Machine Learning for Subtyping Concussion Using a Clustering Approach
Background: Concussion subtypes are typically organized into commonly affected symptom areas or a combination of affected systems, an approach that may be flawed by bias in conceptualization or the inherent limitations of interdisciplinary expertise.Objective: The purpose of this study was to determ...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-09-01
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| Series: | Frontiers in Human Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnhum.2021.716643/full |
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| author | Cirelle K. Rosenblatt Cirelle K. Rosenblatt Alexandra Harriss Aliya-Nur Babul Samuel A. Rosenblatt |
| author_facet | Cirelle K. Rosenblatt Cirelle K. Rosenblatt Alexandra Harriss Aliya-Nur Babul Samuel A. Rosenblatt |
| author_sort | Cirelle K. Rosenblatt |
| collection | DOAJ |
| description | Background: Concussion subtypes are typically organized into commonly affected symptom areas or a combination of affected systems, an approach that may be flawed by bias in conceptualization or the inherent limitations of interdisciplinary expertise.Objective: The purpose of this study was to determine whether a bottom-up, unsupervised, machine learning approach, could more accurately support concussion subtyping.Methods: Initial patient intake data as well as objective outcome measures including, the Patient-Reported Outcomes Measurement Information System (PROMIS), Dizziness Handicap Inventory (DHI), Pain Catastrophizing Scale (PCS), and Immediate Post-Concussion Assessment and Cognitive Testing Tool (ImPACT) were retrospectively extracted from the Advance Concussion Clinic's database. A correlation matrix and principal component analysis (PCA) were used to reduce the dimensionality of the dataset. Sklearn's agglomerative clustering algorithm was then applied, and the optimal number of clusters within the patient database were generated. Between-group comparisons among the formed clusters were performed using a Mann-Whitney U test.Results: Two hundred seventy-five patients within the clinics database were analyzed. Five distinct clusters emerged from the data when maximizing the Silhouette score (0.36) and minimizing the Davies-Bouldin score (0.83). Concussion subtypes derived demonstrated clinically distinct profiles, with statistically significant differences (p < 0.05) between all five clusters.Conclusion: This machine learning approach enabled the identification and characterization of five distinct concussion subtypes, which were best understood according to levels of complexity, ranging from Extremely Complex to Minimally Complex. Understanding concussion in terms of Complexity with the utilization of artificial intelligence, could provide a more accurate concussion classification or subtype approach; one that better reflects the true heterogeneity and complex system disruptions associated with mild traumatic brain injury. |
| first_indexed | 2024-12-21T15:21:35Z |
| format | Article |
| id | doaj.art-0890f713dd6d4bcf9de83443e28be9b9 |
| institution | Directory Open Access Journal |
| issn | 1662-5161 |
| language | English |
| last_indexed | 2024-12-21T15:21:35Z |
| publishDate | 2021-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Human Neuroscience |
| spelling | doaj.art-0890f713dd6d4bcf9de83443e28be9b92022-12-21T18:59:01ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612021-09-011510.3389/fnhum.2021.716643716643Machine Learning for Subtyping Concussion Using a Clustering ApproachCirelle K. Rosenblatt0Cirelle K. Rosenblatt1Alexandra Harriss2Aliya-Nur Babul3Samuel A. Rosenblatt4Advance Concussion Clinic Inc., Vancouver, BC, CanadaDivision of Sport & Exercise Medicine, Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, CanadaAdvance Concussion Clinic Inc., Vancouver, BC, CanadaDepartment of Astronomy, Columbia University, New York, NY, United StatesAdvance Concussion Clinic Inc., Vancouver, BC, CanadaBackground: Concussion subtypes are typically organized into commonly affected symptom areas or a combination of affected systems, an approach that may be flawed by bias in conceptualization or the inherent limitations of interdisciplinary expertise.Objective: The purpose of this study was to determine whether a bottom-up, unsupervised, machine learning approach, could more accurately support concussion subtyping.Methods: Initial patient intake data as well as objective outcome measures including, the Patient-Reported Outcomes Measurement Information System (PROMIS), Dizziness Handicap Inventory (DHI), Pain Catastrophizing Scale (PCS), and Immediate Post-Concussion Assessment and Cognitive Testing Tool (ImPACT) were retrospectively extracted from the Advance Concussion Clinic's database. A correlation matrix and principal component analysis (PCA) were used to reduce the dimensionality of the dataset. Sklearn's agglomerative clustering algorithm was then applied, and the optimal number of clusters within the patient database were generated. Between-group comparisons among the formed clusters were performed using a Mann-Whitney U test.Results: Two hundred seventy-five patients within the clinics database were analyzed. Five distinct clusters emerged from the data when maximizing the Silhouette score (0.36) and minimizing the Davies-Bouldin score (0.83). Concussion subtypes derived demonstrated clinically distinct profiles, with statistically significant differences (p < 0.05) between all five clusters.Conclusion: This machine learning approach enabled the identification and characterization of five distinct concussion subtypes, which were best understood according to levels of complexity, ranging from Extremely Complex to Minimally Complex. Understanding concussion in terms of Complexity with the utilization of artificial intelligence, could provide a more accurate concussion classification or subtype approach; one that better reflects the true heterogeneity and complex system disruptions associated with mild traumatic brain injury.https://www.frontiersin.org/articles/10.3389/fnhum.2021.716643/fullconcussionartificial intelligencecluster analysisinterdisciplinaryrehabilitationmild traumatic brain injury |
| spellingShingle | Cirelle K. Rosenblatt Cirelle K. Rosenblatt Alexandra Harriss Aliya-Nur Babul Samuel A. Rosenblatt Machine Learning for Subtyping Concussion Using a Clustering Approach Frontiers in Human Neuroscience concussion artificial intelligence cluster analysis interdisciplinary rehabilitation mild traumatic brain injury |
| title | Machine Learning for Subtyping Concussion Using a Clustering Approach |
| title_full | Machine Learning for Subtyping Concussion Using a Clustering Approach |
| title_fullStr | Machine Learning for Subtyping Concussion Using a Clustering Approach |
| title_full_unstemmed | Machine Learning for Subtyping Concussion Using a Clustering Approach |
| title_short | Machine Learning for Subtyping Concussion Using a Clustering Approach |
| title_sort | machine learning for subtyping concussion using a clustering approach |
| topic | concussion artificial intelligence cluster analysis interdisciplinary rehabilitation mild traumatic brain injury |
| url | https://www.frontiersin.org/articles/10.3389/fnhum.2021.716643/full |
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