Integrating machine learning techniques and physiology based heart rate features for antepartum fetal monitoring.

Fetal Heart Rate monitoring Machine learning and statistical models Multivariate analysis Physiology-based features Predictive analytics

Journal

Computer methods and programs in biomedicine
ISSN: 1872-7565
Titre abrégé: Comput Methods Programs Biomed
Pays: Ireland
ID NLM: 8506513

Informations de publication

Date de publication:
Mar 2020
Historique:
received: 26 05 2019
revised: 17 07 2019
accepted: 04 08 2019
pubmed: 5 11 2019
medline: 7 1 2021
entrez: 4 11 2019
Statut: ppublish

Résumé

Intrauterine Growth Restriction (IUGR) is a fetal condition defined as the abnormal rate of fetal growth. The pathology is a documented cause of fetal and neonatal morbidity and mortality. In clinical practice, diagnosis is confirmed at birth and may only be suspected during pregnancy. Therefore, designing an accurate model for the early and prompt identification of pathology in the antepartum period is crucial in view of pregnancy management. We tested the performance of 15 machine learning techniques in discriminating healthy versus IUGR fetuses. The various models were trained with a set of 12 physiology based heart rate features extracted from a single antepartum CardioTocographic (CTG) recording. The reason for the utilization of time, frequency, and nonlinear indices is based on their standalone documented ability to describe several physiological and pathological fetal conditions. We validated our approach on a database of 60 healthy and 60 IUGR fetuses. The machine learning methodology achieving the best performance was Random Forests. Specifically, we obtained a mean classification accuracy of 0.911 [0.860, 0.961 (0.95 confidence interval)] averaged over 10 test sets (10 Fold Cross Validation). Similar results were provided by Classification Trees, Logistic Regression, and Support Vector Machines. A features ranking procedure highlighted that nonlinear indices showed the highest capability to discriminate between the considered fetal conditions. Nevertheless, is the combination of features investigating CTG signal in different domains, that contributes to an increase in classification accuracy. We provided validation of an accurate artificially intelligence framework for the diagnosis of IUGR condition in the antepartum period. The employed physiology based heart rate features constitute an interpretable link between the machine learning results and the quantitative estimators of fetal wellbeing.

Sections du résumé

BACKGROUND AND OBJECTIVES OBJECTIVE
Intrauterine Growth Restriction (IUGR) is a fetal condition defined as the abnormal rate of fetal growth. The pathology is a documented cause of fetal and neonatal morbidity and mortality. In clinical practice, diagnosis is confirmed at birth and may only be suspected during pregnancy. Therefore, designing an accurate model for the early and prompt identification of pathology in the antepartum period is crucial in view of pregnancy management.
METHODS METHODS
We tested the performance of 15 machine learning techniques in discriminating healthy versus IUGR fetuses. The various models were trained with a set of 12 physiology based heart rate features extracted from a single antepartum CardioTocographic (CTG) recording. The reason for the utilization of time, frequency, and nonlinear indices is based on their standalone documented ability to describe several physiological and pathological fetal conditions.
RESULTS RESULTS
We validated our approach on a database of 60 healthy and 60 IUGR fetuses. The machine learning methodology achieving the best performance was Random Forests. Specifically, we obtained a mean classification accuracy of 0.911 [0.860, 0.961 (0.95 confidence interval)] averaged over 10 test sets (10 Fold Cross Validation). Similar results were provided by Classification Trees, Logistic Regression, and Support Vector Machines. A features ranking procedure highlighted that nonlinear indices showed the highest capability to discriminate between the considered fetal conditions. Nevertheless, is the combination of features investigating CTG signal in different domains, that contributes to an increase in classification accuracy.
CONCLUSIONS CONCLUSIONS
We provided validation of an accurate artificially intelligence framework for the diagnosis of IUGR condition in the antepartum period. The employed physiology based heart rate features constitute an interpretable link between the machine learning results and the quantitative estimators of fetal wellbeing.

Identifiants

pubmed: 31678794
pii: S0169-2607(19)30810-7
doi: 10.1016/j.cmpb.2019.105015
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

105015

Informations de copyright

Copyright © 2019. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Maria G Signorini (MG)

Department of Electronics, Information and Bioengineering (DEIB), Politecnico Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy. Electronic address: mariagabriella.signorini@polimi.it.

Nicolò Pini (N)

Department of Electronics, Information and Bioengineering (DEIB), Politecnico Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy. Electronic address: nicolo.pini@polimi.it.

Alberto Malovini (A)

IRCCS Fondazione S. Maugeri, Via Maugeri 10, 27100 Pavia, Italy. Electronic address: alberto.malovini@unipv.it.

Riccardo Bellazzi (R)

Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Via Ferrata 5, 27100 Pavia, Italy. Electronic address: riccardo.bellazzi@unipv.it.

Giovanni Magenes (G)

Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Via Ferrata 5, 27100 Pavia, Italy. Electronic address: giovanni.magenes@unipv.it.

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