Ana Bobinac
Access to Healthcare and Health Literacy in Croatia: Empirical Investigation
Healthcare (Basel, Switzerland)
ability predict rheumatoid arthritis ra flares clinic visits based realtime longitudinal patientgenerated data could potentially allow timely interventions avoid disease worsening exploratory study aims investigate feasibility using machine learning methods classify selfreported ra flares based small data set daily symptom data collected smartphone app daily symptoms weekly flares reported remote monitoring rheumatoid arthritis remora smartphone app 20 patients ra 3 months used predictors several summary features daily symptom scores eg pain fatigue collected week leading flare question fitted 3 binary classifiers logistic regression without elastic net regularization random forest naive bayes performance evaluated according area curve auc receiver operating characteristic curve bestperforming model considered sensitivity specificity different thresholds order illustrate different ways predictive model could behave clinical setting data comprised average 606 daily reports 105 weekly reports per participant participants reported median 2 iqr 075425 flares median followup time 81 iqr 7982 days aucs broadly similar models logistic regression elastic net regularization highest auc 082 cutoff requiring specificity 080 corresponding sensitivity detect flares 060 model positive predictive value ppv population 53 negative predictive value npv 85 given prevalence flares best ppv achieved meant around 2 every 3 positive predictions correct ppv 065 prioritizing higher npv model correctly predicted 9 every 10 nonflare weeks accuracy predicted flares fell 1 2 correct npv ppv 092 051 respectively predicting selfreported flares based daily symptom scorings preceding week using machine learning methods feasible observed predictive accuracy might improve obtain data exploratory results need validated external cohort future analysis frequently collected patientgenerated data may allow us predict flares unfold opening opportunities justintime adaptative interventions depending nature implication intervention different cutoff values intervention decision need considered well level predictive certainty required