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Identifying fallers among ophthalmic patients using classification tree methodology
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Melillo, Paolo, Orrico, Ada, Chirico, Franco, Pecchia, Leandro, Rossi, Settimio, Testa, Francesco and Simonelli, Francesca (2017) Identifying fallers among ophthalmic patients using classification tree methodology. PLoS One, 12 (3). e0174083. doi:10.1371/journal.pone.0174083
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Official URL: http://dx.doi.org/10.1371/journal.pone.0174083
Abstract
Purpose
To develop and validate a tool aiming to support ophthalmologists in identifying, during routine ophthalmologic visits, patients at higher risk of falling in the following year.
Methods
A group of 141 subjects (age: 73.2 ± 11.4 years), recruited at our Eye Clinic, underwent a baseline ophthalmic examination and a standardized questionnaire, including lifestyles, general health, social engagement and eyesight problems. Moreover, visual disability was assessed by the Activity of Daily Vision Scale (ADVS). The subjects were followed up for 12 months in order to record prospective falls. A subject who reported at least one fall within one year from the baseline assessment was considered as faller, otherwise as non-faller. Different tree-based algorithms (i.e., C4.5, AdaBoost and Random Forests) were used to develop automatic classifiers and their performances were evaluated by the cross-validation approach.
Results
Over the follow-up, 25 falls were referred by 13 patients. The logistic regression analysis showed the following variables as significant predictors of prospective falls: pseudophakia and use of prescribed eyeglasses as protective factors, recent worsening of visual acuity as risk factor. Random Forest ranked best corrected visual acuity, number of sleeping hours and job type as the most important features. Finally, AdaBoost enabled the identification of subjects at higher risk of falling in the following 12 months with a sensitivity rate of 69.2% and a specificity rate of 76.6%.
Conclusions
The current study proposes a novel method, based on classification trees applied to self-reported factors and health information assessed by a standardized questionnaire during ophthalmological visits, to identify ophthalmic patients at higher risk of falling in the following 12 months. The findings of the current study pave the way to the validation of the proposed novel tool for fall risk screening on a larger cohort of patients with visual impairment referred to eye clinics.
| Item Type: | Journal Article | ||||||
|---|---|---|---|---|---|---|---|
| Subjects: | R Medicine > RE Ophthalmology | ||||||
| Divisions: | Faculty of Science > Engineering | ||||||
| Library of Congress Subject Headings (LCSH): | Vision disorders in old age -- Treatment, Falls (Accidents) in old age | ||||||
| Journal or Publication Title: | PLoS One | ||||||
| Publisher: | Public Library of Science | ||||||
| ISSN: | 1932-6203 | ||||||
| Official Date: | 23 March 2017 | ||||||
| Dates: |
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| Volume: | 12 | ||||||
| Number: | 3 | ||||||
| Article Number: | e0174083 | ||||||
| DOI: | 10.1371/journal.pone.0174083 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access | ||||||
| Funder: | European Regional Development Fund (ERDF) | ||||||
| Grant number: | Grant PON04a3_001 39 (ERDF) |
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