Machine learning prediction of motor function in chronic stroke patients: a systematic review and meta-analysis

Abstract

BackgroundRecent studies have reported that machine learning (ML), with a relatively strong capacity for processing non-linear data and adaptive ability, could improve the accuracy and efficiency of prediction. The article summarizes the published studies on ML models that predict motor function 3–6 months post-stroke.MethodsA systematic literature search was conducted in PubMed, Embase, Cochorane and Web of Science as of April 3, 2023 for studies on ML prediction of motor function in stroke patients. The quality of the literature was assessed using the Prediction model Risk Of Bias Assessment Tool (PROBAST). A random-effects model was preferred for meta-analysis using R4.2.0 because of the different variables and parameters.ResultsA total of 44 studies were included in this meta-analysis, involving 72,368 patients and 136 models. Models were categorized into subgroups according to the predicted outcome Modified Rankin Scale cut-off value and whether they were constructed based on radiomics. C-statistics, sensitivity, and specificity were calculated. The random-effects model showed that the C-statistics of all models were 0.81 (95% CI: 0.79; 0.83) in the training set and 0.82 (95% CI: 0.80; 0.85) in the validation set. According to different Modified Rankin Scale cut-off values, C-statistics of ML models predicting Modified Rankin Scale>2(used most widely) in stroke patients were 0.81 (95% CI: 0.78; 0.84) in the training set, and 0.84 (95% CI: 0.81; 0.87) in the validation set. C-statistics of radiomics-based ML models in the training set and validation set were 0.81 (95% CI: 0.78; 0.84) and 0.87 (95% CI: 0.83; 0.90), respectively.ConclusionML can be used as an assessment tool for predicting the motor function in patients with 3–6 months of post-stroke. Additionally, the study found that ML models with radiomics as a predictive variable were also demonstrated to have good predictive capabilities. This systematic review provides valuable guidance for the future optimization of ML prediction systems that predict poor motor outcomes in stroke patients.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022335260, identifier: CRD42022335260.

Stratified predictions of upper limb motor outcomes after stroke

“…White matter (WM) tractography was performed for the preprocessed dMRI data to reconstruct WM fibers over the whole brain by using tools in MRtrix3. 2 For registration between the dMRI native space and the standard space, a deformation field was estimated for the sMRI data coregistered to the dMRI data by using tools in SPM12. 3…”

“…These concerns have led to the development of models enabling individualized outcome predictions. As artificial intelligence approaches become increasingly available, various machine learning algorithms ranging from linear regression to deep learning have been applied to demographic, clinical, electrophysiological, and neuroimaging data, as well as their combinations, as inputs, suggesting the potential of multidimensional markers for more accurate outcome predictions (for reviews, see ( 1 , 2 )).…”