistaxis, a computer-aided diagnostic system based on Dynamic Uncertain Causality Graph (DUCG) was designed in this study. METHODS We build a visual epistaxis knowledge base based on medical experts' knowledge and experience. The knowledge base intuitively expresses the causal relationship among diseases, risk factors, symptoms, signs, laboratory checks, and image examinations. The DUCG inference algorithm well addresses the patients' clinical information with the knowledge base to deduce the currently suspected diseases and calculate the probability of each suspected disease. RESULT The model can differentially diagnose 24 diseases with epistaxis as the chief complaint. A third-party verification was performed, and the total diagnostic precision was 97.81%. In addition, the DUCG-based diagnostic model was applied in Jiaozhou city and Zhongxian county, China, covering hundreds of primary hospitals and clinics. So far, the clinicians using the model have all agreed with the diagnostic results. The 432 real-world application cases show that this model is good for the differential diagnoses of epistaxis. CONCLUSION The results show that the DUCG-based epistaxis diagnosis model has high diagnostic accuracy. It can assist primary clinicians in completing the differential diagnosis of epistaxis and can be accepted by clinicians.
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Identifying neurocognitive disorder using vector representation of free conversation. Sci Rep 2022; 12:12461. [PMID: 35922457 PMCID: PMC9349220 DOI: 10.1038/s41598-022-16204-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 07/06/2022] [Indexed: 11/17/2022] Open
Abstract
In recent years, studies on the use of natural language processing (NLP) approaches to identify dementia have been reported. Most of these studies used picture description tasks or other similar tasks to encourage spontaneous speech, but the use of free conversation without requiring a task might be easier to perform in a clinical setting. Moreover, free conversation is unlikely to induce a learning effect. Therefore, the purpose of this study was to develop a machine learning model to discriminate subjects with and without dementia by extracting features from unstructured free conversation data using NLP. We recruited patients who visited a specialized outpatient clinic for dementia and healthy volunteers. Participants’ conversation was transcribed and the text data was decomposed from natural sentences into morphemes by performing a morphological analysis using NLP, and then converted into real-valued vectors that were used as features for machine learning. A total of 432 datasets were used, and the resulting machine learning model classified the data for dementia and non-dementia subjects with an accuracy of 0.900, sensitivity of 0.881, and a specificity of 0.916. Using sentence vector information, it was possible to develop a machine-learning algorithm capable of discriminating dementia from non-dementia subjects with a high accuracy based on free conversation.
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Martínez-Florez JF, Osorio JD, Cediel JC, Rivas JC, Granados-Sánchez AM, López-Peláez J, Jaramillo T, Cardona JF. Short-Term Memory Binding Distinguishing Amnestic Mild Cognitive Impairment from Healthy Aging: A Machine Learning Study. J Alzheimers Dis 2021; 81:729-742. [PMID: 33814438 DOI: 10.3233/jad-201447] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Amnestic mild cognitive impairment (aMCI) is the most common preclinical stage of Alzheimer's disease (AD). A strategy to reduce the impact of AD is the early aMCI diagnosis and clinical intervention. Neuroimaging, neurobiological, and genetic markers have proved to be sensitive and specific for the early diagnosis of AD. However, the high cost of these procedures is prohibitive in low-income and middle-income countries (LIMCs). The neuropsychological assessments currently aim to identify cognitive markers that could contribute to the early diagnosis of dementia. OBJECTIVE Compare machine learning (ML) architectures classifying and predicting aMCI and asset the contribution of cognitive measures including binding function in distinction and prediction of aMCI. METHODS We conducted a two-year follow-up assessment of a sample of 154 subjects with a comprehensive multidomain neuropsychological battery. Statistical analysis was proposed using complete ML architectures to compare subjects' performance to classify and predict aMCI. Additionally, permutation importance and Shapley additive explanations (SHAP) routines were implemented for feature importance selection. RESULTS AdaBoost, gradient boosting, and XGBoost had the highest performance with over 80%success classifying aMCI, and decision tree and random forest had the highest performance with over 70%success predictive routines. Feature importance points, the auditory verbal learning test, short-term memory binding tasks, and verbal and category fluency tasks were used as variables with the first grade of importance to distinguish healthy cognition and aMCI. CONCLUSION Although neuropsychological measures do not replace biomarkers' utility, it is a relatively sensitive and specific diagnostic tool for aMCI. Further studies with ML must identify cognitive performance that differentiates conversion from average MCI to the pathological MCI observed in AD.
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Affiliation(s)
| | - Juan D Osorio
- Instituto de Psicología, Universidad del Valle, Santiago de Cali, Colombia
| | - Judith C Cediel
- Instituto de Psicología, Universidad del Valle, Santiago de Cali, Colombia.,Departamento de Estudios Psicológicos, Facultad de Derecho y Ciencias Sociales, Universidad ICESI , Santiago de Cali, Colombia
| | - Juan C Rivas
- Departamento de Psiquiatría, Facultad de Salud, Universidad del Valle, Santiago de Cali, Colombia.,Hospital Departamental Psiquiátrico Universitario del Valle, Santiago de Cali, Colombia.,Departamento de Psiquiatría, Fundación Valle del Lili, Santiago de Cali, Colombia
| | - Ana M Granados-Sánchez
- Departamento de Imágenes Diagnósticas, Fundación Valle del Lili, Santiago de Cali, Colombia
| | | | - Tania Jaramillo
- Instituto de Psicología, Universidad del Valle, Santiago de Cali, Colombia
| | - Juan F Cardona
- Instituto de Psicología, Universidad del Valle, Santiago de Cali, Colombia
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Battista P, Salvatore C, Berlingeri M, Cerasa A, Castiglioni I. Artificial intelligence and neuropsychological measures: The case of Alzheimer's disease. Neurosci Biobehav Rev 2020; 114:211-228. [PMID: 32437744 DOI: 10.1016/j.neubiorev.2020.04.026] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 04/03/2020] [Accepted: 04/23/2020] [Indexed: 12/19/2022]
Abstract
One of the current challenges in the field of Alzheimer's disease (AD) is to identify patients with mild cognitive impairment (MCI) that will convert to AD. Artificial intelligence, in particular machine learning (ML), has established as one of more powerful approach to extract reliable predictors and to automatically classify different AD phenotypes. It is time to accelerate the translation of this knowledge in clinical practice, mainly by using low-cost features originating from the neuropsychological assessment. We performed a meta-analysis to assess the contribution of ML and neuropsychological measures for the automated classification of MCI patients and the prediction of their conversion to AD. The pooled sensitivity and specificity of patients' classifications was obtained by means of a quantitative bivariate random-effect meta-analytic approach. Although a high heterogeneity was observed, the results of meta-analysis show that ML applied to neuropsychological measures can lead to a successful automatic classification, being more specific as screening rather than prognosis tool. Relevant categories of neuropsychological tests can be extracted by ML that maximize the classification accuracy.
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Affiliation(s)
- Petronilla Battista
- Scientific Clinical Institutes Maugeri IRCCS, Institute of Bari, Pavia, Italy.
| | - Christian Salvatore
- Department of Science, Technology and Society, Scuola Universitaria Superiore IUSS Pavia, Piazza della Vittoria 15, 27100 Pavia, Italy; DeepTrace Technologies S.r.l., Via Conservatorio 17, 20122 Milan, Italy.
| | - Manuela Berlingeri
- Department of Humanistic Studies, University of Urbino Carlo Bo, Urbino, Italy; Institute for Biomedical Research and Innovation, National Research Council, 87050 Mangone (CS), Italy; NeuroMi, Milan Centre for Neuroscience, Milan, Italy.
| | - Antonio Cerasa
- Department of Physics "Giuseppe Occhialini", University of Milano Bicocca, Milan, Italy; S. Anna Institute and Research in Advanced Neurorehabilitation (RAN), Crotone, Italy.
| | - Isabella Castiglioni
- Center of Developmental Neuropsychology, Area Vasta 1, ASUR Marche, Pesaro, Italy; Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Segrate, Milan, Italy.
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Sheng B, Huang L, Wang X, Zhuang J, Tang L, Deng C, Zhang Y. Identification of Knee Osteoarthritis Based on Bayesian Network: Pilot Study. JMIR Med Inform 2019; 7:e13562. [PMID: 31322132 PMCID: PMC6670282 DOI: 10.2196/13562] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 05/21/2019] [Accepted: 05/31/2019] [Indexed: 01/13/2023] Open
Abstract
Background Early identification of knee osteoarthritis (OA) can improve treatment outcomes and reduce medical costs. However, there are major limitations among existing classification or prediction models, including abstract data processing and complicated dataset attributes, which hinder their applications in clinical practice. Objective The aim of this study was to propose a Bayesian network (BN)–based classification model to classify people with knee OA. The proposed model can be treated as a prescreening tool, which can provide decision support for health professionals. Methods The proposed model’s structure was based on a 3-level BN structure and then retrained by the Bayesian Search (BS) learning algorithm. The model’s parameters were determined by the expectation-maximization algorithm. The used dataset included backgrounds, the target disease, and predictors. The performance of the model was evaluated based on classification accuracy, area under the curve (AUC), specificity, sensitivity, positive predictive value (PPV), and negative predictive value (NPV); it was also compared with other well-known classification models. A test was also performed to explore whether physical fitness tests could improve the performance of the proposed model. Results A total of 249 elderly people between the ages of 60 and 80 years, living in the Kongjiang community (Shanghai), were recruited from April to September 2007. A total of 157 instances were adopted as the dataset after data preprocessing. The experimental results showed that the results of the proposed model were higher than, or equal to, the mean scores of other classification models: .754 for accuracy, .78 for AUC, .78 for specificity, and .73 for sensitivity. The proposed model provided .45 for PPV and .92 for NPV at the prevalence of 20%. The proposed model also showed a significant improvement when compared with the traditional BN model: 6.3% increase in accuracy (from .709 to .754), 4.0% increase in AUC (from .75 to .78), 6.8% increase in specificity (from .73 to .78), 5.8% increase in sensitivity (from .69 to .73), 15.4% increase in PPV (from .39 to .45), and 2.2% increase in NPV (from .90 to .92). Furthermore, the test results showed that the performance of the proposed model could be largely enhanced through physical fitness tests in 3 evaluation indices: 10.6% increase in accuracy (from .682 to .754), 16.4% increase in AUC (from .67 to .78), and 30.0% increase in specificity (from .60 to .78). Conclusions The proposed model presents a promising method to classify people with knee OA when compared with other classification models and the traditional BN model. It could be implemented in clinical practice as a prescreening tool for knee OA, which would not only improve the quality of health care for elderly people but also reduce overall medical costs.
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Affiliation(s)
- Bo Sheng
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fujian, China.,Department of Mechanical Engineering, The University of Auckland, Auckland, New Zealand
| | - Liang Huang
- Department of Exercise Sciences, The University of Auckland, Auckland, New Zealand
| | - Xiangbin Wang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fujian, China
| | - Jie Zhuang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Lihua Tang
- Department of Mechanical Engineering, The University of Auckland, Auckland, New Zealand
| | - Chao Deng
- School of Mechanical Science and Engineering, Huazhong University of Science and Technology, Wuhan, China
| | - Yanxin Zhang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fujian, China.,Department of Exercise Sciences, The University of Auckland, Auckland, New Zealand.,School of Kinesiology, Shanghai University of Sport, Shanghai, China
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8
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Ding X, Bucholc M, Wang H, Glass DH, Wang H, Clarke DH, Bjourson AJ, Dowey LRC, O'Kane M, Prasad G, Maguire L, Wong-Lin K. A hybrid computational approach for efficient Alzheimer's disease classification based on heterogeneous data. Sci Rep 2018; 8:9774. [PMID: 29950585 PMCID: PMC6021389 DOI: 10.1038/s41598-018-27997-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 06/12/2018] [Indexed: 12/20/2022] Open
Abstract
There is currently a lack of an efficient, objective and systemic approach towards the classification of Alzheimer's disease (AD), due to its complex etiology and pathogenesis. As AD is inherently dynamic, it is also not clear how the relationships among AD indicators vary over time. To address these issues, we propose a hybrid computational approach for AD classification and evaluate it on the heterogeneous longitudinal AIBL dataset. Specifically, using clinical dementia rating as an index of AD severity, the most important indicators (mini-mental state examination, logical memory recall, grey matter and cerebrospinal volumes from MRI and active voxels from PiB-PET brain scans, ApoE, and age) can be automatically identified from parallel data mining algorithms. In this work, Bayesian network modelling across different time points is used to identify and visualize time-varying relationships among the significant features, and importantly, in an efficient way using only coarse-grained data. Crucially, our approach suggests key data features and their appropriate combinations that are relevant for AD severity classification with high accuracy. Overall, our study provides insights into AD developments and demonstrates the potential of our approach in supporting efficient AD diagnosis.
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Affiliation(s)
- Xuemei Ding
- Intelligent Systems Research Centre, Ulster University, Magee Campus, Derry~Londonderry, Northern Ireland, UK.
- Faculty of Mathematics and Informatics, Fujian Normal University, Fuzhou, China.
| | - Magda Bucholc
- Intelligent Systems Research Centre, Ulster University, Magee Campus, Derry~Londonderry, Northern Ireland, UK
| | - Haiying Wang
- School of Computing and Mathematics, Ulster University, Jordanstown Campus, Northern Ireland, UK
| | - David H Glass
- School of Computing and Mathematics, Ulster University, Jordanstown Campus, Northern Ireland, UK
| | - Hui Wang
- School of Computing and Mathematics, Ulster University, Jordanstown Campus, Northern Ireland, UK
| | - Dave H Clarke
- Clarke Analytics Ltd., 6 Dernville, Annabella Mallow, Cork, Ireland
| | - Anthony John Bjourson
- Northern Ireland Centre for Stratified Medicine, Biomedical Sciences Research Institute, C-TRIC, Ulster University, Altnagelvin Hospital, Derry~Londonderry, Northern Ireland, UK
| | - Le Roy C Dowey
- C-TRIC, Altnagelvin Hospital campus, Derry~Londonderry, Northern Ireland, UK
- School of Biomedical Sciences, Ulster University, Coleraine Campus, Northern Ireland, UK
| | - Maurice O'Kane
- C-TRIC, Altnagelvin Hospital campus, Derry~Londonderry, Northern Ireland, UK
| | - Girijesh Prasad
- Intelligent Systems Research Centre, Ulster University, Magee Campus, Derry~Londonderry, Northern Ireland, UK
| | - Liam Maguire
- Intelligent Systems Research Centre, Ulster University, Magee Campus, Derry~Londonderry, Northern Ireland, UK
| | - KongFatt Wong-Lin
- Intelligent Systems Research Centre, Ulster University, Magee Campus, Derry~Londonderry, Northern Ireland, UK.
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Arias Tapia SA, Martínez-Tomás R, Gómez HF, Hernández Del Salto V, Sánchez Guerrero J, Mocha-Bonilla JA, Barbosa Corbacho J, Khan A, Chicaiza Redin V. The Dissociation between Polarity, Semantic Orientation, and Emotional Tone as an Early Indicator of Cognitive Impairment. Front Comput Neurosci 2016; 10:95. [PMID: 27683555 PMCID: PMC5021699 DOI: 10.3389/fncom.2016.00095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 08/25/2016] [Indexed: 11/13/2022] Open
Abstract
The present study aims to identify early cognitive impairment through the efficient use of therapies that can improve the quality of daily life and prevent disease progress. We propose a methodology based on the hypothesis that the dissociation between oral semantic expression and the physical expressions, facial gestures, or emotions transmitted in a person's tone of voice is a possible indicator of cognitive impairment. Experiments were carried out with phrases, analyzing the semantics of the message, and the tone of the voice of patients through unstructured interviews in healthy people and patients at an early Alzheimer's stage. The results show that the dissociation in cognitive impairment was an effective indicator, arising from patterns of inconsistency between the analyzed elements. Although the results of our study are encouraging, we believe that further studies are necessary to confirm that this dissociation is a probable indicator of cognitive impairment.
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Affiliation(s)
- Susana A Arias Tapia
- Facultad de Ciencias Humanas y de la Educación, Universidad Técnica de AmbatoAmbato, Ecuador; Departamento de Filosofia, Universidad Técnica Particular de LojaLoja, Ecuador
| | - Rafael Martínez-Tomás
- Departamento de Inteligencia Artificial, Universidad Nacional de Educación a Distancia Madrid, España
| | - Héctor F Gómez
- Facultad de Ciencias Humanas y de la Educación, Universidad Técnica de Ambato Ambato, Ecuador
| | | | - Javier Sánchez Guerrero
- Facultad de Ciencias Humanas y de la Educación, Universidad Técnica de Ambato Ambato, Ecuador
| | - J A Mocha-Bonilla
- Facultad de Ciencias Humanas y de la Educación, Universidad Técnica de Ambato Ambato, Ecuador
| | | | - Azizudin Khan
- Psychophysiology Laboratory, Department of Humanities and Social Sciences, Indian Institute of Technology Bombay Mumbai, India
| | - Veronica Chicaiza Redin
- Facultad de Ciencias Humanas y de la Educación, Universidad Técnica de Ambato Ambato, Ecuador
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