Delivering Precision Medicine to Patients with Spinal Cord Disorders; Insights into Applications of Bioinformatics and Machine Learning from Studies of Degenerative Cervical Myelopathy

With the common adoption of electronic health records and new technologies capable of producing an unprecedented scale of data, a shift must occur in how we practice medicine in order to utilize these resources. We are entering an era in which the capacity of even the most clever human doctor simply is insufficient. As such, realizing “personalized” or “precision” medicine requires new methods that can leverage the massive amounts of data now available. Machine learning techniques provide one important toolkit in this venture, as they are fundamentally designed to deal with (and, in fact, benefit from) massive datasets. The clinical applications for such machine learning systems are still in their infancy, however, and the field of medicine presents a unique set of design considerations. In this chapter, we will walk through how we selected and adjusted the “Progressive Learning framework” to account for these considerations in the case of Degenerative Cervical Myeolopathy. We additionally compare a model designed with these techniques to similar static models run in “perfect world” scenarios (free of the clinical issues address), and we use simulated clinical data acquisition scenarios to demonstrate the advantages of our machine learning approach in providing personalized diagnoses