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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Integrating expert knowledge for dementia risk prediction in individuals with mild cognitive impairment (MCI): a
Meng Wang1,2, Eric E Smith1, Nils Daniel Forkert1,3
1Department of Clinical Neurosciences & Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
Introduction:
To date, there is no broadly accepted dementia risk score for use in individuals with mild cognitive impairment (MCI), partly because there are few large datasets available for model development. When evidence is limited, the knowledge and experience of experts becomes more crucial for risk stratification and providing MCI patients with prognosis. Structured expert elicitation (SEE) includes formal methods to quantify experts' beliefs and help experts to express their beliefs in a quantitative form, reducing biases in the process. This study proposes to (1) assess experts' beliefs about important predictors for 3-year dementia risk in persons with MCI through SEE methodology and (2) to integrate expert knowledge and patient data to derive dementia risk scores in persons with MCI using a Bayesian approach.
Methods And Analysis:
This study will use a combination of SEE methodology, prospectively collected clinical data, and statistical modelling to derive a dementia risk score in persons with MCI . Clinical expert knowledge will be quantified using SEE methodology that involves the selection and training of the experts, administration of questionnaire for eliciting expert knowledge, discussion meetings and results aggregation. Patient data from the Prospective Registry for Persons with Memory Symptoms of the Cognitive Neurosciences Clinic at the University of Calgary; the Alzheimer's Disease Neuroimaging Initiative; and the National Alzheimer's Coordinating Center's Uniform Data Set will be used for model training and validation. Bayesian Cox models will be used to incorporate patient data and elicited data to predict 3-year dementia risk.
Discussion:
This study will develop a robust dementia risk score that incorporates clinician expert knowledge with patient data for accurate risk stratification, prognosis and management of dementia.
Insights
This study develops a dementia risk score for mild cognitive impairment (MCI) patients by combining expert knowledge and clinical data. This approach aims to improve dementia risk prediction and prognosis when large datasets are limited.
Area of Science:
- Neurology
- Gerontology
- Biostatistics
Background:
- Mild cognitive impairment (MCI) lacks a validated dementia risk score due to limited large-scale data.
- Expert knowledge is crucial for prognostication in MCI when data is scarce.
- Structured expert elicitation (SEE) quantifies expert beliefs to reduce bias.
Purpose of the Study:
- To assess expert beliefs on predictors of 3-year dementia risk in MCI.
- To integrate expert knowledge with patient data using a Bayesian approach.
- To derive a dementia risk score for individuals with MCI.
Main Methods:
- Utilizing Structured Expert Elicitation (SEE) to quantify clinical expertise.
- Employing prospectively collected clinical data from multiple registries.
- Applying Bayesian Cox models for risk prediction and model validation.
Main Results:
- Quantification of expert-identified dementia risk predictors in MCI.
- Integration of elicited expert beliefs and patient data into a predictive model.
- Development of a novel dementia risk score for MCI patients.
Conclusions:
- The study will yield a robust dementia risk score for MCI.
- This score will enhance risk stratification and prognosis for dementia.
- The methodology combines expert insight with empirical data for improved clinical utility.
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