Early Identification of High-Risk TIA or Minor Stroke Using Artificial Neural Network
Background and Purpose: The risk of recurrent stroke following a transient ischemic attack (TIA) or minor stroke is high, despite of a significant reduction in the past decade. In this study, we investigated the feasibility of using artificial neural network (ANN) for risk stratification of TIA or m...
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doaj-26061226b28c473e923f9035bf487dbe2020-11-24T23:11:37ZengFrontiers Media S.A.Frontiers in Neurology1664-22952019-03-011010.3389/fneur.2019.00171380981Early Identification of High-Risk TIA or Minor Stroke Using Artificial Neural NetworkKa Lung Chan0Xinyi Leng1Xinyi Leng2Wei Zhang3Weinan Dong4Quanli Qiu5Jie Yang6Yannie Soo7Ka Sing Wong8Thomas W. Leung9Jia Liu10Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, ChinaDepartment of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, ChinaShenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, ChinaShenzhen Institutes of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, ChinaShenzhen Institutes of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, ChinaShenzhen Institutes of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, ChinaDepartment of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaDepartment of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, ChinaDepartment of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, ChinaDepartment of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, ChinaShenzhen Institutes of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, ChinaBackground and Purpose: The risk of recurrent stroke following a transient ischemic attack (TIA) or minor stroke is high, despite of a significant reduction in the past decade. In this study, we investigated the feasibility of using artificial neural network (ANN) for risk stratification of TIA or minor stroke patients.Methods: Consecutive patients with acute TIA or minor ischemic stroke presenting at a tertiary hospital during a 2-year period were recruited. We collected demographics, clinical and imaging data at baseline. The primary outcome was recurrent ischemic stroke within 1 year. We developed ANN models to predict the primary outcome. We randomly down-sampled patients without a primary outcome to 1:1 match with those with a primary outcome to mitigate data imbalance. We used a 5-fold cross-validation approach to train and test the ANN models to avoid overfitting. We employed 19 independent variables at baseline as the input neurons in the ANN models, using a learning algorithm based on backpropagation to minimize the loss function. We obtained the sensitivity, specificity, accuracy and the c statistic of each ANN model from the 5 rounds of cross-validation and compared that of support vector machine (SVM) and Naïve Bayes classifier in risk stratification of the patients.Results: A total of 451 acute TIA or minor stroke patients were enrolled. Forty (8.9%) patients had a recurrent ischemic stroke within 1 year. Another 40 patients were randomly selected from those with no recurrent stroke, so that data from 80 patients in total were used for 5 rounds of training and testing of ANN models. The median sensitivity, specificity, accuracy and c statistic of the ANN models to predict recurrent stroke at 1 year was 75%, 75%, 75%, and 0.77, respectively. ANN model outperformed SVM and Naïve Bayes classifier in our dataset for predicting relapse after TIA or minor stroke.Conclusion: This pilot study indicated that ANN may yield a novel and effective method in risk stratification of TIA and minor stroke. Further studies are warranted for verification and improvement of the current ANN model.https://www.frontiersin.org/article/10.3389/fneur.2019.00171/fulltransient ischemic attackminor strokeartificial neural networkrisk stratificationprognosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ka Lung Chan Xinyi Leng Xinyi Leng Wei Zhang Weinan Dong Quanli Qiu Jie Yang Yannie Soo Ka Sing Wong Thomas W. Leung Jia Liu |
spellingShingle |
Ka Lung Chan Xinyi Leng Xinyi Leng Wei Zhang Weinan Dong Quanli Qiu Jie Yang Yannie Soo Ka Sing Wong Thomas W. Leung Jia Liu Early Identification of High-Risk TIA or Minor Stroke Using Artificial Neural Network Frontiers in Neurology transient ischemic attack minor stroke artificial neural network risk stratification prognosis |
author_facet |
Ka Lung Chan Xinyi Leng Xinyi Leng Wei Zhang Weinan Dong Quanli Qiu Jie Yang Yannie Soo Ka Sing Wong Thomas W. Leung Jia Liu |
author_sort |
Ka Lung Chan |
title |
Early Identification of High-Risk TIA or Minor Stroke Using Artificial Neural Network |
title_short |
Early Identification of High-Risk TIA or Minor Stroke Using Artificial Neural Network |
title_full |
Early Identification of High-Risk TIA or Minor Stroke Using Artificial Neural Network |
title_fullStr |
Early Identification of High-Risk TIA or Minor Stroke Using Artificial Neural Network |
title_full_unstemmed |
Early Identification of High-Risk TIA or Minor Stroke Using Artificial Neural Network |
title_sort |
early identification of high-risk tia or minor stroke using artificial neural network |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neurology |
issn |
1664-2295 |
publishDate |
2019-03-01 |
description |
Background and Purpose: The risk of recurrent stroke following a transient ischemic attack (TIA) or minor stroke is high, despite of a significant reduction in the past decade. In this study, we investigated the feasibility of using artificial neural network (ANN) for risk stratification of TIA or minor stroke patients.Methods: Consecutive patients with acute TIA or minor ischemic stroke presenting at a tertiary hospital during a 2-year period were recruited. We collected demographics, clinical and imaging data at baseline. The primary outcome was recurrent ischemic stroke within 1 year. We developed ANN models to predict the primary outcome. We randomly down-sampled patients without a primary outcome to 1:1 match with those with a primary outcome to mitigate data imbalance. We used a 5-fold cross-validation approach to train and test the ANN models to avoid overfitting. We employed 19 independent variables at baseline as the input neurons in the ANN models, using a learning algorithm based on backpropagation to minimize the loss function. We obtained the sensitivity, specificity, accuracy and the c statistic of each ANN model from the 5 rounds of cross-validation and compared that of support vector machine (SVM) and Naïve Bayes classifier in risk stratification of the patients.Results: A total of 451 acute TIA or minor stroke patients were enrolled. Forty (8.9%) patients had a recurrent ischemic stroke within 1 year. Another 40 patients were randomly selected from those with no recurrent stroke, so that data from 80 patients in total were used for 5 rounds of training and testing of ANN models. The median sensitivity, specificity, accuracy and c statistic of the ANN models to predict recurrent stroke at 1 year was 75%, 75%, 75%, and 0.77, respectively. ANN model outperformed SVM and Naïve Bayes classifier in our dataset for predicting relapse after TIA or minor stroke.Conclusion: This pilot study indicated that ANN may yield a novel and effective method in risk stratification of TIA and minor stroke. Further studies are warranted for verification and improvement of the current ANN model. |
topic |
transient ischemic attack minor stroke artificial neural network risk stratification prognosis |
url |
https://www.frontiersin.org/article/10.3389/fneur.2019.00171/full |
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