Choice between Surgery and Conservative Treatment for Patients with Lumbar Spinal Stenosis: Predicting Results through Data Mining Technology
Abstract
:1. Introduction
2. Previous Studies on LSS Prediction Models
3. Methods
3.1. Data
3.2. Application of Data Preprocessing Techniques
- , are the minimum and maximum value of A, respectively,
- is the new value of each entry in data,
- is the old value of each entry in data,
- , is the max and min value of the range (i.e., boundary value of range required), respectively.
3.3. Supervised Learning Techniques
3.4. Feature Selection
3.5. Experimental Setup and Performance Measure
4. Measurements and Experimental Results
4.1. Feature Selection Results
4.2. Evaluation of Model Performance
- ✓
- If no reduction of the intervertebral disc height occurred and the patient was older than 77 years, the patient ultimately underwent the operation.
- ✓
- If a reduction of the intervertebral disc height occurred and the patient’s blood pressure difference was less than 60 mm/Hg, the patient ultimately underwent the operation.
- ✓
- If a reduction of the intervertebral disc height occurred, the patient’s blood pressure difference was greater than 60 mm/Hg, the patient was younger than 77 years, the patient was male, and the patient had leg pain, the patient ultimately underwent the operation.
- ✓
- If a reduction of the intervertebral disc height occurred, the patient’s blood pressure difference was greater than 60 mm/Hg, and the patient was older than 77 years, the patient ultimately underwent the operation.
- ✓
- If no reduction of the intervertebral disc height occurred and the patient was younger than 77 years, the patient ultimately did not undergo the operation.
- ✓
- If a reduction of the intervertebral disc height occurred, the patient’s blood pressure difference was greater than 60 mm/Hg, the patient was younger than 77 years, the patient was female, and the patient had leg pain, the patient ultimately did not undergo the operation.
- ✓
- If a reduction of the intervertebral disc height occurred, the patient’s blood pressure difference was greater than 60 mm/Hg, the patient was younger than 77 years, and patient did not have leg pain, the patient ultimately did not undergo the operation.
5. Discussion
6. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Abbreviations
LSS | lumbar spinal stenosis; |
LGR | logistic regression; |
LBP | lower back pain; |
MRI | magnetic resonance imaging; |
VAS | visual analog scale; |
DT | decision tree; |
CHAID | chi-square automatic interaction detection; |
BPNN | back-propagation neural network; |
SVM | support vector machine; |
CART | classification and regression tree; |
SMOTE | synthetic minority oversampling technique; |
AUC | operating characteristic curve. |
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Input Variables | ||
---|---|---|
Medical records | ||
Demographic data | Age | Continuous variable |
Gender | Male or female | |
Education | No education, elementary school, junior high school, senior high school, university or higher | |
Physiological data | Body mass index (BMI) | Continuous variable |
Diastolic pressure | Continuous variable | |
Systolic pressure | Continuous variable | |
Lifestyle | Smoking history | present or absent |
Drinking history | present or absent | |
Physical examination | Presence of other medical conditions | present or absent |
Walking distance on level ground | Requires complete assistance, requires partial assistance, can walk slowly for approximately 50 m, or can walk independently | |
Leg pain | present or absent | |
Joint pain | present or absent | |
Muscle pain | present or absent | |
Muscle weakness | present or absent | |
Mild paralysis/numbness | present or absent | |
Leg numbness | present or absent | |
MRI diagnosis | ||
Reduction of intervertebral disc height | present or absent | |
Intervertebral disc herniation | present or absent | |
Output variable | ||
Surgery | Surgery performed or not performed |
Technique | Parameter | Value/Range | Configuration |
---|---|---|---|
BPNN | Learning rate | 0.1–1 | 0.9 |
Number of hidden units | 1–2 | 2 | |
Number of learning sample | 9–18 | 18 | |
C5.0 | Minimum number of instances per leaf | 10 | |
SVM | Kernel | RBF kernel | C:10 Gamma:0.1 |
Feature Selection Method | ||
---|---|---|
LGR | C5.0 DT | LGR and C5.0 DT |
Gender | Gender | Gender |
Age | Age | Age |
Education | - | Education |
Systolic pressure | - | Systolic pressure |
Diastolic pressure | Diastolic pressure | Diastolic pressure |
Reduction of intervertebral disc height | Reduction of intervertebral disc height | Reduction of intervertebral disc height |
Leg pain | Leg pain | Leg pain |
Joint pain | - | Joint pain |
Muscle pain | Muscle pain | Muscle pain |
- | Muscle weakness | Muscle weakness |
- | Whether patient has other medical history | Whether patient has other medical history |
Constructed Model | Sensitivity | Specificity | Accuracy rate | AUC |
---|---|---|---|---|
LGR+ C5.0 DT for feature selection using a BPNN | 0.9 | 1 | 94.87 | 0.952 |
BPNN | 0.95 | 0.947 | 94.87 | 0.949 |
C5.0 DT for feature selection using a BPNN | 0.9 | 0.947 | 92.30 | 0.924 |
LGR + C5.0 DT for feature selection using a SVM | 0.9 | 0.947 | 92.30 | 0.924 |
LGR + C5.0 DT for feature selection using a C5.0 DT | 0.9 | 0.94 | 92.3 | 0.924 |
LGR for feature selection using a BPNN | 0.8 | 1 | 89.74 | 0.913 |
SVM | 0.8 | 1 | 89.74 | 0.913 |
C5.0 DT | 1 | 0.8 | 89.74 | 0.910 |
C5.0 DT for feature selection using a SVM | 0.8 | 0.947 | 87.17 | 0.880 |
LGR for feature selection using a SVM | 0.8 | 0.947 | 87.17 | 0.880 |
C5.0 DT for feature selection using a C5.0 DT | 0.9 | 0.83 | 87.17 | 0.873 |
LGR for feature selection using a C5.0 DT | 0.8 | 0.88 | 84.6 | 0.840 |
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Tseng, L.-P.; Pei, Y.-C.; Chen, Y.-S.; Hou, T.-H.; Ou, Y.-K. Choice between Surgery and Conservative Treatment for Patients with Lumbar Spinal Stenosis: Predicting Results through Data Mining Technology. Appl. Sci. 2020, 10, 6406. https://doi.org/10.3390/app10186406
Tseng L-P, Pei Y-C, Chen Y-S, Hou T-H, Ou Y-K. Choice between Surgery and Conservative Treatment for Patients with Lumbar Spinal Stenosis: Predicting Results through Data Mining Technology. Applied Sciences. 2020; 10(18):6406. https://doi.org/10.3390/app10186406
Chicago/Turabian StyleTseng, Li-Ping, Yu-Cheng Pei, Yen-Sheng Chen, Tung-Hsu Hou, and Yang-Kun Ou. 2020. "Choice between Surgery and Conservative Treatment for Patients with Lumbar Spinal Stenosis: Predicting Results through Data Mining Technology" Applied Sciences 10, no. 18: 6406. https://doi.org/10.3390/app10186406
APA StyleTseng, L.-P., Pei, Y.-C., Chen, Y.-S., Hou, T.-H., & Ou, Y.-K. (2020). Choice between Surgery and Conservative Treatment for Patients with Lumbar Spinal Stenosis: Predicting Results through Data Mining Technology. Applied Sciences, 10(18), 6406. https://doi.org/10.3390/app10186406