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  5. Data-Driven Differential Diagnosis of Dementia Using Multiclass Disease State Index Classifier
 
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Data-Driven Differential Diagnosis of Dementia Using Multiclass Disease State Index Classifier
File(s)
fnagi-10-00111.pdf (974.78 KB)
Published version
OA Location
https://www.frontiersin.org/articles/10.3389/fnagi.2018.00111/full
Author(s)
Tolonen, Antti
Rhodius-Meester, Hanneke FM
Bruun, Marie
Koikkalainen, Juha
Barkhof, Frederik
more
Type
Journal Article
Abstract
Clinical decision support systems (CDSSs) hold potential for the differential diagnosis of neurodegenerative diseases. We developed a novel CDSS, the PredictND tool, designed for differential diagnosis of different types of dementia. It combines information obtained from multiple diagnostic tests such as neuropsychological tests, MRI and cerebrospinal fluid samples. Here we evaluated how the classifier used in it performs in differentiating between controls with subjective cognitive decline, dementia due to Alzheimer’s disease, vascular dementia, frontotemporal lobar degeneration and dementia with Lewy bodies. We used the multiclass Disease State Index classifier, which is the classifier used by the PredictND tool, to differentiate between controls and patients with the four different types of dementia. The multiclass Disease State Index classifier is an extension of a previously developed two-class Disease State Index classifier. As the two-class Disease State Index classifier, the multiclass Disease State Index classifier also offers a visualization of its decision making process, which makes it especially suitable for medical decision support where interpretability of the results is highly important. A subset of the Amsterdam Dementia cohort, consisting of 504 patients (age 65 ± 8 years, 44% females) with data from neuropsychological tests, cerebrospinal fluid samples and both automatic and visual MRI quantifications, was used for the evaluation. The Disease State Index classifier was highly accurate in separating the five classes from each other (balanced accuracy 82.3%). Accuracy was highest for vascular dementia and lowest for dementia with Lewy bodies. For the 50% of patients for which the classifier was most confident on the classification the balanced accuracy was 93.6%. Data-driven CDSSs can be of aid in differential diagnosis in clinical practice. The decision support system tested in this study was highly accurate in separating the different dementias and controls from each other. In addition to the predicted class, it also provides a confidence measure for the classification.
Date Issued
2018-04-25
Date Acceptance
2018-04-03
Citation
FRONTIERS IN AGING NEUROSCIENCE, 2018, 10
URI
http://hdl.handle.net/10044/1/59808
DOI
https://www.dx.doi.org/10.3389/fnagi.2018.00111
ISSN
1663-4365
Publisher
FRONTIERS MEDIA SA
Journal / Book Title
FRONTIERS IN AGING NEUROSCIENCE
Volume
10
Copyright Statement
© 2018 Tolonen, Rhodius-Meester, Bruun, Koikkalainen, Barkhof, Lemstra, Koene, Scheltens, Teunissen, Tong, Guerrero, Schuh, Ledig, Baroni, Rueckert, Soininen, Remes, Waldemar, Hasselbalch, Mecocci, van der Flier and Lötjönen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY https://creativecommons.org/licenses/by/4.0/). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Sponsor
Commission of the European Communities
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000430859400001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
611005
Subjects
Science & Technology
Life Sciences & Biomedicine
Geriatrics & Gerontology
Neurosciences
Neurosciences & Neurology
neurodegenerative diseases
classification
decision support
Alzheimer's disease
frontotemporal lobar degeneration
vascular dementia
dementia with Lewy bodies
MILD COGNITIVE IMPAIRMENT
EARLY ALZHEIMERS-DISEASE
TEMPORAL-LOBE ATROPHY
FRONTOTEMPORAL DEMENTIA
LEWY BODIES
BEHAVIORAL VARIANT
INTRAOBSERVER REPRODUCIBILITY
NEUROPSYCHOLOGICAL TESTS
INTERNATIONAL WORKSHOP
CLINICAL-DIAGNOSIS
Publication Status
Published
Article Number
ARTN 111
Date Publish Online
2018-04-25
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