Cross-validation of predictive models for functional recovery after post-stroke rehabilitation.

Background: Rehabilitation treatments and services are essential for the recovery of post-stroke patients' functions; however, the increasing number of available therapies and the lack of consensus among outcome measures compromises the possibility to determine an appropriate level of evidence. Mach...

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Publicado en:Journal of NeuroEngineering & Rehabilitation (JNER) Vol. 19; no. 1; pp. 1 - 12
Autores principales: Campagnini, Silvia, Liuzzi, Piergiuseppe, Mannini, Andrea, Basagni, Benedetta, Macchi, Claudio, Carrozza, Maria Chiara, Cecchi, Francesca
Formato: research Journal Article
Publicado: BioMed Central 9/7/2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 9/7/2022
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      pub: BioMed Central
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        10.1186/s12984-022-01075-7
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        atl: Cross-validation of predictive models for functional recovery after post-stroke rehabilitation.
      aug:
        au:
          Campagnini, Silvia
          Liuzzi, Piergiuseppe
          Mannini, Andrea
          Basagni, Benedetta
          Macchi, Claudio
          Carrozza, Maria Chiara
          Cecchi, Francesca
        affil: The Biorobotics Institute, Scuola Superiore Sant'Anna, Viale Rinaldo Piaggio 34, 56025, Pontedera, Italy
      sug:
        subj:
          Stroke
          Recovery
          Scales
          Barthel Index
      ab: Background: Rehabilitation treatments and services are essential for the recovery of post-stroke patients' functions; however, the increasing number of available therapies and the lack of consensus among outcome measures compromises the possibility to determine an appropriate level of evidence. Machine learning techniques for prognostic applications offer accurate and interpretable predictions, supporting the clinical decision for personalised treatment. The aim of this study is to develop and cross-validate predictive models for the functional prognosis of patients, highlighting the contributions of each predictor.Methods: A dataset of 278 post-stroke patients was used for the prediction of the class transition, obtained from the modified Barthel Index. Four classification algorithms were cross-validated and compared. On the best performing model on the validation set, an analysis of predictors contribution was conducted.Results: The Random Forest obtained the best overall results on the accuracy (76.2%), balanced accuracy (74.3%), sensitivity (0.80), and specificity (0.68). The combination of all the classification results on the test set, by weighted voting, reached 80.2% accuracy. The predictors analysis applied on the Support Vector Machine, showed that a good trunk control and communication level, and the absence of bedsores retain the major contribution in the prediction of a good functional outcome.Conclusions: Despite a more comprehensive assessment of the patients is needed, this work paves the way for the implementation of solutions for clinical decision support in the rehabilitation of post-stroke patients. Indeed, offering good prognostic accuracies for class transition and patient-wise view of the predictors contributions, it might help in a personalised optimisation of the patients' rehabilitation path.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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