Machine learning approaches for supporting patient-specific cardiac rehabilitation programs

Cardiac rehabilitation is a well-recognised non-pharmacological intervention that prevents the recurrence of cardiovascular events. Previous studies investigated the application of data mining techniques for the prediction of the rehabilitation outcome in terms of physical, but fewer reports are focused on using predictive models to support clinicians in the choice of a patient-specific rehabilitative treatment path. Aim of the work was to derive a prediction model for help clinicians in the prescription of the rehabilitation program. We enrolled 129 patients admitted for cardiac rehabilitation after a major cardiovascular event. Data on anthropometric measures, surgical procedure and complications, comorbidities and physical performance scales were collected at admission. The prediction outcome was the rehabilitation program divided in four different paths. Different algorithms were tested to find the best predictive model. Models performance were measured by prediction accuracy. Mean model accuracy was 0.790 (SD 0.118). Best model selected was Lasso regression showing an average classification accuracy on test set of0.935. Data mining techniques have shown to be a reliable tool for support clinicians in the decision of cardiac rehabilitation treatment path.

[1]  M. Jetté,et al.  Metabolic equivalents (METS) in exercise testing, exercise prescription, and evaluation of functional capacity , 1990, Clinical cardiology.

[2]  M. Lauer,et al.  Cardiac rehabilitation and secondary prevention of coronary heart disease: an American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Su , 2005, Circulation.

[3]  Vera Bittner,et al.  Core components of cardiac rehabilitation/secondary prevention programs: 2007 update: a scientific statement from the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Epidemiology and Pr , 2007, Journal of cardiopulmonary rehabilitation and prevention.

[4]  Paul J. Kennedy,et al.  Understanding risk factors in cardiac rehabilitation patients with random forests and decision trees , 2011, AusDM.

[5]  V F Froelicher,et al.  Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. , 2001, Circulation.

[6]  Peyman Rezaei Hachesu,et al.  Use of Data Mining Techniques to Determine and Predict Length of Stay of Cardiac Patients , 2013, Healthcare informatics research.

[7]  I. Gouni-Berthold,et al.  Lipid-lowering drug therapy in elderly patients. , 2011, Current pharmaceutical design.

[8]  R. Tibshirani,et al.  Flexible Discriminant Analysis by Optimal Scoring , 1994 .

[9]  Majid Sarrafzadeh,et al.  Optimizing Interval Training Protocols Using Data Mining Decision Trees , 2009, 2009 Sixth International Workshop on Wearable and Implantable Body Sensor Networks.

[10]  E Geraci,et al.  Assessment of absolute risk of death after myocardial infarction by use of multiple-risk-factor assessment equations: GISSI-Prevenzione mortality risk chart. , 2001, European heart journal.

[11]  Bernadette A. Thomas,et al.  Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 , 2015, The Lancet.

[12]  C. Lavie,et al.  Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss. , 2009, Journal of the American College of Cardiology.

[13]  Guy Lapalme,et al.  A systematic analysis of performance measures for classification tasks , 2009, Inf. Process. Manag..

[14]  S. Ebrahim,et al.  Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. , 2004, The American journal of medicine.

[15]  H. McGee,et al.  A representative study of cardiac rehabilitation activities in European Union Member States: the Carinex survey. , 2002, Journal of cardiopulmonary rehabilitation.

[16]  Vera Bittner,et al.  Core components of cardiac rehabilitation/secondary prevention programs: 2007 update: a scientific statement from the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Epidemiology and Pr , 2007, Circulation.