Quantum-Inspired Interpretable AI-Empowered Decision Support System for Detection of Early-Stage Rheumatoid Arthritis in Primary Care Using Scarce Dataset
Abstract
:1. Introduction
The Importance of Early Diagnosis of Rheumatoid Arthritis in Primary Care
2. Background
2.1. Previous Works on Diagnosis of RA
2.2. Fuzzy Cognitive Maps
2.3. Particle Swarm Optimization
2.4. The QFCM Algorithm
3. Materials and Methods
3.1. Dataset
3.2. Proposed Method
Algorithm 1 The QFCM algorithm, modified for classification problems |
Input: Patient’s Data Output: Fuzzy Cognitive Map
|
4. Experimental Results
4.1. Classification Accuracy
4.2. Weight Matrix of the FCM and Its Interpretability
4.3. Web Based DSS
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Section/Topic | Item | Checklist Item | Page | |
---|---|---|---|---|
Title and Abstract | ||||
Title | 1 | D;V | Identify the study as developing and/or validating a multi-variable prediction model, the target population, and the outcome to be predicted | 1 |
Abstract | 2 | D;V | Provide a summary of objectives, study design, setting, participants, sample size, predictors, outcome, statistical analysis, results, and conclusions. | 1 |
Introduction | ||||
Background and objectives | 3a | D;V | Explain the medical context (including whether diagnostic or prognostic) and rationale for developing or validating the multi-variable prediction model, including references to existing models. | 1, 2, 3, 4, 5 |
3b | D;V | Specify the objectives, including whether the study describes the development or validation of the model or both. | 2 | |
Methods | ||||
Source of data | 4a | D;V | Describe the study design or source of data (e.g., randomized trial, cohort, or registry data), separately for the development and validation datasets, if applicable. | 5,6 |
4b | D;V | Specify the key study dates, including start of accrual; end of accrual; and, if applicable, end of follow-up. | 5, 6 | |
Participants | 5a | D;V | Specify key elements of the study setting (e.g., primary care, secondary care, general population) including number and location of centres. | 5, 6 |
5b | D;V | Describe eligibility criteria for participants. | 5 | |
5c | D;V | Give details of treatments received, if relevant | 6 | |
Outcome | 6a | D;V | Clearly define the outcome that is predicted by the prediction model, including how and when assessed. | 10 |
6b | D;V | Report any actions to blind assessment of the outcome to be predicted | N.A. | |
Predictors | 7a | D;V | Clearly define all predictors used in developing or validating the multi-variable prediction model, including how and when they were measured. | 6 |
7b | D;V | Report any actions to blind assessment of predictors for the outcome and other predictors. | N.A. | |
Sample size | 8 | D;V | Explain how the study size was arrived at. | N.A. |
Missing data | 9 | D;V | Describe how missing data were handled (e.g., complete-case analysis, single imputation, multiple imputation) with details of any imputation method. | 6 |
Statistical analysis methods | 10a | D | Describe how predictors were handled in the analyses. | 6 |
10b | D | Specify type of model, all model-building procedures (including any predictor selection), and method for internal validation. | 4, 5, 6 | |
10c | V | For validation, describe how the predictions were calculated. | 9 | |
10d | D;V | Specify all measures used to assess model performance and, if relevant, to compare multiple models. | 9, 10, 11, 12 | |
10e | V | Describe any model updating (e.g., recalibration) arising from the validation, if done. | N.A. | |
Risk groups | 11 | D;V | Provide details on how risk groups were created, if done. | N.A. |
Development vs. validation | 12 | V | For validation, identify any differences from the development data in setting, eligibility criteria, outcome, and predictors. | 9 |
Results | ||||
Participants | 13a | D;V | Describe the flow of participants through the study, including the number of participants with and without the outcome and, if applicable, a summary of the follow-up time. A diagram may be helpful. | N.A. |
13b | D;V | Describe the characteristics of the participants (basic demographics, clinical features, available predictors), including the number of participants with missing data for predictors and outcome. | N.A. | |
13c | V | For validation, show a comparison with the development data of the distribution of important variables (demographics, predictors and outcome). | N.A. | |
Model development | 14a | D | Specify the number of participants and outcome events in each analysis | 10, 11, 12 |
14b | D | If done, report the unadjusted association between each candidate predictor and outcome. | 12, 13 | |
Model specification | 15a | D | Present the full prediction model to allow predictions for individuals (i.e., all regression coefficients, and model intercept or baseline survival at a given time point). | 13, 14 |
15b | D | Explain how to the use the prediction model. | 9, 13, 14 | |
Model performance | 16 | D;V | Report performance measures (with CIs) for the prediction model. | 10 |
Model-updating | 17 | V | If done, report the results from any model updating (i.e., model specification, model performance). | N.A. |
Discussion | ||||
Limitations | 18 | D;V | Discuss any limitations of the study (such as non-representative sample, few events per predictor, missing data). | 13 |
Interpretation | 19a | V | For validation, discuss the results with reference to performance in the development data, and any other validation data. | 10, 11, 12 |
19b | D;V | Give an overall interpretation of the results, considering objectives, limitations, results from similar studies, and other relevant evidence. | 10, 11, 12, 13 | |
Implications | 20 | D;V | Discuss the potential clinical use of the model and implications for future research. | 14 |
Other Information | ||||
Supplementary information | 21 | D;V | Provide information about the availability of supplementary resources, such as study protocol, Web calculator, anddatasets. | 13, 14, 18, 19 |
Funding | 22 | D;V | Give the source of funding and the role of the funders for the present study. | 15 |
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Selected Criteria | Justification |
---|---|
C1: Rest pain | Pain is one the most common symptoms in patients with RA. While it is assumed to be interlinked with inflammation, in many cases, despite controlling the inflammation, the FL pain persists [32,33]. |
C2: Morning stiffness | This symptom is common among patients with RA. Clinical trials have shown that the duration of this symptom is associated with reduced quality of life [34]. |
C3: Symmetry of joint infection | Symmetrical joint involvement is a hallmark of RA. Patients usually have several infections in their joints [35]. |
C4: Redness | Due to inflammation, joints may become red and warm in comparison to FL the surrounding tissue [35]. |
C5: Body pain | Patients with RA usually experience moderate and persistent pain in their body [36]. |
C6: Swelling | One symptom of RA, synovitis, can cause swelling in the joints [37]. |
C7: Positive Rheumatoid factor (RF) test | This test determines the amount of RF in one’s blood. RFs, produced by immune system, are a kind of proteins which are able to destroy healthy tissue. In 70–80% of RA patients test positively for RF. This test has a specificity of 86% [35]. |
C8: Elevated Erythrocyte sedimentation rate (ESR): | It is a test which is able to determine the severity of inflammation inside a body. It measures the pace at which erythrocytes falls. Patients with RA usually have elevated ESR, owing to hypergammaglobulinemia [35,38]. |
C9: Positive Anti-cyclic citrullinated peptide antibody test (Anti-CCP) | 57% to 66% of RA patients have a positive-anti-CCP. Positive-anti-CCP patients usually have more severe RA with poor prognosis [35]. |
No. | C1 | C2 | C3 | C4 | C5 | C6 | C7 | C8 | C9 | Severity (Class Label) |
---|---|---|---|---|---|---|---|---|---|---|
1 | 0.85 | 0.7 | 0.5 | 0.3 | 0.5 | 0.7 | 0.7 | 0.7 | 0.7 | Extremely severe (5) |
2 | 1.0 | 0.7 | 0.5 | 0.3 | 0.5 | 0.7 | 0.7 | 0.7 | 0.7 | Extremely severe (5) |
3 | 0.5 | 0.7 | 0.5 | 0.3 | 0.5 | 0.3 | 0.3 | 0.5 | 0.5 | Very severe (4) |
4 | 0.7 | 0.5 | 0.5 | 0.3 | 0.5 | 0.3 | 0.7 | 0.7 | 0.3 | Very severe (4) |
⋮ | ||||||||||
10 | 0.15 | 0.15 | 0.15 | 0.3 | 0.15 | 0.5 | 0.3 | 0.5 | 0.3 | Very minor (1) |
11 | 0.0 | 0.15 | 0.15 | 0.0 | 0.15 | 0.15 | 0.15 | 0.5 | 0.15 | Very minor (1) |
12 | 0.15 | 0.0 | 0.15 | 0.0 | 0.15 | 0.15 | 0.0 | 0.3 | 0.15 | Extremely minor (0) |
13 | 0.0 | 0.0 | 0.15 | 0.0 | 0.15 | 0.15 | 0.0 | 0.3 | 0.15 | Extremely minor (0) |
MaxIter | Global Migration Period | Local Migration Period | ||
---|---|---|---|---|
1200 | 20 | 10 | 0.01 | 0.01 |
Predicted | |||||||
---|---|---|---|---|---|---|---|
Actual | 0 | 1 | 2 | 3 | 4 | 5 | |
0 | 2 | 0 | 0 | 0 | 0 | 0 | |
1 | 0 | 1 | 1 | 0 | 0 | 0 | |
2 | 0 | 0 | 0 | 0 | 2 | 0 | |
3 | 0 | 0 | 0 | 2 | 0 | 0 | |
4 | 0 | 0 | 0 | 1 | 2 | 0 | |
5 | 0 | 0 | 0 | 0 | 0 | 2 |
Predicted | |||||||
---|---|---|---|---|---|---|---|
Actual | 0 | 1 | 2 | 3 | 4 | 5 | |
0 | 2 | 0 | 0 | 0 | 0 | 0 | |
1 | 1 | 0 | 1 | 0 | 0 | 0 | |
2 | 0 | 0 | 0 | 2 | 0 | 0 | |
3 | 0 | 0 | 1 | 0 | 1 | 0 | |
4 | 0 | 0 | 0 | 0 | 3 | 0 | |
5 | 0 | 0 | 0 | 0 | 0 | 2 |
Predicted | |||||||
---|---|---|---|---|---|---|---|
Actual | 0 | 1 | 2 | 3 | 4 | 5 | |
0 | 0 | 2 | 0 | 0 | 0 | 0 | |
1 | 1 | 0 | 1 | 0 | 0 | 0 | |
2 | 0 | 0 | 0 | 1 | 1 | 0 | |
3 | 0 | 0 | 1 | 0 | 1 | 0 | |
4 | 0 | 0 | 1 | 0 | 2 | 0 | |
5 | 0 | 0 | 0 | 0 | 2 | 0 |
Predicted | |||||||
---|---|---|---|---|---|---|---|
Actual | 0 | 1 | 2 | 3 | 4 | 5 | |
0 | 2 | 0 | 0 | 0 | 0 | 0 | |
1 | 1 | 1 | 0 | 0 | 0 | 0 | |
2 | 0 | 0 | 0 | 2 | 0 | 0 | |
3 | 0 | 0 | 2 | 0 | 0 | 0 | |
4 | 0 | 0 | 1 | 1 | 1 | 0 | |
5 | 0 | 0 | 0 | 0 | 0 | 2 |
Predicted | |||||||
---|---|---|---|---|---|---|---|
Actual | 0 | 1 | 2 | 3 | 4 | 5 | |
0 | 2 | 0 | 0 | 0 | 0 | 0 | |
1 | 1 | 0 | 1 | 0 | 0 | 0 | |
2 | 0 | 0 | 0 | 2 | 0 | 0 | |
3 | 0 | 0 | 2 | 0 | 0 | 0 | |
4 | 0 | 0 | 1 | 1 | 1 | 0 | |
5 | 0 | 0 | 0 | 0 | 0 | 2 |
Predicted | |||||||
---|---|---|---|---|---|---|---|
Actual | 0 | 1 | 2 | 3 | 4 | 5 | |
0 | 2 | 0 | 0 | 0 | 0 | 0 | |
1 | 1 | 1 | 0 | 0 | 0 | 0 | |
2 | 0 | 0 | 0 | 1 | 1 | 0 | |
3 | 0 | 0 | 2 | 0 | 0 | 0 | |
4 | 0 | 0 | 1 | 1 | 1 | 0 | |
5 | 0 | 0 | 0 | 0 | 0 | 2 |
Predicted | |||||||
---|---|---|---|---|---|---|---|
Actual | 0 | 1 | 2 | 3 | 4 | 5 | |
0 | 2 | 0 | 0 | 0 | 0 | 0 | |
1 | 1 | 0 | 1 | 0 | 0 | 0 | |
2 | 0 | 0 | 0 | 1 | 1 | 0 | |
3 | 0 | 0 | 1 | 0 | 1 | 0 | |
4 | 0 | 0 | 1 | 0 | 2 | 0 | |
5 | 0 | 0 | 0 | 0 | 0 | 2 |
Predicted | |||||||
---|---|---|---|---|---|---|---|
Actual | 0 | 1 | 2 | 3 | 4 | 5 | |
0 | 2 | 0 | 0 | 0 | 0 | 0 | |
1 | 0 | 2 | 0 | 0 | 0 | 0 | |
2 | 0 | 0 | 0 | 2 | 0 | 0 | |
3 | 0 | 0 | 0 | 1 | 1 | 0 | |
4 | 0 | 0 | 0 | 0 | 3 | 0 | |
5 | 0 | 0 | 0 | 0 | 0 | 2 |
Predicted | |||||||
---|---|---|---|---|---|---|---|
Actual | 0 | 1 | 2 | 3 | 4 | 5 | |
0 | 2 | 0 | 0 | 0 | 0 | 0 | |
1 | 0 | 1 | 1 | 0 | 0 | 0 | |
2 | 0 | 0 | 0 | 0 | 2 | 0 | |
3 | 0 | 0 | 1 | 0 | 1 | 0 | |
4 | 0 | 0 | 0 | 0 | 3 | 0 | |
5 | 0 | 0 | 0 | 0 | 0 | 2 |
LDA | Linear | Quadratic | Cubic | Fine | Weighted | |
---|---|---|---|---|---|---|
SVM | SVM | SVM | KNN | KNN | ||
QFCM | 0.002 | 0.005 | 0.001 | 0.006 | 0.002 | 0.002 |
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Rahimi, S.A.; Kolahdoozi, M.; Mitra, A.; Salmeron, J.L.; Navali, A.M.; Sadeghpour, A.; Mir Mohammadi, S.A. Quantum-Inspired Interpretable AI-Empowered Decision Support System for Detection of Early-Stage Rheumatoid Arthritis in Primary Care Using Scarce Dataset. Mathematics 2022, 10, 496. https://doi.org/10.3390/math10030496
Rahimi SA, Kolahdoozi M, Mitra A, Salmeron JL, Navali AM, Sadeghpour A, Mir Mohammadi SA. Quantum-Inspired Interpretable AI-Empowered Decision Support System for Detection of Early-Stage Rheumatoid Arthritis in Primary Care Using Scarce Dataset. Mathematics. 2022; 10(3):496. https://doi.org/10.3390/math10030496
Chicago/Turabian StyleRahimi, Samira Abbasgholizadeh, Mojtaba Kolahdoozi, Arka Mitra, Jose L. Salmeron, Amir Mohammad Navali, Alireza Sadeghpour, and Seyed Amir Mir Mohammadi. 2022. "Quantum-Inspired Interpretable AI-Empowered Decision Support System for Detection of Early-Stage Rheumatoid Arthritis in Primary Care Using Scarce Dataset" Mathematics 10, no. 3: 496. https://doi.org/10.3390/math10030496
APA StyleRahimi, S. A., Kolahdoozi, M., Mitra, A., Salmeron, J. L., Navali, A. M., Sadeghpour, A., & Mir Mohammadi, S. A. (2022). Quantum-Inspired Interpretable AI-Empowered Decision Support System for Detection of Early-Stage Rheumatoid Arthritis in Primary Care Using Scarce Dataset. Mathematics, 10(3), 496. https://doi.org/10.3390/math10030496