Applications of Machine Learning in Cancer Prediction and Prognosis

Machine learning is a branch of artificial intelligence that employs a variety of statistical, probabilistic and optimization techniques that allows computers to “learn” from past examples and to detect hard-to-discern patterns from large, noisy or complex data sets. This capability is particularly well-suited to medical applications, especially those that depend on complex proteomic and genomic measurements. As a result, machine learning is frequently used in cancer diagnosis and detection. More recently machine learning has been applied to cancer prognosis and prediction. This latter approach is particularly interesting as it is part of a growing trend towards personalized, predictive medicine. In assembling this review we conducted a broad survey of the different types of machine learning methods being used, the types of data being integrated and the performance of these methods in cancer prediction and prognosis. A number of trends are noted, including a growing dependence on protein biomarkers and microarray data, a strong bias towards applications in prostate and breast cancer, and a heavy reliance on “older” technologies such artificial neural networks (ANNs) instead of more recently developed or more easily interpretable machine learning methods. A number of published studies also appear to lack an appropriate level of validation or testing. Among the better designed and validated studies it is clear that machine learning methods can be used to substantially (15–25%) improve the accuracy of predicting cancer susceptibility, recurrence and mortality. At a more fundamental level, it is also evident that machine learning is also helping to improve our basic understanding of cancer development and progression

From Wearable Sensors to Smart Implants – Towards Pervasive and Personalised Healthcare

<p>Objective: This article discusses the evolution of pervasive healthcare from its inception for activity recognition using wearable sensors to the future of sensing implant deployment and data processing. Methods: We provide an overview of some of the past milestones and recent developments, categorised into different generations of pervasive sensing applications for health monitoring. This is followed by a review on recent technological advances that have allowed unobtrusive continuous sensing combined with diverse technologies to reshape the clinical workflow for both acute and chronic disease management. We discuss the opportunities of pervasive health monitoring through data linkages with other health informatics systems including the mining of health records, clinical trial databases, multi-omics data integration and social media. Conclusion: Technical advances have supported the evolution of the pervasive health paradigm towards preventative, predictive, personalised and participatory medicine. Significance: The sensing technologies discussed in this paper and their future evolution will play a key role in realising the goal of sustainable healthcare systems.</p> <p> </p

An Augmented Artificial Intelligence Approach for Chronic Diseases Prediction

Chronic diseases are increasing in prevalence and mortality worldwide. Early diagnosis has therefore become an important research area to enhance patient survival rates. Several research studies have reported classification approaches for specific disease prediction. In this paper, we propose a novel augmented artificial intelligence approach using an artificial neural network (ANN) with particle swarm optimization (PSO) to predict five prevalent chronic diseases including breast cancer, diabetes, heart attack, hepatitis, and kidney disease. Seven classification algorithms are compared to evaluate the proposed model's prediction performance. The ANN prediction model constructed with a PSO based feature extraction approach outperforms other state-of-the-art classification approaches when evaluated with accuracy. Our proposed approach gave the highest accuracy of 99.67%, with the PSO. However, the classification model's performance is found to depend on the attributes of data used for classification. Our results are compared with various chronic disease datasets and shown to outperform other benchmark approaches. In addition, our optimized ANN processing is shown to require less time compared to random forest (RF), deep learning and support vector machine (SVM) based methods. Our study could play a role for early diagnosis of chronic diseases in hospitals, including through development of online diagnosis systems

Optimising outcomes for potentially resectable pancreatic cancer through personalised predictive medicine : the application of complexity theory to probabilistic statistical modeling

Survival outcomes for pancreatic cancer remain poor. Surgical resection with adjuvant therapy is the only potentially curative treatment, but for many people surgery is of limited benefit. Neoadjuvant therapy has emerged as an alternative treatment pathway however the evidence base surrounding the treatment of potentially resectable pancreatic cancer is highly heterogeneous and fraught with uncertainty and controversy. This research seeks to engage with conjunctive theorising by avoiding simplification and abstraction to draw on different kinds of data from multiple sources to move research towards a theory that can build a rich picture of pancreatic cancer management pathways as a complex system. The overall aim is to move research towards personalised realistic medicine by using personalised predictive modeling to facilitate better decision making to achieve the optimisation of outcomes. This research is theory driven and empirically focused from a complexity perspective. Combining operational and healthcare research methodology, and drawing on influences from complementary paradigms of critical realism and systems theory, then enhancing their impact by using Cilliers’ complexity theory ‘lean ontology’, an open-world ontology is held and both epistemic reality and judgmental relativity are accepted. The use of imperfect data within statistical simulation models is explored to attempt to expand our capabilities for handling the emergent and uncertainty and to find other ways of relating to complexity within the field of pancreatic cancer research. Markov and discrete-event simulation modelling uncovered new insights and added a further dimension to the current debate by demonstrating that superior treatment pathway selection depended on individual patient and tumour factors. A Bayesian Belief Network was developed that modelled the dynamic nature of this complex system to make personalised prognostic predictions across competing treatments pathways throughout the patient journey to facilitate better shared clinical decision making with an accuracy exceeding existing predictive models.Survival outcomes for pancreatic cancer remain poor. Surgical resection with adjuvant therapy is the only potentially curative treatment, but for many people surgery is of limited benefit. Neoadjuvant therapy has emerged as an alternative treatment pathway however the evidence base surrounding the treatment of potentially resectable pancreatic cancer is highly heterogeneous and fraught with uncertainty and controversy. This research seeks to engage with conjunctive theorising by avoiding simplification and abstraction to draw on different kinds of data from multiple sources to move research towards a theory that can build a rich picture of pancreatic cancer management pathways as a complex system. The overall aim is to move research towards personalised realistic medicine by using personalised predictive modeling to facilitate better decision making to achieve the optimisation of outcomes. This research is theory driven and empirically focused from a complexity perspective. Combining operational and healthcare research methodology, and drawing on influences from complementary paradigms of critical realism and systems theory, then enhancing their impact by using Cilliers’ complexity theory ‘lean ontology’, an open-world ontology is held and both epistemic reality and judgmental relativity are accepted. The use of imperfect data within statistical simulation models is explored to attempt to expand our capabilities for handling the emergent and uncertainty and to find other ways of relating to complexity within the field of pancreatic cancer research. Markov and discrete-event simulation modelling uncovered new insights and added a further dimension to the current debate by demonstrating that superior treatment pathway selection depended on individual patient and tumour factors. A Bayesian Belief Network was developed that modelled the dynamic nature of this complex system to make personalised prognostic predictions across competing treatments pathways throughout the patient journey to facilitate better shared clinical decision making with an accuracy exceeding existing predictive models

Acute lung injury in paediatric intensive care: course and outcome

Introduction: Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) carry a high morbidity and mortality (10-90%). ALI is characterised by non-cardiogenic pulmonary oedema and refractory hypoxaemia of multifactorial aetiology [1]. There is limited data about outcome particularly in children. Methods This retrospective cohort study of 85 randomly selected patients with respiratory failure recruited from a prospectively collected database represents 7.1% of 1187 admissions. They include those treated with High Frequency Oscillation Ventilation (HFOV). The patients were admitted between 1 November 1998 and 31 October 2000. Results: Of the 85, 49 developed acute lung injury and 47 had ARDS. There were 26 males and 23 females with a median age and weight of 7.7 months (range 1 day-12.8 years) and 8 kg (range 0.8-40 kg). There were 7 deaths giving a crude mortality of 14.3%, all of which fulfilled the Consensus I [1] criteria for ARDS. Pulmonary occlusion pressures were not routinely measured. The A-a gradient and PaO2/FiO2 ratio (median + [95% CI]) were 37.46 [31.82-43.1] kPa and 19.12 [15.26-22.98] kPa respectively. The non-survivors had a significantly lower PaO2/FiO2 ratio (13 [6.07-19.93] kPa) compared to survivors (23.85 [19.57-28.13] kPa) (P = 0.03) and had a higher A-a gradient (51.05 [35.68-66.42] kPa) compared to survivors (36.07 [30.2-41.94]) kPa though not significant (P = 0.06). Twenty-nine patients (59.2%) were oscillated (Sensormedics 3100A) including all 7 non-survivors. There was no difference in ventilation requirements for CMV prior to oscillation. Seventeen of the 49 (34.7%) were treated with Nitric Oxide including 5 out of 7 non-survivors (71.4%). The median (95% CI) number of failed organs was 3 (1.96-4.04) for non-survivors compared to 1 (0.62-1.62) for survivors (P = 0.03). There were 27 patients with isolated respiratory failure all of whom survived. Six (85.7%) of the non-survivors also required cardiovascular support.Conclusion: A crude mortality of 14.3% compares favourably to published data. The A-a gradient and PaO2/FiO2 ratio may be of help in morbidity scoring in paediatric ARDS. Use of Nitric Oxide and HFOV is associated with increased mortality, which probably relates to the severity of disease. Multiple organ failure particularly respiratory and cardiac disease is associated with increased mortality. ARDS with isolated respiratory failure carries a good prognosis in children

Artificial neural network techniques to investigate potential interactions between biomarkers

High-throughput technologies in biomedical sciences, including gene microarrays, supposed to revolutionise the post-genomic era, have barely met the great expectations they inspired to the biomedical community at first. Current efforts are still focused toward improving the technology, its reproducibility and accuracy. In the meantime, computational techniques for the analysis of the data from these technologies have achieved great progresses and show encouraging results. New approaches have been developed to extract relevant information out from these results. However, important work needs to be further conducted in order to extract even more meaningful and relevant information. These techniques offer great possibilities to explore the overall dynamic held within a living organism. The potential information contained in their output can reveal important leads at deciphering the interconnection, interaction or regulation influences that can exist between several molecules. In front of an increasing interest of the scientific community toward the exploration of these dynamics, some groups have started to develop solutions based on different technologies to extract these information related to interactions. Here we present an Artificial Neural Network-based methodology for the study of interactions in gene transcriptomic data. This will be applied and validated in a breast cancer context

Dynamics under Uncertainty: Modeling Simulation and Complexity

The dynamics of systems have proven to be very powerful tools in understanding the behavior of different natural phenomena throughout the last two centuries. However, the attributes of natural systems are observed to deviate from their classical states due to the effect of different types of uncertainties. Actually, randomness and impreciseness are the two major sources of uncertainties in natural systems. Randomness is modeled by different stochastic processes and impreciseness could be modeled by fuzzy sets, rough sets, Dempster–Shafer theory, etc

A Multi-omic Precision Oncology Pipeline to Elucidate Mechanistic Determinants of Cancer

Despite decades of effort, the mechanistic underpinnings of many cancers remain unsolved It has increasingly become appreciated that cancers can be more readily classified by their transcriptional identities rather than by genomics alone. A fuller understanding of the mechanistic connections between the aberrant genomics leading to the transcriptional dysregulation of tumors is key to both improving our knowledge of cancer biology as well as developing more precise and effective therapeutics. This thesis explores the development and application of a network based multi-omic master regulator framework designed to elucidate these pathways. In Chapter 2 we apply this analysis across 20 tumor types from the Cancer Genome Atlas and in doing so identify 407 key master regulators responsible for canalizing a high percentage of the driver genetics present across these samples. Further evaluation of these key regulators revealed a highly modular structure, indicating that the regulators work in coordinated groups to implement a variety of key cancer hallmarks. Genetic and pharmacological validation assays confirmed the predicted interactions and biological phenotypes. Chapter 3 focuses on the application of this analytical framework specifically on gastroesophageal tumors. Using a more fine-grained approach we find 15 distinct subtypes across a cohort of these heterogenous tumors. These subtypes align well with previously identified features of these cancers but also reveal novel genomic associations and key master regulators that can serve as potential avenues for therapeutic treatment

Methods to Improve the Prediction Accuracy and Performance of Ensemble Models

The application of ensemble predictive models has been an important research area in predicting medical diagnostics, engineering diagnostics, and other related smart devices and related technologies. Most of the current predictive models are complex and not reliable despite numerous efforts in the past by the research community. The performance accuracy of the predictive models have not always been realised due to many factors such as complexity and class imbalance. Therefore there is a need to improve the predictive accuracy of current ensemble models and to enhance their applications and reliability and non-visual predictive tools. The research work presented in this thesis has adopted a pragmatic phased approach to propose and develop new ensemble models using multiple methods and validated the methods through rigorous testing and implementation in different phases. The first phase comprises of empirical investigations on standalone and ensemble algorithms that were carried out to ascertain their performance effects on complexity and simplicity of the classifiers. The second phase comprises of an improved ensemble model based on the integration of Extended Kalman Filter (EKF), Radial Basis Function Network (RBFN) and AdaBoost algorithms. The third phase comprises of an extended model based on early stop concepts, AdaBoost algorithm, and statistical performance of the training samples to minimize overfitting performance of the proposed model. The fourth phase comprises of an enhanced analytical multivariate logistic regression predictive model developed to minimize the complexity and improve prediction accuracy of logistic regression model. To facilitate the practical application of the proposed models; an ensemble non-invasive analytical tool is proposed and developed. The tool links the gap between theoretical concepts and practical application of theories to predict breast cancer survivability. The empirical findings suggested that: (1) increasing the complexity and topology of algorithms does not necessarily lead to a better algorithmic performance, (2) boosting by resampling performs slightly better than boosting by reweighting, (3) the prediction accuracy of the proposed ensemble EKF-RBFN-AdaBoost model performed better than several established ensemble models, (4) the proposed early stopped model converges faster and minimizes overfitting better compare with other models, (5) the proposed multivariate logistic regression concept minimizes the complexity models (6) the performance of the proposed analytical non-invasive tool performed comparatively better than many of the benchmark analytical tools used in predicting breast cancers and diabetics ailments. The research contributions to ensemble practice are: (1) the integration and development of EKF, RBFN and AdaBoost algorithms as an ensemble model, (2) the development and validation of ensemble model based on early stop concepts, AdaBoost, and statistical concepts of the training samples, (3) the development and validation of predictive logistic regression model based on breast cancer, and (4) the development and validation of a non-invasive breast cancer analytic tools based on the proposed and developed predictive models in this thesis. To validate prediction accuracy of ensemble models, in this thesis the proposed models were applied in modelling breast cancer survivability and diabetics’ diagnostic tasks. In comparison with other established models the simulation results of the models showed improved predictive accuracy. The research outlines the benefits of the proposed models, whilst proposes new directions for future work that could further extend and improve the proposed models discussed in this thesis