Predicting motor, cognitive and functional impairment in Parkinson's

<strong>Objective</strong> We recently demonstrated that 998 features derived from a simple 7‐minute smartphone test could distinguish between controls, people with Parkinson's and people with idiopathic Rapid Eye Movement sleep behavior disorder, with mean sensitivity/specificity v...

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Main Authors: Lo, C, Arora, S, Baig, F, Lawton, M, El Mouden, C, Barber, T, Ruffmann, C, Klein, J, Brown, P, Ben‐Shlomo, Y, Vos, M, Hu, M
Format: Journal article
Language:English
Published: Wiley 2019
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author Lo, C
Arora, S
Baig, F
Lawton, M
El Mouden, C
Barber, T
Ruffmann, C
Klein, J
Brown, P
Ben‐Shlomo, Y
Vos, M
Hu, M
author_facet Lo, C
Arora, S
Baig, F
Lawton, M
El Mouden, C
Barber, T
Ruffmann, C
Klein, J
Brown, P
Ben‐Shlomo, Y
Vos, M
Hu, M
author_sort Lo, C
collection OXFORD
description <strong>Objective</strong> We recently demonstrated that 998 features derived from a simple 7‐minute smartphone test could distinguish between controls, people with Parkinson's and people with idiopathic Rapid Eye Movement sleep behavior disorder, with mean sensitivity/specificity values of 84.6‐91.9%. Here, we investigate whether the same smartphone features can be used to predict future clinically relevant outcomes in early Parkinson's. <br/><br/> <strong>Methods</strong> A total of 237 participants with Parkinson's (mean (SD) disease duration 3.5 (2.2) years) in the Oxford Discovery cohort performed smartphone tests in clinic and at home. Each test assessed voice, balance, gait, reaction time, dexterity, rest, and postural tremor. In addition, standard motor, cognitive and functional assessments and questionnaires were administered in clinic. Machine learning algorithms were trained to predict the onset of clinical outcomes provided at the next 18‐month follow‐up visit using baseline smartphone recordings alone. The accuracy of model predictions was assessed using 10‐fold and subject‐wise cross validation schemes. <br/><br/> <strong>Results</strong> Baseline smartphone tests predicted the new onset of falls, freezing, postural instability, cognitive impairment, and functional impairment at 18 months. For all outcome predictions AUC values were greater than 0.90 for 10‐fold cross validation using all smartphone features. Using only the 30 most salient features, AUC values greater than 0.75 were obtained. <br/><br/> <strong>Interpretation</strong> We demonstrate the ability to predict key future clinical outcomes using a simple smartphone test. This work has the potential to introduce individualized predictions to routine care, helping to target interventions to those most likely to benefit, with the aim of improving their outcome.
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spelling oxford-uuid:360725c0-cd43-4807-994b-1cf1eaa1a1562022-03-26T13:35:18ZPredicting motor, cognitive and functional impairment in Parkinson'sJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:360725c0-cd43-4807-994b-1cf1eaa1a156EnglishSymplectic Elements at OxfordWiley2019Lo, CArora, SBaig, FLawton, MEl Mouden, CBarber, TRuffmann, CKlein, JBrown, PBen‐Shlomo, YVos, MHu, M<strong>Objective</strong> We recently demonstrated that 998 features derived from a simple 7‐minute smartphone test could distinguish between controls, people with Parkinson's and people with idiopathic Rapid Eye Movement sleep behavior disorder, with mean sensitivity/specificity values of 84.6‐91.9%. Here, we investigate whether the same smartphone features can be used to predict future clinically relevant outcomes in early Parkinson's. <br/><br/> <strong>Methods</strong> A total of 237 participants with Parkinson's (mean (SD) disease duration 3.5 (2.2) years) in the Oxford Discovery cohort performed smartphone tests in clinic and at home. Each test assessed voice, balance, gait, reaction time, dexterity, rest, and postural tremor. In addition, standard motor, cognitive and functional assessments and questionnaires were administered in clinic. Machine learning algorithms were trained to predict the onset of clinical outcomes provided at the next 18‐month follow‐up visit using baseline smartphone recordings alone. The accuracy of model predictions was assessed using 10‐fold and subject‐wise cross validation schemes. <br/><br/> <strong>Results</strong> Baseline smartphone tests predicted the new onset of falls, freezing, postural instability, cognitive impairment, and functional impairment at 18 months. For all outcome predictions AUC values were greater than 0.90 for 10‐fold cross validation using all smartphone features. Using only the 30 most salient features, AUC values greater than 0.75 were obtained. <br/><br/> <strong>Interpretation</strong> We demonstrate the ability to predict key future clinical outcomes using a simple smartphone test. This work has the potential to introduce individualized predictions to routine care, helping to target interventions to those most likely to benefit, with the aim of improving their outcome.
spellingShingle Lo, C
Arora, S
Baig, F
Lawton, M
El Mouden, C
Barber, T
Ruffmann, C
Klein, J
Brown, P
Ben‐Shlomo, Y
Vos, M
Hu, M
Predicting motor, cognitive and functional impairment in Parkinson's
title Predicting motor, cognitive and functional impairment in Parkinson's
title_full Predicting motor, cognitive and functional impairment in Parkinson's
title_fullStr Predicting motor, cognitive and functional impairment in Parkinson's
title_full_unstemmed Predicting motor, cognitive and functional impairment in Parkinson's
title_short Predicting motor, cognitive and functional impairment in Parkinson's
title_sort predicting motor cognitive and functional impairment in parkinson s
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