Improving Medication Regimen Recommendation for Parkinson’s Disease Using Sensor Technology
Parkinson’s disease medication treatment planning is generally based on subjective data obtained through clinical, physician-patient interactions. The Personal KinetiGraph™ (PKG) and similar wearable sensors have shown promise in enabling objective, continuous remote health monitoring for Parkinson’...
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doaj-8b175a355e4945ec8f4625bf1c286dcb2021-06-01T00:33:14ZengMDPI AGSensors1424-82202021-05-01213553355310.3390/s21103553Improving Medication Regimen Recommendation for Parkinson’s Disease Using Sensor TechnologyJeremy Watts0Anahita Khojandi1Rama Vasudevan2Fatta B. Nahab3Ritesh A. Ramdhani4Department of Industrial and Systems Engineering, University of Tennessee, Knoxville, TN 37996, USADepartment of Industrial and Systems Engineering, University of Tennessee, Knoxville, TN 37996, USACenter for Nanophase Materials Science, Oak Ridge National Laboratory, Oak Ridge, TN 37830, USADepartment of Neurosciences, University of California San Diego, La Jolla, CA 92093, USADepartment of Neurology, Donald and Barbara School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, USAParkinson’s disease medication treatment planning is generally based on subjective data obtained through clinical, physician-patient interactions. The Personal KinetiGraph™ (PKG) and similar wearable sensors have shown promise in enabling objective, continuous remote health monitoring for Parkinson’s patients. In this proof-of-concept study, we propose to use objective sensor data from the PKG and apply machine learning to cluster patients based on levodopa regimens and response. The resulting clusters are then used to enhance treatment planning by providing improved initial treatment estimates to supplement a physician’s initial assessment. We apply k-means clustering to a dataset of within-subject Parkinson’s medication changes—clinically assessed by the MDS-Unified Parkinson’s Disease Rating Scale-III (MDS-UPDRS-III) and the PKG sensor for movement staging. A random forest classification model was then used to predict patients’ cluster allocation based on their respective demographic information, MDS-UPDRS-III scores, and PKG time-series data. Clinically relevant clusters were partitioned by levodopa dose, medication administration frequency, and total levodopa equivalent daily dose—with the PKG providing similar symptomatic assessments to physician MDS-UPDRS-III scores. A random forest classifier trained on demographic information, MDS-UPDRS-III scores, and PKG time-series data was able to accurately classify subjects of the two most demographically similar clusters with an accuracy of 86.9%, an F1 score of 90.7%, and an AUC of 0.871. A model that relied solely on demographic information and PKG time-series data provided the next best performance with an accuracy of 83.8%, an F1 score of 88.5%, and an AUC of 0.831, hence further enabling fully remote assessments. These computational methods demonstrate the feasibility of using sensor-based data to cluster patients based on their medication responses with further potential to assist with medication recommendations.https://www.mdpi.com/1424-8220/21/10/3553Parkinson’s diseasewearable sensorsmachine learninglevodoparegimendecision support tool |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jeremy Watts Anahita Khojandi Rama Vasudevan Fatta B. Nahab Ritesh A. Ramdhani |
spellingShingle |
Jeremy Watts Anahita Khojandi Rama Vasudevan Fatta B. Nahab Ritesh A. Ramdhani Improving Medication Regimen Recommendation for Parkinson’s Disease Using Sensor Technology Sensors Parkinson’s disease wearable sensors machine learning levodopa regimen decision support tool |
author_facet |
Jeremy Watts Anahita Khojandi Rama Vasudevan Fatta B. Nahab Ritesh A. Ramdhani |
author_sort |
Jeremy Watts |
title |
Improving Medication Regimen Recommendation for Parkinson’s Disease Using Sensor Technology |
title_short |
Improving Medication Regimen Recommendation for Parkinson’s Disease Using Sensor Technology |
title_full |
Improving Medication Regimen Recommendation for Parkinson’s Disease Using Sensor Technology |
title_fullStr |
Improving Medication Regimen Recommendation for Parkinson’s Disease Using Sensor Technology |
title_full_unstemmed |
Improving Medication Regimen Recommendation for Parkinson’s Disease Using Sensor Technology |
title_sort |
improving medication regimen recommendation for parkinson’s disease using sensor technology |
publisher |
MDPI AG |
series |
Sensors |
issn |
1424-8220 |
publishDate |
2021-05-01 |
description |
Parkinson’s disease medication treatment planning is generally based on subjective data obtained through clinical, physician-patient interactions. The Personal KinetiGraph™ (PKG) and similar wearable sensors have shown promise in enabling objective, continuous remote health monitoring for Parkinson’s patients. In this proof-of-concept study, we propose to use objective sensor data from the PKG and apply machine learning to cluster patients based on levodopa regimens and response. The resulting clusters are then used to enhance treatment planning by providing improved initial treatment estimates to supplement a physician’s initial assessment. We apply k-means clustering to a dataset of within-subject Parkinson’s medication changes—clinically assessed by the MDS-Unified Parkinson’s Disease Rating Scale-III (MDS-UPDRS-III) and the PKG sensor for movement staging. A random forest classification model was then used to predict patients’ cluster allocation based on their respective demographic information, MDS-UPDRS-III scores, and PKG time-series data. Clinically relevant clusters were partitioned by levodopa dose, medication administration frequency, and total levodopa equivalent daily dose—with the PKG providing similar symptomatic assessments to physician MDS-UPDRS-III scores. A random forest classifier trained on demographic information, MDS-UPDRS-III scores, and PKG time-series data was able to accurately classify subjects of the two most demographically similar clusters with an accuracy of 86.9%, an F1 score of 90.7%, and an AUC of 0.871. A model that relied solely on demographic information and PKG time-series data provided the next best performance with an accuracy of 83.8%, an F1 score of 88.5%, and an AUC of 0.831, hence further enabling fully remote assessments. These computational methods demonstrate the feasibility of using sensor-based data to cluster patients based on their medication responses with further potential to assist with medication recommendations. |
topic |
Parkinson’s disease wearable sensors machine learning levodopa regimen decision support tool |
url |
https://www.mdpi.com/1424-8220/21/10/3553 |
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