1. Improving clinical efficiency in screening for cognitive impairment due to Alzheimer's
- Author
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Ren, Yueqi, Shahbaba, Babak, and Stark, Craig EL
- Subjects
Biological Psychology ,Biomedical and Clinical Sciences ,Neurosciences ,Psychology ,Prevention ,Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD) ,Brain Disorders ,Machine Learning and Artificial Intelligence ,Dementia ,Alzheimer's Disease ,Acquired Cognitive Impairment ,Neurodegenerative ,Aging ,4.1 Discovery and preclinical testing of markers and technologies ,4.2 Evaluation of markers and technologies ,Neurological ,Alzheimer's disease ,clinical efficiency ,conversion rate ,diagnosis classification ,prediction ,progression monitoring ,screening ,statistical machine learning ,Genetics ,Biological psychology - Abstract
IntroductionTo reduce demands on expert time and improve clinical efficiency, we developed a framework to evaluate whether inexpensive, accessible data could accurately classify Alzheimer's disease (AD) clinical diagnosis and predict the likelihood of progression.MethodsWe stratified relevant data into three tiers: obtainable at primary care (low-cost), mostly available at specialty visits (medium-cost), and research-only (high-cost). We trained several machine learning models, including a hierarchical model, an ensemble model, and a clustering model, to distinguish between diagnoses of cognitively unimpaired, mild cognitive impairment, and dementia due to AD.ResultsAll models showed viable classification, but the hierarchical and ensemble models outperformed the conventional model. Classifier "error" was predictive of progression rates, and cluster membership identified subgroups with high and low risk of progression within 1.5 to 3 years.DiscussionAccessible, inexpensive clinical data can be used to guide AD diagnosis and are predictive of current and future disease states.HighlightsClassification performance using cost-effective features was accurate and robustHierarchical classification outperformed conventional multinomial classificationClassification labels indicated significant changes in conversion risk at follow-upA clustering-classification method identified subgroups at high risk of decline.
- Published
- 2023