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Darsha Jayamini WK, Mirza F, Asif Naeem M, Chan AHY. Investigating Machine Learning Techniques for Predicting Risk of Asthma Exacerbations: A Systematic Review. J Med Syst 2024; 48:49. [PMID: 38739297 PMCID: PMC11090925 DOI: 10.1007/s10916-024-02061-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 04/04/2024] [Indexed: 05/14/2024]
Abstract
Asthma, a common chronic respiratory disease among children and adults, affects more than 200 million people worldwide and causes about 450,000 deaths each year. Machine learning is increasingly applied in healthcare to assist health practitioners in decision-making. In asthma management, machine learning excels in performing well-defined tasks, such as diagnosis, prediction, medication, and management. However, there remain uncertainties about how machine learning can be applied to predict asthma exacerbation. This study aimed to systematically review recent applications of machine learning techniques in predicting the risk of asthma attacks to assist asthma control and management. A total of 860 studies were initially identified from five databases. After the screening and full-text review, 20 studies were selected for inclusion in this review. The review considered recent studies published from January 2010 to February 2023. The 20 studies used machine learning techniques to support future asthma risk prediction by using various data sources such as clinical, medical, biological, and socio-demographic data sources, as well as environmental and meteorological data. While some studies considered prediction as a category, other studies predicted the probability of exacerbation. Only a group of studies applied prediction windows. The paper proposes a conceptual model to summarise how machine learning and available data sources can be leveraged to produce effective models for the early detection of asthma attacks. The review also generated a list of data sources that other researchers may use in similar work. Furthermore, we present opportunities for further research and the limitations of the preceding studies.
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Affiliation(s)
- Widana Kankanamge Darsha Jayamini
- School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, Auckland, 1010, New Zealand.
- Department of Software Engineering, Faculty of Computing and Technology, University of Kelaniya, Kelaniya, 11300, Sri Lanka.
| | - Farhaan Mirza
- School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, Auckland, 1010, New Zealand
| | - M Asif Naeem
- Department of Data Science & Artificial Intelligence, National University of Computer and Emerging Sciences (NUCES), Islamabad, 44000, Pakistan
| | - Amy Hai Yan Chan
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, 1142, New Zealand
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Lira GVDAG, da Silva GAP, Bezerra PGDM, Sarinho ESC. Avoidance of Inhaled Pollutants and Irritants in Asthma from a Salutogenic Perspective. J Asthma Allergy 2024; 17:237-250. [PMID: 38524100 PMCID: PMC10960548 DOI: 10.2147/jaa.s445864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 12/19/2023] [Indexed: 03/26/2024] Open
Abstract
Much is known about the role of aeroallergens in asthma, but little is described about the damage caused by inhaled pollutants and irritants to the respiratory epithelium. In this context, the most frequent pollutants and irritants inhaled in the home environment were identified, describing the possible repercussions that may occur in the respiratory tract of the pediatric population with asthma and highlighting the role of the caregiver in environmental control through a salutogenic perspective. Searches were carried out in the MEDLINE/PubMed, Web of Science, Lilacs and Scopus databases for articles considered relevant for the theoretical foundation of this integrative review, in which interactions between exposure to pollutants and inhaled irritants and lung involvement. Articles published in the last 10 years that used the following descriptors were considered: air pollution; tobacco; particulate matter; disinfectants; hydrocarbons, fluorinated; odorants; chloramines; pesticide; asthma; and beyond Antonovsky's sense of coherence. Exposure to smoke and some substances found in cleaning products, such as benzalkonium chloride, ethylenediaminetetraacetic acid and monoethanolamine, offer potential risks for sensitization and exacerbation of asthma. The vast majority of the seven main inhaled products investigated provoke irritative inflammatory reactions and oxidative imbalance in the respiratory epithelium. In turn, the caregiver's role is essential in health promotion and the clinical control of paediatric asthma. From a salutogenic point of view, pollutants and irritants inhaled at home should be carefully investigated in the clinical history so that strategies to remove or reduce exposures can be used by caregivers of children and adolescents with asthma.
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Affiliation(s)
- Georgia Véras de Araújo Gueiros Lira
- Allergy and Immunology Research Centre, Federal University of Pernambuco, Recife, PE, Brazil
- Department of Paediatrics, Federal University of Pernambuco, Recife, PE, Brazil
| | | | | | - Emanuel S C Sarinho
- Allergy and Immunology Research Centre, Federal University of Pernambuco, Recife, PE, Brazil
- Department of Paediatrics, Federal University of Pernambuco, Recife, PE, Brazil
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Sarikloglou E, Fouzas S, Paraskakis E. Prediction of Asthma Exacerbations in Children. J Pers Med 2023; 14:20. [PMID: 38248721 PMCID: PMC10820562 DOI: 10.3390/jpm14010020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/17/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
Asthma exacerbations are common in asthmatic children, even among those with good disease control. Asthma attacks result in the children and their parents missing school and work days; limit the patient's social and physical activities; and lead to emergency department visits, hospital admissions, or even fatal events. Thus, the prompt identification of asthmatic children at risk for exacerbation is crucial, as it may allow for proactive measures that could prevent these episodes. Children prone to asthma exacerbation are a heterogeneous group; various demographic factors such as younger age, ethnic group, low family income, clinical parameters (history of an exacerbation in the past 12 months, poor asthma control, poor adherence to treatment, comorbidities), Th2 inflammation, and environmental exposures (pollutants, stress, viral and bacterial pathogens) determine the risk of a future exacerbation and should be carefully considered. This paper aims to review the existing evidence regarding the predictors of asthma exacerbations in children and offer practical monitoring guidance for promptly recognizing patients at risk.
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Affiliation(s)
| | - Sotirios Fouzas
- Department of Pediatrics, University of Patras Medical School, 26504 Patras, Greece;
| | - Emmanouil Paraskakis
- Paediatric Respiratory Unit, Paediatric Department, University of Crete, 71500 Heraklion, Greece
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Kallis C, Calvo RA, Schuller B, Quint JK. Development of an Asthma Exacerbation Risk Prediction Model for Conversational Use by Adults in England. Pragmat Obs Res 2023; 14:111-125. [PMID: 37817913 PMCID: PMC10560745 DOI: 10.2147/por.s424098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 09/19/2023] [Indexed: 10/12/2023] Open
Abstract
Background Improving accurate risk assessment of asthma exacerbations, and reduction via relevant behaviour change among people with asthma could save lives and reduce health care costs. We developed a simple personalised risk prediction model for asthma exacerbations using factors collected in routine healthcare data for use in a risk modelling feature for automated conversational systems. Methods We used pseudonymised primary care electronic healthcare records from the Clinical Practice Research Datalink (CPRD) Aurum database in England. We combined variables for prediction of asthma exacerbations using logistic regression including age, gender, ethnicity, Index of Multiple Deprivation, geographical region and clinical variables related to asthma events. Results We included 1,203,741 patients divided into three cohorts to implement temporal validation: 898,763 (74.7%) in the training sample, 226,754 (18.8%) in the testing sample and 78,224 (6.5%) in the validation sample. The Area under the ROC curve (AUC) for the full model was 0.72 and for the restricted model was 0.71. Using a cut-off point of 0.1, approximately 27 asthma reviews by clinicians per 100 patients would be prevented compared with a strategy that all patients are regarded as high risk. Compared with patients without an exacerbation, patients who exacerbated were older, more likely to be female, prescribed more SABA and ICS in the preceding 12 months, have history of GORD, COPD, anxiety, depression, live in very deprived areas and have more severe disease. Conclusion Using information available from routinely collected electronic healthcare record data, we developed a model that has moderate ability to separate patients who had an asthma exacerbation within 3 months from their index date from patients who did not. When comparing this model with a simplified model with variables that can easily be self-reported through a WhatsApp chatbot, we have shown that the predictive performance of the model is not substantially different.
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Affiliation(s)
- Constantinos Kallis
- National Heart and Lung Institute, and School of Public Health, Imperial College London, London, UK
| | - Rafael A Calvo
- Dyson School of Engineering, Faculty of Engineering, Imperial College London, London, UK
| | - Bjorn Schuller
- Department of Computing, Faculty of Engineering, Imperial College London, London, UK
| | - Jennifer K Quint
- National Heart and Lung Institute, and School of Public Health, Imperial College London, London, UK
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Rodríguez-Martínez CE, Sossa-Briceño MP, Forno E. Composite predictive models for asthma exacerbations or asthma deterioration in pediatric asthmatic patients: A systematic review of the literature. Pediatr Pulmonol 2023; 58:2703-2718. [PMID: 37403820 DOI: 10.1002/ppul.26584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 06/05/2023] [Accepted: 06/24/2023] [Indexed: 07/06/2023]
Abstract
A variety of factors have shown to be useful in predicting which children are at high risk for future asthma exacerbations, some of them combined into composite predictive models. The objective of the present review was to systematically identify all the available published composite predictive models developed for predicting which children are at high risk for future asthma exacerbations or asthma deterioration. A systematic search of the literature was performed to identify studies in which a composite predictive model developed for predicting which children are at high risk for future asthma exacerbations or asthma deterioration was described. Methodological quality assessment was performed using accepted criteria for prediction rules and prognostic models. A total of 18 articles, describing a total of 17 composite predictive models were identified and included in the review. The number of predictors included in the models ranged from 2-149. Upon analyzing the content of the models, use of healthcare services for asthma and prescribed or dispensed asthma medications were the most frequently used items (in 8/17, 47.0% of the models). Seven (41.2%) models fulfilled all the quality criteria considered in our evaluation. The identified models may help clinicians dealing with asthmatic children to identify which children are at a higher risk for future asthma exacerbations or asthma deterioration, therefore targeting and/or reinforcing specific interventions for these children in an attempt to prevent exacerbations or deterioration of the disease.
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Affiliation(s)
- Carlos E Rodríguez-Martínez
- Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
- Department of Pediatric Pulmonology, School of Medicine, Universidad El Bosque, Bogota, Colombia
| | - Monica P Sossa-Briceño
- Department of Internal Medicine, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
| | - Erick Forno
- Division of Pulmonary Medicine, Department of Pediatrics, Indiana University School of Medicine and Riley Children's Hospital, Indianapolis, Indiana, USA
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Budiarto A, Sheikh A, Wilson A, Price DB, Shah SA. Handling Class Imbalance in Machine Learning-based Prediction Models: A Case Study in Asthma Management. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-5. [PMID: 38083129 DOI: 10.1109/embc40787.2023.10340751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
A data-driven prediction tool has the potential to provide early warning of an asthma attack and improve asthma management and outcomes. Most previous machine learning (ML)-based studies for asthma attack prediction have reported a severe class imbalance, with major implications for model performance. We aimed to undertake a systematic comparison of several class imbalance handling techniques in the context of risk prediction models for asthma prognosis. We used data from 9,835 asthma patients extracted from the Medical Information Mart for Intensive Care (MIMIC) IV database and deployed five class imbalance handling methods based on synthetic minority oversampling technique (SMOTE) and cost function customisation. We then compared their performances in improving two-class classifier models developed using logistic regression (LR) and extreme gradient boosting (XGBoost) for three different prediction tasks with varying severity of class imbalance (proportion of majority class ranging from 90.86% to 98.98%). The cost function customisation technique substantially outperformed the SMOTE-based methods in all tasks. XGBoost combined with cost function customisation achieved the highest prediction performance for the outcome with the most extreme class imbalance ratio (AUC = 0.72). Our findings suggest that the cost function customisation-based approach to tackle class imbalance provides substantially better performance compared to oversampling in the context of asthma management.Clinical Relevance- This study underscores the challenge of class imbalance in the context of prediction tools to improve asthma management and outcomes and provides a methodological solution that addresses the challenge. Accurate asthma prediction tools can provide early warning and potentially prevent deterioration thereby improving the quality of life of patients with asthma.
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Stafie CS, Sufaru IG, Ghiciuc CM, Stafie II, Sufaru EC, Solomon SM, Hancianu M. Exploring the Intersection of Artificial Intelligence and Clinical Healthcare: A Multidisciplinary Review. Diagnostics (Basel) 2023; 13:1995. [PMID: 37370890 DOI: 10.3390/diagnostics13121995] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/31/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
Artificial intelligence (AI) plays a more and more important role in our everyday life due to the advantages that it brings when used, such as 24/7 availability, a very low percentage of errors, ability to provide real time insights, or performing a fast analysis. AI is increasingly being used in clinical medical and dental healthcare analyses, with valuable applications, which include disease diagnosis, risk assessment, treatment planning, and drug discovery. This paper presents a narrative literature review of AI use in healthcare from a multi-disciplinary perspective, specifically in the cardiology, allergology, endocrinology, and dental fields. The paper highlights data from recent research and development efforts in AI for healthcare, as well as challenges and limitations associated with AI implementation, such as data privacy and security considerations, along with ethical and legal concerns. The regulation of responsible design, development, and use of AI in healthcare is still in early stages due to the rapid evolution of the field. However, it is our duty to carefully consider the ethical implications of implementing AI and to respond appropriately. With the potential to reshape healthcare delivery and enhance patient outcomes, AI systems continue to reveal their capabilities.
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Affiliation(s)
- Celina Silvia Stafie
- Department of Preventive Medicine and Interdisciplinarity, Grigore T. Popa University of Medicine and Pharmacy Iasi, Universitatii Street 16, 700115 Iasi, Romania
| | - Irina-Georgeta Sufaru
- Department of Periodontology, Grigore T. Popa University of Medicine and Pharmacy Iasi, Universitatii Street 16, 700115 Iasi, Romania
| | - Cristina Mihaela Ghiciuc
- Department of Morpho-Functional Sciences II-Pharmacology and Clinical Pharmacology, Grigore T. Popa University of Medicine and Pharmacy Iasi, Universitatii Street 16, 700115 Iasi, Romania
| | - Ingrid-Ioana Stafie
- Endocrinology Residency Program, Sf. Spiridon Clinical Emergency Hospital, Independentei 1, 700111 Iasi, Romania
| | | | - Sorina Mihaela Solomon
- Department of Periodontology, Grigore T. Popa University of Medicine and Pharmacy Iasi, Universitatii Street 16, 700115 Iasi, Romania
| | - Monica Hancianu
- Pharmacognosy-Phytotherapy, Grigore T. Popa University of Medicine and Pharmacy Iasi, Universitatii Street 16, 700115 Iasi, Romania
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MacMath D, Chen M, Khoury P. Artificial Intelligence: Exploring the Future of Innovation in Allergy Immunology. Curr Allergy Asthma Rep 2023:10.1007/s11882-023-01084-z. [PMID: 37160554 PMCID: PMC10169188 DOI: 10.1007/s11882-023-01084-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE OF REVIEW Artificial intelligence (AI) has increasingly been used in healthcare. Given the capacity of AI to handle large data and complex relationships between variables, AI is well suited for applications in healthcare. Recently, AI has been applied to allergy research. RECENT FINDINGS In this article, we review how AI technologies have been utilized in basic science and clinical allergy research for asthma, atopic dermatitis, rhinology, adverse reactions to drugs and vaccines, food allergy, anaphylaxis, urticaria, and eosinophilic gastrointestinal disorders. We discuss barriers for AI adoption to improve the care of patients with atopic diseases. These studies demonstrate the utility of applying AI to the field of allergy to help investigators expand their understanding of disease pathogenesis, improve diagnostic accuracy, enable prediction for treatments and outcomes, and for drug discovery.
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Affiliation(s)
- Derek MacMath
- Department of Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Meng Chen
- Division of Pulmonary, Allergy & Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Paneez Khoury
- National Institutes of Allergic and Infectious Diseases, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, USA.
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