4.7 Article

Machine learning in diagnosis and disability prediction of multiple sclerosis using optical coherence tomography

Journal

COMPUTERS IN BIOLOGY AND MEDICINE
Volume 133, Issue -, Pages -

Publisher

PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.compbiomed.2021.104416

Keywords

Multiple sclerosis; Machine learning; Optical coherence tomography; Retinal nerve fiber layer; Expanded disability status scale

Funding

  1. Spanish Ministry of Economy and Competitiveness [DPI 201679302R]
  2. Spanish Ministry of Science, Innovation and Universities [BES2017080384]
  3. Instituto de Salud Carlos III [PI17/01726]

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Machine learning techniques using clinical and OCT data were utilized to develop two predictive models for MS diagnosis and disability course prediction. These models showed promising results in establishing early diagnosis and predicting the course of MS, highlighting the potential of RNFL thickness as a reliable MS biomarker.
Background: Multiple sclerosis (MS) is a neurodegenerative disease that affects the central nervous system, especially the brain, spinal cord, and optic nerve. Diagnosis of this disease is a very complex process and generally requires a lot of time. In addition, treatments are applied without any information on the disability course in each MS patient. For these two reasons, the objective of this study was to improve the MS diagnosis and predict the long-term course of disability in MS patients based on clinical data and retinal nerve fiber layer (RNFL) thickness, measured by optical coherence tomography (OCT). Material and methods: A total of 104 healthy controls and 108 MS patients, 82 of whom had a 10-year follow-up, were enrolled. Classification algorithms such as multiple linear regression (MLR), support vector machines (SVM), decision tree (DT), k-nearest neighbours (k-NN), Na & iuml;ve Bayes (NB), ensemble classifier (EC) and long short-term memory (LSTM) recurrent neural network were tested to develop two predictive models: MS diagnosis model and MS disability course prediction model. Results: For MS diagnosis, the best result was obtained using EC (accuracy: 87.7%; sensitivity: 87.0%; specificity: 88.5%; precision: 88.7%; AUC: 0.8775). In line with this good performance, the accuracy was 85.4% using k-NN and 84.4% using SVM. And, for long-term prediction of MS disability course, LSTM recurrent neural network was the most appropriate classifier (accuracy: 81.7%; sensitivity: 81.1%; specificity: 82.2%; precision: 78.9%; AUC: 0.8165). The use of MLR, SVM and k-NN also showed a good performance (AUC >= 0.8). Conclusions: This study demonstrated that machine learning techniques, using clinical and OCT data, can help establish an early diagnosis and predict the course of MS. This advance could help clinicians select more specific treatments for each MS patient. Therefore, our findings underscore the potential of RNFL thickness as a reliable MS biomarker.

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