scholarly journals Machine learning for modeling the progression of Alzheimer disease dementia using clinical data: a systematic literature review

JAMIA Open ◽  
2021 ◽  
Vol 4 (3) ◽  
Author(s):  
Sayantan Kumar ◽  
Inez Oh ◽  
Suzanne Schindler ◽  
Albert M Lai ◽  
Philip R O Payne ◽  
...  

Abstract Objective Alzheimer disease (AD) is the most common cause of dementia, a syndrome characterized by cognitive impairment severe enough to interfere with activities of daily life. We aimed to conduct a systematic literature review (SLR) of studies that applied machine learning (ML) methods to clinical data derived from electronic health records in order to model risk for progression of AD dementia. Materials and Methods We searched for articles published between January 1, 2010, and May 31, 2020, in PubMed, Scopus, ScienceDirect, IEEE Explore Digital Library, Association for Computing Machinery Digital Library, and arXiv. We used predefined criteria to select relevant articles and summarized them according to key components of ML analysis such as data characteristics, computational algorithms, and research focus. Results There has been a considerable rise over the past 5 years in the number of research papers using ML-based analysis for AD dementia modeling. We reviewed 64 relevant articles in our SLR. The results suggest that majority of existing research has focused on predicting progression of AD dementia using publicly available datasets containing both neuroimaging and clinical data (neurobehavioral status exam scores, patient demographics, neuroimaging data, and laboratory test values). Discussion Identifying individuals at risk for progression of AD dementia could potentially help to personalize disease management to plan future care. Clinical data consisting of both structured data tables and clinical notes can be effectively used in ML-based approaches to model risk for AD dementia progression. Data sharing and reproducibility of results can enhance the impact, adaptation, and generalizability of this research.

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1337.2-1337
Author(s):  
T. W. Swinnen ◽  
M. Willems ◽  
I. Jonkers ◽  
F. P. Luyten ◽  
J. Vanrenterghem ◽  
...  

Background:The personal and societal burden of knee osteoarthritis (KOA) urges the research community to identify factors that predict its onset and progression. A mechanistic understanding of disease is currently lacking but needed to develop targeted interventions. Traditionally, risk factors for KOA are termed ‘local’ to the joint or ‘systemic’ referring to whole-body systems. There are however clear indications in the scientific literature that contextual factors such as socioeconomic position merit further scientific scrutiny, in order to justify a more biopsychosocial view on risk factors in KOA.Objectives:The aims of this systematic literature review were to assess the inclusion of socioeconomic factors in KOA research and to identify the impact of socioeconomic factors on pain and function in KOA.Methods:Major bibliographic databases, namely Medline, Embase, CINAHL, Web of Science and Cochrane, were independently screened by two reviewers (plus one to resolve conflicts) to identify research articles dealing with socioeconomic factors in the KOA population without arthroplasty. Included studies had to quantify the relationship between socioeconomic factors and pain or function. Main exclusion criteria were: a qualitative design, subject age below 16 years and articles not written in English or Dutch. Methodological quality was assessed via the Cochrane risk of bias tools for randomized (ROB-II) and non-randomized intervention studies (ROBIN-I) and the Newcastle-Ottawa Scale for assessing the quality of non-randomised studies. Due to heterogeneity of studies with respect to outcomes assessed and analyses performed, no meta-analysis was performed.Results:Following de-duplication, 7639 articles were available for screening (120 conflicts resolved without a third reader). In 4112 articles, the KOA population was confirmed. 1906 (25%) were excluded because of knee arthroplasty and 1621 (21%) because of other issues related to the population definition. Socioeconomic factors could not be identified in 4058 (53%) papers and were adjusted for in 211 (3%) articles. In the remaining papers covering pain (n=110) and/or function (n=81), education (62%) and race (37%) were most frequently assessed as socioeconomic factors. A huge variety of mainly dichotomous or ordinal socioeconomic outcomes was found without further methodological justification nor sensitivity analysis to unravel the impact of selected categories. Although the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was the most popular instrument to assess pain and function, data pooling was not possible as socioeconomic factors estimates were part of multilevel models in most studies. Overall results showed that lower education and African American race were consistent predictors of pain and poor function, but those effects diminished or disappeared when psychological aspects (e.g. discrimination) or poverty estimates were taken into account. When function was assessed using self-reported outcomes, the impact of socioeconomic factors was more clear versus performance-based instruments. Quality of research was low to moderate and the moderating or mediating impact of socioeconomic factors on intervention effects in KOA is understudied.Conclusion:Research on contextual socioeconomic factors in KOA is insufficiently addressed and their assessment is highly variable methodologically. Following this systematic literature review, we can highlight the importance of implementing a standardised and feasible set of socioeconomic outcomes in KOA trials1, as well as the importance of public availability of research databases including these factors. Future research should prioritise the underlying mechanisms in the effect of especially education and race on pain and function and assess its impact on intervention effects to fuel novel (non-)pharmacological approaches in KOA.References:[1]Smith TO et al. The OMERACT-OARSI Core Domain Set for Measurement in Clinical Trials of Hip and/or Knee Osteoarthritis J Rheumatol 2019. 46:981–9.Disclosure of Interests:None declared.


2021 ◽  
Vol 21 (2) ◽  
pp. 1-31
Author(s):  
Bjarne Pfitzner ◽  
Nico Steckhan ◽  
Bert Arnrich

Data privacy is a very important issue. Especially in fields like medicine, it is paramount to abide by the existing privacy regulations to preserve patients’ anonymity. However, data is required for research and training machine learning models that could help gain insight into complex correlations or personalised treatments that may otherwise stay undiscovered. Those models generally scale with the amount of data available, but the current situation often prohibits building large databases across sites. So it would be beneficial to be able to combine similar or related data from different sites all over the world while still preserving data privacy. Federated learning has been proposed as a solution for this, because it relies on the sharing of machine learning models, instead of the raw data itself. That means private data never leaves the site or device it was collected on. Federated learning is an emerging research area, and many domains have been identified for the application of those methods. This systematic literature review provides an extensive look at the concept of and research into federated learning and its applicability for confidential healthcare datasets.


2021 ◽  
pp. 097215092098485
Author(s):  
Sonika Gupta ◽  
Sushil Kumar Mehta

Data mining techniques have proven quite effective not only in detecting financial statement frauds but also in discovering other financial crimes, such as credit card frauds, loan and security frauds, corporate frauds, bank and insurance frauds, etc. Classification of data mining techniques, in recent years, has been accepted as one of the most credible methodologies for the detection of symptoms of financial statement frauds through scanning the published financial statements of companies. The retrieved literature that has used data mining classification techniques can be broadly categorized on the basis of the type of technique applied, as statistical techniques and machine learning techniques. The biggest challenge in executing the classification process using data mining techniques lies in collecting the data sample of fraudulent companies and mapping the sample of fraudulent companies against non-fraudulent companies. In this article, a systematic literature review (SLR) of studies from the area of financial statement fraud detection has been conducted. The review has considered research articles published between 1995 and 2020. Further, a meta-analysis has been performed to establish the effect of data sample mapping of fraudulent companies against non-fraudulent companies on the classification methods through comparing the overall classification accuracy reported in the literature. The retrieved literature indicates that a fraudulent sample can either be equally paired with non-fraudulent sample (1:1 data mapping) or be unequally mapped using 1:many ratio to increase the sample size proportionally. Based on the meta-analysis of the research articles, it can be concluded that machine learning approaches, in comparison to statistical approaches, can achieve better classification accuracy, particularly when the availability of sample data is low. High classification accuracy can be obtained with even a 1:1 mapping data set using machine learning classification approaches.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alan Brnabic ◽  
Lisa M. Hess

Abstract Background Machine learning is a broad term encompassing a number of methods that allow the investigator to learn from the data. These methods may permit large real-world databases to be more rapidly translated to applications to inform patient-provider decision making. Methods This systematic literature review was conducted to identify published observational research of employed machine learning to inform decision making at the patient-provider level. The search strategy was implemented and studies meeting eligibility criteria were evaluated by two independent reviewers. Relevant data related to study design, statistical methods and strengths and limitations were identified; study quality was assessed using a modified version of the Luo checklist. Results A total of 34 publications from January 2014 to September 2020 were identified and evaluated for this review. There were diverse methods, statistical packages and approaches used across identified studies. The most common methods included decision tree and random forest approaches. Most studies applied internal validation but only two conducted external validation. Most studies utilized one algorithm, and only eight studies applied multiple machine learning algorithms to the data. Seven items on the Luo checklist failed to be met by more than 50% of published studies. Conclusions A wide variety of approaches, algorithms, statistical software, and validation strategies were employed in the application of machine learning methods to inform patient-provider decision making. There is a need to ensure that multiple machine learning approaches are used, the model selection strategy is clearly defined, and both internal and external validation are necessary to be sure that decisions for patient care are being made with the highest quality evidence. Future work should routinely employ ensemble methods incorporating multiple machine learning algorithms.


2020 ◽  
Vol 13 (11) ◽  
pp. 400
Author(s):  
Arnold G. Vulto ◽  
Jackie Vanderpuye-Orgle ◽  
Martin van der Graaff ◽  
Steven R. A. Simoens ◽  
Lorenzo Dagna ◽  
...  

Introduction: Biosimilars have the potential to enhance the sustainability of evolving health care systems. A sustainable biosimilars market requires all stakeholders to balance competition and supply chain security. However, there is significant variation in the policies for pricing, procurement, and use of biosimilars in the European Union. A modified Delphi process was conducted to achieve expert consensus on biosimilar market sustainability in Europe. Methods: The priorities of 11 stakeholders were explored in three stages: a brainstorming stage supported by a systematic literature review (SLR) and key materials identified by the participants; development and review of statements derived during brainstorming; and a facilitated roundtable discussion. Results: Participants argued that a sustainable biosimilar market must deliver tangible and transparent benefits to the health care system, while meeting the needs of all stakeholders. Key drivers of biosimilar market sustainability included: (i) competition is more effective than regulation; (ii) there should be incentives to ensure industry investment in biosimilar development and innovation; (iii) procurement processes must avoid monopolies and minimize market disruption; and (iv) principles for procurement should be defined by all stakeholders. However, findings from the SLR were limited, with significant gaps on the impact of different tender models on supply risks, savings, and sustainability. Conclusions: A sustainable biosimilar market means that all stakeholders benefit from appropriate and reliable access to biological therapies. Failure to care for biosimilar market sustainability may impoverish biosimilar development and offerings, eventually leading to increased cost for health care systems and patients, with fewer resources for innovation.


2013 ◽  
Vol 21 (02) ◽  
pp. 123-151 ◽  
Author(s):  
MICHAEL LORZ ◽  
SUSAN MUELLER ◽  
THIERRY VOLERY

The majority of studies that analyze the impact of entrepreneurship education on entrepreneurial attitudes, intentions, and venture activities report positive influences. However, several scholars have recently cast doubts about research methods and the generalizability of entrepreneurship education impact studies. In this study, we conducted a systematic literature review of the methods used in entrepreneurship education impact studies. Our results uncover significant methodological deficiencies and question the overwhelmingly positive impact of entrepreneurship education. Based on this evidence, we propose a series of recommendations to improve the reliability and validity of entrepreneurship education impact studies and we outline promising topics which are currently under-researched.


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