Multiple sclerosis is an idiopathic inflammatory disease of the central nervous system and the second most common cause of disability in young adults. Choosing an effective treatment is crucial to preventing disability. However, response to treatment varies greatly between patients. Because of this, accurate and timely detection of individual response to treatment is an essential requisite of efficient personalised multiple sclerosis therapy. Nowadays, there is a lack of comprehensive predictive models of response to individual treatment.This paper arises from the clinical need to improve this situation. To achieve it, all patient's information was used to evaluate the effectiveness of demographic, clinical and paraclinical variables of individual response to fourteen disease-modifying therapies in MSBase, an international cohort. A personalized prediction model to three stages of disease, as a support tool in clinical decision making for each MS patient, was developed applying machine learning and Big Data techniques. These techniques were also used to reduce the data set and define a minimum set of characteristics for each patient. Best predictors for the response to treatment were identified to refine the predictive model. Fourteen relevant variables were selected. A web application was implemented to be used to support the specialist neurologist in real time. This tool provides a prediction of progression in EDSS from the last relapse of an individual patient, and a report for the medical expert.
Induction of the labour process is an extraordinarily common procedure used in some pregnancies. Obstetricians face the need to end a pregnancy, for medical reasons usually (maternal or fetal requirements) or less frequently, social (elective inductions for convenience). The success of induction procedure is conditioned by a multitude of maternal and fetal variables that appear before or during pregnancy or birth process, with a low predictive value. The failure of the induction process involves performing a caesarean section. This project arises from the clinical need to resolve a situation of uncertainty that occurs frequently in our clinical practice. Since the weight of clinical variables is not adequately weighted, we consider very interesting to know a priori the possibility of success of induction to dismiss those inductions with high probability of failure, avoiding unnecessary procedures or postponing end if possible. We developed a predictive model of induced labour success as a support tool in clinical decision making. Improve the predictability of a successful induction is one of the current challenges of Obstetrics because of its negative impact. The identification of those patients with high chances of failure, will allow us to offer them better care improving their health outcomes (adverse perinatal outcomes for mother and newborn), costs (medication, hospitalization, qualified staff) and patient perceived quality. Therefore a Clinical Decision Support System was developed to give support to the Obstetricians. In this article, we had proposed a robust method to explore and model a source of clinical information with the purpose of obtaining all possible knowledge. Generally, in classification models are difficult to know the contribution that each attribute provides to the model. We had worked in this direction to offer transparency to models that may be considered as black boxes. The positive results obtained from both the information recovery system and the predictions and explanations of the classification show the effectiveness and strength of this tool.
Induction of the labour process is an extraordinarily common procedure used in some pregnancies. Obstetricians face the need to end a pregnancy, for medical reasons usually (maternal or fetal requirements) or less frequently, social (elective inductions for convenience). The success of induction procedure is conditioned by a multitude of maternal and fetal variables that appear before or during pregnancy or birth process, with a low predictive value. The failure of the induction process involves performing a caesarean section. This project arises from the clinical need to resolve a situation of uncertainty that occurs frequently in our clinical practice. Since the weight of clinical variables is not adequately weighted, we consider very interesting to know a priori the possibility of success of induction to dismiss those inductions with high probability of failure, avoiding unnecessary procedures or postponing end if possible. We developed a predictive model of induced labour success as a support tool in clinical decision making. Improve the predictability of a successful induction is one of the current challenges of Obstetrics because of its negative impact. The identification of those patients with high chances of failure, will allow us to offer them better care improving their health outcomes (adverse perinatal outcomes for mother and newborn), costs (medication, hospitalization, qualified staff) and patient perceived quality. Therefore a Clinical Decision Support System was developed to give support to the Obstetricians. In this article, we had proposed a robust method to explore and model a source of clinical information with the purpose of obtaining all possible knowledge. Generally, in classification models are difficult to know the contribution that each attribute provides to the model. We had worked in this direction to offer transparency to models that may be considered as black boxes. The positive results obtained from both the information recovery system and the predictions and explanations of the classification show the effectiveness and strength of this tool.
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