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      Using machine learning to extract information and predict outcomes from reports of randomised trials of smoking cessation interventions in the Human Behaviour-Change Project

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          Abstract

          Background 

          Using reports of randomised trials of smoking cessation interventions as a test case, this study aimed to develop and evaluate machine learning (ML) algorithms for extracting information from study reports and predicting outcomes as part of the Human Behaviour-Change Project. It is the first of two linked papers, with the second paper reporting on further development of a prediction system.

          Methods 

          Researchers manually annotated 70 items of information (‘entities’) in 512 reports of randomised trials of smoking cessation interventions covering intervention content and delivery, population, setting, outcome and study methodology using the Behaviour Change Intervention Ontology. These entities were used to train ML algorithms to extract the information automatically. The information extraction ML algorithm involved a named-entity recognition system using the ‘FLAIR’ framework. The manually annotated intervention, population, setting and study entities were used to develop a deep-learning algorithm using multiple layers of long-short-term-memory (LSTM) components to predict smoking cessation outcomes.

          Results 

          The F1 evaluation score, derived from the false positive and false negative rates (range 0–1), for the information extraction algorithm averaged 0.42 across different types of entity (SD=0.22, range 0.05–0.88) compared with an average human annotator’s score of 0.75 (SD=0.15, range 0.38–1.00). The algorithm for assigning entities to study arms ( e.g., intervention or control) was not successful. This initial ML outcome prediction algorithm did not outperform prediction based just on the mean outcome value or a linear regression model.

          Conclusions 

          While some success was achieved in using ML to extract information from reports of randomised trials of smoking cessation interventions, we identified major challenges that could be addressed by greater standardisation in the way that studies are reported. Outcome prediction from smoking cessation studies may benefit from development of novel algorithms, e.g., using ontological information to inform ML (as reported in the linked paper 3 ).

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          Most cited references33

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          Long Short-Term Memory

          Learning to store information over extended time intervals by recurrent backpropagation takes a very long time, mostly because of insufficient, decaying error backflow. We briefly review Hochreiter's (1991) analysis of this problem, then address it by introducing a novel, efficient, gradient-based method called long short-term memory (LSTM). Truncating the gradient where this does not do harm, LSTM can learn to bridge minimal time lags in excess of 1000 discrete-time steps by enforcing constant error flow through constant error carousels within special units. Multiplicative gate units learn to open and close access to the constant error flow. LSTM is local in space and time; its computational complexity per time step and weight is O(1). Our experiments with artificial data involve local, distributed, real-valued, and noisy pattern representations. In comparisons with real-time recurrent learning, back propagation through time, recurrent cascade correlation, Elman nets, and neural sequence chunking, LSTM leads to many more successful runs, and learns much faster. LSTM also solves complex, artificial long-time-lag tasks that have never been solved by previous recurrent network algorithms.
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            Glove: Global Vectors for Word Representation

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              Root mean square error (RMSE) or mean absolute error (MAE)? – Arguments against avoiding RMSE in the literature

              Both the root mean square error (RMSE) and the mean absolute error (MAE) are regularly employed in model evaluation studies. Willmott and Matsuura (2005) have suggested that the RMSE is not a good indicator of average model performance and might be a misleading indicator of average error, and thus the MAE would be a better metric for that purpose. While some concerns over using RMSE raised by Willmott and Matsuura (2005) and Willmott et al. (2009) are valid, the proposed avoidance of RMSE in favor of MAE is not the solution. Citing the aforementioned papers, many researchers chose MAE over RMSE to present their model evaluation statistics when presenting or adding the RMSE measures could be more beneficial. In this technical note, we demonstrate that the RMSE is not ambiguous in its meaning, contrary to what was claimed by Willmott et al. (2009). The RMSE is more appropriate to represent model performance than the MAE when the error distribution is expected to be Gaussian. In addition, we show that the RMSE satisfies the triangle inequality requirement for a distance metric, whereas Willmott et al. (2009) indicated that the sums-of-squares-based statistics do not satisfy this rule. In the end, we discussed some circumstances where using the RMSE will be more beneficial. However, we do not contend that the RMSE is superior over the MAE. Instead, a combination of metrics, including but certainly not limited to RMSEs and MAEs, are often required to assess model performance.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Formal AnalysisRole: MethodologyRole: ValidationRole: VisualizationRole: Writing – Original Draft PreparationRole: Writing – Review & Editing
                Role: Data CurationRole: Formal AnalysisRole: MethodologyRole: SoftwareRole: VisualizationRole: Writing – Original Draft PreparationRole: Writing – Review & Editing
                Role: ConceptualizationRole: Data CurationRole: Formal AnalysisRole: Funding AcquisitionRole: MethodologyRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – Original Draft PreparationRole: Writing – Review & Editing
                Role: Data CurationRole: Formal AnalysisRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – Original Draft PreparationRole: Writing – Review & Editing
                Role: ConceptualizationRole: Data CurationRole: SoftwareRole: SupervisionRole: VisualizationRole: Writing – Review & Editing
                Role: Formal AnalysisRole: SoftwareRole: Writing – Review & Editing
                Role: Formal AnalysisRole: SoftwareRole: Writing – Review & Editing
                Role: Formal AnalysisRole: Writing – Review & Editing
                Role: ConceptualizationRole: Data CurationRole: Formal AnalysisRole: SoftwareRole: VisualizationRole: Writing – Original Draft PreparationRole: Writing – Review & Editing
                Role: ConceptualizationRole: Writing – Review & Editing
                Role: ConceptualizationRole: Funding AcquisitionRole: Project AdministrationRole: SupervisionRole: ValidationRole: Writing – Original Draft PreparationRole: Writing – Review & Editing
                Journal
                Wellcome Open Res
                Wellcome Open Res
                Wellcome Open Research
                F1000 Research Limited (London, UK )
                2398-502X
                12 October 2023
                2023
                : 8
                : 452
                Affiliations
                [1 ]Research Department of Behavioural Science and Health, University College London, London, England, UK
                [2 ]IBM Research Europe, Dublin, Ireland
                [3 ]EPPI-Centre, Social Research Institute, University College London, London, England, UK
                [4 ]Institute of Pharmaceutical Science, King's College London, London, England, UK
                [5 ]Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Zürich, Zurich, Switzerland
                [6 ]School of Medicine, University of St Gallen, St. Gallen, St. Gallen, Switzerland
                [7 ]Aberdeen Health Psychology Group, University of Aberdeen, Aberdeen, Scotland, UK
                [8 ]Centre for Behaviour Change, University College London, London, England, UK
                [1 ]Department of Philosophy, University at Buffalo, Buffalo, New York, USA
                [1 ]University of Queensland, Herston, Queensland, Australia
                [1 ]Department of Health Law, Policy and Management, Boston University, Boston, Massachusetts, USA
                Author notes

                Competing interests: RW and SM are unpaid directors of the Unlocking Behaviour Change Community Interest Company.

                Competing interests: No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Author information
                https://orcid.org/0000-0001-6398-0921
                https://orcid.org/0000-0003-4805-4190
                https://orcid.org/0000-0002-7640-9668
                https://orcid.org/0000-0002-0359-6423
                https://orcid.org/0000-0002-3469-4923
                https://orcid.org/0000-0003-0124-4827
                https://orcid.org/0000-0003-0063-6378
                Article
                10.12688/wellcomeopenres.20000.1
                11109593
                38779058
                b1d41baf-e85d-4ce0-83db-b7085fb667e2
                Copyright: © 2023 West R et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 September 2023
                Funding
                Funded by: Wellcome Trust
                Award ID: 201524
                This work was supported by Wellcome (201524, <a href=https://doi.org/10.35802/201524>https://doi.org/10.35802/201524</a>] ; a collaborative award to the Human Behaviour-Change Project (HBCP): Building the science of behaviour change for complex intervention development).
                The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Articles

                behaviour change interventions,artificial intelligence,machine learning,natural language processing,prediction systems,information extractions,ontologies,evidence synthesis

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