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      Machine-Learning Algorithms Based on Screening Tests for Mild Cognitive Impairment

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          Abstract

          Background:

          The mobile screening test system for mild cognitive impairment (mSTS-MCI) was developed and validated to address the low sensitivity and specificity of the Montreal Cognitive Assessment (MoCA) widely used clinically.

          Objective:

          This study was to evaluate the efficacy machine learning algorithms based on the mSTS-MCI and Korean version of MoCA.

          Method:

          In total, 103 healthy individuals and 74 patients with MCI were randomly divided into training and test data sets, respectively. The algorithm using TensorFlow was trained based on the training data set, and then its accuracy was calculated based on the test data set. The cost was calculated via logistic regression in this case.

          Result:

          Predictive power of the algorithms was higher than those of the original tests. In particular, the algorithm based on the mSTS-MCI showed the highest positive-predictive value.

          Conclusion:

          The machine learning algorithms predicting MCI showed the comparable findings with the conventional screening tools.

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          Most cited references24

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          The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment.

          To develop a 10-minute cognitive screening tool (Montreal Cognitive Assessment, MoCA) to assist first-line physicians in detection of mild cognitive impairment (MCI), a clinical state that often progresses to dementia. Validation study. A community clinic and an academic center. Ninety-four patients meeting MCI clinical criteria supported by psychometric measures, 93 patients with mild Alzheimer's disease (AD) (Mini-Mental State Examination (MMSE) score > or =17), and 90 healthy elderly controls (NC). The MoCA and MMSE were administered to all participants, and sensitivity and specificity of both measures were assessed for detection of MCI and mild AD. Using a cutoff score 26, the MMSE had a sensitivity of 18% to detect MCI, whereas the MoCA detected 90% of MCI subjects. In the mild AD group, the MMSE had a sensitivity of 78%, whereas the MoCA detected 100%. Specificity was excellent for both MMSE and MoCA (100% and 87%, respectively). MCI as an entity is evolving and somewhat controversial. The MoCA is a brief cognitive screening tool with high sensitivity and specificity for detecting MCI as currently conceptualized in patients performing in the normal range on the MMSE.
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            Mild cognitive impairment as a diagnostic entity.

            The concept of cognitive impairment intervening between normal ageing and very early dementia has been in the literature for many years. Recently, the construct of mild cognitive impairment (MCI) has been proposed to designate an early, but abnormal, state of cognitive impairment. MCI has generated a great deal of research from both clinical and research perspectives. Numerous epidemiological studies have documented the accelerated rate of progression to dementia and Alzheimer's disease (AD) in MCI subjects and certain predictor variables appear valid. However, there has been controversy regarding the precise definition of the concept and its implementation in various clinical settings. Clinical subtypes of MCI have been proposed to broaden the concept and include prodromal forms of a variety of dementias. It is suggested that the diagnosis of MCI can be made in a fashion similar to the clinical diagnoses of dementia and AD. An algorithm is presented to assist the clinician in identifying subjects and subclassifying them into the various types of MCI. By refining the criteria for MCI, clinical trials can be designed with appropriate inclusion and exclusion restrictions to allow for the investigation of therapeutics tailored for specific targets and populations.
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              Machine learning for medical diagnosis: history, state of the art and perspective.

              The paper provides an overview of the development of intelligent data analysis in medicine from a machine learning perspective: a historical view, a state-of-the-art view, and a view on some future trends in this subfield of applied artificial intelligence. The paper is not intended to provide a comprehensive overview but rather describes some subareas and directions which from my personal point of view seem to be important for applying machine learning in medical diagnosis. In the historical overview, I emphasize the naive Bayesian classifier, neural networks and decision trees. I present a comparison of some state-of-the-art systems, representatives from each branch of machine learning, when applied to several medical diagnostic tasks. The future trends are illustrated by two case studies. The first describes a recently developed method for dealing with reliability of decisions of classifiers, which seems to be promising for intelligent data analysis in medicine. The second describes an approach to using machine learning in order to verify some unexplained phenomena from complementary medicine, which is not (yet) approved by the orthodox medical community but could in the future play an important role in overall medical diagnosis and treatment.
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                Author and article information

                Journal
                Am J Alzheimers Dis Other Demen
                Am J Alzheimers Dis Other Demen
                AJA
                spaja
                American Journal of Alzheimer's Disease and Other Dementias
                SAGE Publications (Sage CA: Los Angeles, CA )
                1533-3175
                1938-2731
                30 June 2020
                Jan-Dec 2020
                : 35
                : 1533317520927163
                Affiliations
                [1 ]Department of Occupational Therapy, College of Medical Science, Soonchunhyang University, Asan, Korea
                Author notes
                [*]Jin-Hyuck Park, PhD, Room 1401, College of Medical Science, 22 Soonchunhyang-ro, Shinchang-myeon, Asan-si, Chungcheongnam-do, Republic of Korea 31538. Email: roophy@ 123456naver.com
                Author information
                https://orcid.org/0000-0002-0222-8901
                Article
                10.1177_1533317520927163
                10.1177/1533317520927163
                10623967
                32602347
                6c17ce69-fb3a-40d0-8818-9890d0502b88
                © The Author(s) 2020

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Funding
                Funded by: Soonchunhyang University, https://doi.org/10.13039/501100002560;
                Award ID: Research Fund
                Categories
                Original Research
                Custom metadata
                January-December 2020
                ts3

                mild cognitive impairment,machine learning,tensorflow,moca

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