4.6 Article

A Machine Learning Approach to Classifying Self-Reported Health Status in a Cohort of Patients With Heart Disease Using Activity Tracker Data

Journal

IEEE JOURNAL OF BIOMEDICAL AND HEALTH INFORMATICS
Volume 24, Issue 3, Pages 878-884

Publisher

IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC
DOI: 10.1109/JBHI.2019.2922178

Keywords

Hidden Markov models; Data models; Heart rate; Monitoring; Biomedical measurement; Machine learning; Clinical diagnosis; machine learning; patient monitoring; telemedicine; wearable sensors

Funding

  1. California Initiative to Advance Precision Medicine (CIAPM)
  2. National Heart, Lung, and Blood Institute [NIH/NHLBI R56HL135425, K23HL127262, R01HL141773]
  3. National Center for Research Resources [NIH/NCRR UL1RR033176]
  4. National Center for Advancing Translational Sciences (NCATS) [NIH/NCATS UL1TR000124]
  5. UCLA Clinical Translational Science Institute [NIH/NCATS UL1TR000124]
  6. Advanced Clinical Biosystems Research Institute
  7. Erika Glazer Endowed Chair in Women's Heart Health
  8. Barbra Streisand Women's Cardiovascular Research and Education Program

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Constructing statistical models using personal sensor data could allow for tracking health status over time, thereby enabling the possibility of early intervention. The goal of this study was to use machine learning algorithms to classify patient-reported outcomes (PROs) using activity tracker data in a cohort of patients with stable ischemic heart disease (SIHD). A population of 182 patients with SIHD were monitored over a period of 12 weeks. Each subject received a Fitbit Charge 2 device to record daily activity data, and each subject completed eight Patient-Reported Outcomes Measurement Information Systems short form at the end of each week as a self-assessment of their health status. Two models were built to classify PRO scores using activity tracker data. The first model treated each week independently, whereas the second used a hidden Markov model (HMM) to take advantage of correlations between successive weeks. Retrospective analysis compared the classification accuracy of the two models and the importance of each feature. In the independent model, a random forest classifier achieved a mean area under curve (AUC) of 0.76 for classifying the physical function PRO. The HMM model achieved significantly better AUCs for all PROs (p < 0.05) other than Fatigue and Sleep Disturbance, with a highest mean AUC of 0.79 for the physical function-short form 10a. Our study demonstrates the ability of activity tracker data to classify health status over time. These results suggest that patient outcomes can be monitored in real time using activity trackers.

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