Classifying the type of delivery from cardiotocographic signals: A machine learning approach.


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:
Nov 2020
Historique:
received: 28 04 2020
accepted: 12 08 2020
pubmed: 3 9 2020
medline: 15 5 2021
entrez: 3 9 2020
Statut: ppublish

Résumé

Cardiotocography (CTG) is the most employed methodology to monitor the foetus in the prenatal phase. Since the evaluation of CTG is often visual, and hence qualitative and too subjective, some automated methods have been introduced for its assessment. In this paper, a custom-made software is exploited to extract 17 features from the available CTG. A preliminary univariate statistical analysis is performed; then, five machine learning algorithms, exploiting ensemble learning, were implemented (J48, Random Forests (RF), Ada-boosting of decision tree (ADA-B), Gradient Boosting and Decorate) through Knime analytics platform to classify patients according to their delivery: vaginal or caesarean section. The dataset is composed by 370 signals collected between 2000 and 2009 in both public and private hospitals. The performance of the algorithms was evaluated using 10 folds cross validation with different evaluation metrics: accuracy, precision, sensitivity, specificity, area under the curve receiver operating characteristic (AUCROC). While only two features were significantly different (gestation week and power expressed by the high frequency band of FHR power spectrum), from the statistical point of view, machine learning results were great. The RF obtained the best results: accuracy (91.1%), sensitivity (90.0%) and AUCROC (96.7%). The ADA-B achieved the highest precision (92.6%) and specificity (93.1%). As expected, the lowest scores were obtained by J48 that was the base classifier employed in all the others empowered implementations. Excluding the J48 results, the AUCROC of all the algorithms was greater than 94.9%. In the light of the obtained results, that are greater than those ones found in the literature from comparable researches, it can be stated that the machine learning approach can actually help the physicians in their decision process when evaluating the foetal well-being.

Sections du résumé

BACKGROUND AND OBJECTIVE OBJECTIVE
Cardiotocography (CTG) is the most employed methodology to monitor the foetus in the prenatal phase. Since the evaluation of CTG is often visual, and hence qualitative and too subjective, some automated methods have been introduced for its assessment.
METHODS METHODS
In this paper, a custom-made software is exploited to extract 17 features from the available CTG. A preliminary univariate statistical analysis is performed; then, five machine learning algorithms, exploiting ensemble learning, were implemented (J48, Random Forests (RF), Ada-boosting of decision tree (ADA-B), Gradient Boosting and Decorate) through Knime analytics platform to classify patients according to their delivery: vaginal or caesarean section. The dataset is composed by 370 signals collected between 2000 and 2009 in both public and private hospitals. The performance of the algorithms was evaluated using 10 folds cross validation with different evaluation metrics: accuracy, precision, sensitivity, specificity, area under the curve receiver operating characteristic (AUCROC).
RESULTS RESULTS
While only two features were significantly different (gestation week and power expressed by the high frequency band of FHR power spectrum), from the statistical point of view, machine learning results were great. The RF obtained the best results: accuracy (91.1%), sensitivity (90.0%) and AUCROC (96.7%). The ADA-B achieved the highest precision (92.6%) and specificity (93.1%). As expected, the lowest scores were obtained by J48 that was the base classifier employed in all the others empowered implementations. Excluding the J48 results, the AUCROC of all the algorithms was greater than 94.9%.
CONCLUSION CONCLUSIONS
In the light of the obtained results, that are greater than those ones found in the literature from comparable researches, it can be stated that the machine learning approach can actually help the physicians in their decision process when evaluating the foetal well-being.

Identifiants

pubmed: 32877811
pii: S0169-2607(20)31545-5
doi: 10.1016/j.cmpb.2020.105712
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

105712

Informations de copyright

Copyright © 2020. 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

C Ricciardi (C)

Department of Advanced Biomedical Sciences, University Hospital of Naples Federico II, Naples, Italy.

G Improta (G)

Department of Public Health, University Hospital of Naples Federico II, Naples, Italy; Centro Interdipartimentale di Ricerca in Management Sanitario e Innovazione in Sanità (CIRMIS).

F Amato (F)

Centro Interdipartimentale di Ricerca in Management Sanitario e Innovazione in Sanità (CIRMIS); Department of Electrical Engineering and Information Technology, DIETI, University of Naples Federico II, Naples 80125, Italy. Electronic address: framato@unina.it.

G Cesarelli (G)

Department of Chemical, Materials and Production Engineering, University of Naples "Federico II", Naples, Italy; Istituto Italiano di Tecnologia, Naples, Italy.

M Romano (M)

Department of Experimental and Clinical Medicine (DMSC), University "Magna Graecia" of Catanzaro, Italy.

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