Detecting asthma exacerbations using daily home monitoring and machine learning

Research output: Contribution to journalArticle

Authors

Colleges, School and Institutes

External organisations

  • INSA Rennes
  • Nottingham City Hospital, Nottingham
  • University of Leicester

Abstract

Objective: Acute exacerbations contribute significantly to the morbidity of asthma. Recent studies have shown that early detection and treatment of asthma exacerbations leads to improved outcomes. We aimed to develop a machine learning algorithm to detect severe asthma exacerbations using easily available daily monitoring data.

Methods: We analysed daily peak expiratory flow and symptom scores recorded by participants in the SAKURA study (NCT00839800), an international multicentre randomised controlled trial comparing budesonide/formoterol as maintenance and reliever therapy versus budesonide/formoterol maintenance plus terbutaline as reliever, in adults with persistent asthma. The dataset consisted of 728,535 records of daily monitoring data in 2010 patients, with 576 severe exacerbation events. Data post-processing techniques included normalisation, standardisation, calculation of differences or slopes over time and the use of smoothing filters. Principal components analysis was used to reduce the large number of derived variables to a smaller number of linearly independent components. Logistic regression, decision tree, naïve Bayes, and perceptron algorithms were evaluated. Model accuracy was assessed using stratified cross-validation. The primary outcome was the detection of exacerbations on the same day or up to three days in the future.

Results: The best model used logistic regression with input variables derived from post-processed data using principal components analysis. This had an area under the receiver operating characteristic curve of 0.85, with a sensitivity of 90% and specificity of 83% for severe asthma exacerbations.

Conclusion: Asthma exacerbations may be detected using machine learning algorithms applied to daily self-monitoring of peak expiratory flow and asthma symptoms.

Details

Original languageEnglish
Number of pages11
JournalJournal of Asthma
Early online date27 Jul 2020
Publication statusE-pub ahead of print - 27 Jul 2020

Keywords

  • asthma, exacerbation, peak expiratory flow, home monitoring, machine learning