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The Trail Making test : a study of its ability to predict falls in the acute neurological in-patient population
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Mateen, Bilal Akhter, Bussas, Matthias, Doogan, Catherine, Waller, Denise, Saverino, Alessia, Király, Franz J. and Playford, E. Diane (2018) The Trail Making test : a study of its ability to predict falls in the acute neurological in-patient population. Clinical Rehabilitation, 32 (10). pp. 1396-1405. doi:10.1177/0269215518771127 ISSN 0269-2155.
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Official URL: http://dx.doi.org/10.1177/0269215518771127
Abstract
Objective:
To determine whether tests of cognitive function and patient-reported outcome measures of motor function can be used to create a machine learning-based predictive tool for falls.
Design:
Prospective cohort study.
Setting:
Tertiary neurological and neurosurgical center.
Subjects:
In all, 337 in-patients receiving neurosurgical, neurological, or neurorehabilitation-based care.
Main Measures:
Binary (Y/N) for falling during the in-patient episode, the Trail Making Test (a measure of attention and executive function) and the Walk-12 (a patient-reported measure of physical function).
Results:
The principal outcome was a fall during the in-patient stay (n = 54). The Trail test was identified as the best predictor of falls. Moreover, addition of other variables, did not improve the prediction (Wilcoxon signed-rank P < 0.001). Classical linear statistical modeling methods were then compared with more recent machine learning based strategies, for example, random forests, neural networks, support vector machines. The random forest was the best modeling strategy when utilizing just the Trail Making Test data (Wilcoxon signed-rank P < 0.001) with 68% (± 7.7) sensitivity, and 90% (± 2.3) specificity.
Conclusion:
This study identifies a simple yet powerful machine learning (Random Forest) based predictive model for an in-patient neurological population, utilizing a single neuropsychological test of cognitive function, the Trail Making test.
Item Type: | Journal Article | ||||||||||||
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Subjects: | Q Science > QP Physiology | ||||||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Falls (Accidents) -- Risk factors, Cognition disorders, Nervous system -- Diseases, Executive functions (Neuropsychology), Attention, Decision support systems | ||||||||||||
Journal or Publication Title: | Clinical Rehabilitation | ||||||||||||
Publisher: | Sage Publications Ltd. | ||||||||||||
ISSN: | 0269-2155 | ||||||||||||
Official Date: | 1 October 2018 | ||||||||||||
Dates: |
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Volume: | 32 | ||||||||||||
Number: | 10 | ||||||||||||
Page Range: | pp. 1396-1405 | ||||||||||||
DOI: | 10.1177/0269215518771127 | ||||||||||||
Status: | Peer Reviewed | ||||||||||||
Publication Status: | Published | ||||||||||||
Reuse Statement (publisher, data, author rights): | Mateen, Bilal Akhter, Bussas, Matthias, Doogan, Catherine, Waller, Denise, Saverino, Alessia, Király, Franz J. and Playford, E. Diane (2018) The Trail Making test: a study of its ability to predict falls in the acute neurological in-patient population. Clinical Rehabilitation, 32 (10). pp. 1396-1405. doi:10.1177/0269215518771127. Copyright © 2018 The Authors. Reprinted by permission of SAGE Publications. doi:10.1177/0269215518771127. | ||||||||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||||||||
Date of first compliant deposit: | 8 October 2018 | ||||||||||||
Date of first compliant Open Access: | 9 October 2018 | ||||||||||||
Open Access Version: |
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