Title: Improving Medication Regimen Recommendation for Parkinson’s Disease Using Sensor Technology

Abstract

Parkinson’s disease medication treatment planning is generally based on subjective data obtained through clinical, physician-patient interactions. The Personal KinetiGraph™ (PKG) and similar wearable sensors have shown promise in enabling objective, continuous remote health monitoring for Parkinson’s patients. In this proof-of-concept study, we propose to use objective sensor data from the PKG and apply machine learning to cluster patients based on levodopa regimens and response. The resulting clusters are then used to enhance treatment planning by providing improved initial treatment estimates to supplement a physician’s initial assessment. We apply k-means clustering to a dataset of within-subject Parkinson’s medication changes—clinically assessed by the MDS-Unified Parkinson’s Disease Rating Scale-III (MDS-UPDRS-III) and the PKG sensor for movement staging. A random forest classification model was then used to predict patients’ cluster allocation based on their respective demographic information, MDS-UPDRS-III scores, and PKG time-series data. Clinically relevant clusters were partitioned by levodopa dose, medication administration frequency, and total levodopa equivalent daily dose—with the PKG providing similar symptomatic assessments to physician MDS-UPDRS-III scores. A random forest classifier trained on demographic information, MDS-UPDRS-III scores, and PKG time-series data was able to accurately classify subjects of the two most demographically similar clusters with an accuracy of 86.9%, an F1more » score of 90.7%, and an AUC of 0.871. A model that relied solely on demographic information and PKG time-series data provided the next best performance with an accuracy of 83.8%, an F1 score of 88.5%, and an AUC of 0.831, hence further enabling fully remote assessments. These computational methods demonstrate the feasibility of using sensor-based data to cluster patients based on their medication responses with further potential to assist with medication recommendations.« less

Authors:

Watts, Jeremy  ^[1];

• Search DOE PAGES for author "Watts, Jeremy"
• Search DOE PAGES for ORCID "0000-0001-9573-264X"

Khojandi, Anahita  ^[1];

• Search DOE PAGES for author "Khojandi, Anahita"
• Search DOE PAGES for ORCID "0000-0001-6818-2048"

Vasudevan, Rama ^[2]; Nahab, Fatta B. ^[3]; Ramdhani, Ritesh A.  ^[4]

• Search DOE PAGES for author "Ramdhani, Ritesh A."
• Search DOE PAGES for ORCID "0000-0002-0695-0707"

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+ Show Author Affiliations

1. Univ. of Tennessee, Knoxville, TN (United States). Dept. of Industrial and Systems Engineering
2. Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Center for Nanophase Materials Sciences (CNMS)
3. Univ. of California, San Diego, La Jolla, CA (United States). Dept. of Neurosciences
4. Donald and Barbara School of Medicine at Hofstra/Northwell, Hempstead, NY (United States). Dept. of Neurology

Publication Date:

Thu May 20 00:00:00 EDT 2021

Research Org.:

Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

Sponsoring Org.:

USDOE Office of Science (SC); USDOE Laboratory Directed Research and Development (LDRD) Program; Science Alliance; The Parkinson’s Alliance

OSTI Identifier:

1815895

Grant/Contract Number:  

AC05-00OR22725

Resource Type:

Accepted Manuscript

Journal Name:

Sensors

Additional Journal Information:

Journal Volume: 21; Journal Issue: 10; Journal ID: ISSN 1424-8220

Publisher:

MDPI AG

Country of Publication:

United States

Language:

English

Subject:

60 APPLIED LIFE SCIENCES; 59 BASIC BIOLOGICAL SCIENCES; Parkinson’s disease; wearable sensors; machine learning; levodopa; regimen; decision support tool; remote assessment; PKG; clustering