Abstract
Abdominal pain in childhood is a common cause of emergency admission in hospital. Its assessment and diagnosis, especially the decision about performing a surgical operation of the abdomen, continues to be a clinical challenge. This study investigates the possibilities of applying state of the art computational intelligence methods for the analysis of abdominal pain data. Specifically, the application of a Genetic Clustering Algorithm and of the Random Forests algorithm (RF) is explored. Clinical appendicitis prediction involves the estimation of at least 15 clinical and laboratory factors (features). The contribution of each factor to the prediction is not known. Thus, the goal of abdominal pain data analysis is not restricted to the classification of the data, but includes the exploration of the underlying data structure. In this study a genetic clustering algorithm is employed for the later task and its performance is compared to a classical K-means clustering approach. For classification purposes, tree methods are frequently used in medical applications since they often reveal simple relationships between variables that can be used to interpret the data. They are however very prone to overfitting problems. Random Forests, applied in this study, is a novel ensemble classifier which builds a number of decision trees to improve the single tree classifier generalization ability. The application of the above mentioned algorithms to real data resulted in very low error rates, (less than 5%), indicating the usefulness of the respective approach. The most informative diagnostic features as proposed by the algorithms are in accordance with known medical expert knowledge. The experimental results furthermore confirmed both, the greater ability of the genetic clustering algorithm to reveal the underlying data patterns as compared to the K-means approach and the effectiveness of RF-based diagnosis as compared to a single decision tree algorithm.
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Newman, K., Ponsky, T., Kittle, K., Dyk, L., Throop, C., Gieseker, K., Sills, M., Gilbert, J.: Appendicitis 2000: Variability in practice, outcomes, and resource utilization at thirty pediatric hospitals. In: 33rd Annual Meeting of the American Pediatric Surgical Association, Phoenix, Arizona, May 19-23 (2002)
Apley, J., Naish, N.: Recurrent abdominal pains: A field survey of 1000 school children. Archives of Disease in Childhood 33, 165–170 (1958)
Hyams, J.S., Burke, G., Davis, P.M., Rzepski, B., Andrulonis, P.A.: Abdominal pain and irritable bowel syndrome in adolescents: A community-based study. J Pediatr 129, 220–226 (1996)
Campo, J.V., DiLorenzo, C., Chiappetta, L., Bridge, J., Colborn, D.K., Gartner Jr., J.C., Gaffney, P., Kocoshis, S., Brent, D.: Adult outcomes of pediatric recurrent abdominal pain: do they grow out of it? Pediatrics 108(e1) (2001) doi: 10.1542/peds.108.1.e1
Berry Jr., J., Malt, R.A.: Appendicitis near its centenary. Massachussetts General Hospital and the Department of Surgery, Harvard Medical School
Paterson-Brown, S.: Emergency laparoscopy surgery. Br. J. Surg. 80, 279–283 (1993)
Olsen, J.B., Myrén, C.J., Haahr, P.E.: Randomized study of the value of laparoscopy before appendectomy. Br. J. Surg. 80, 922–923 (1993)
Raheja, S.K., McDonald, P., Taylor, I.: Non specific abdominal pain an expensive mystery. J. R. Soc. Med. 88, 10–11 (1990)
Hawthorn, I.E.: Abdominal pain as a cause of acute admission to hospital. J. R. Coll. Surg. Edinb. 37, 389–393 (1992)
McAdam, W.A., Brock, B.M., Armitage, T., Davenport, P., Chan, M., de Dombal, F.T.: Twelve years experience of computer-aided diagnosis in a district general hospital. Airedale District General Hospital, West Yorkshire
Sim, K.T., Picone, S., Crade, M., Sweeney, J.P.: Ultrasound with graded compression in the evaluation of acute appendicitis. J. Natl. Med. Assoc. 81(9), 954–957 (1989)
Graham, D.F.: Computer-aided prediction of gangrenous and perforating appendicitis. Br. Med. J. 26 2(6099), 1375–1377 (1977)
de Dombal, F.T., Leaper, D.J., Horrocks, J.C., Staniland, J.R., McCann, A.P.: Human and Computer-aided Diagnosis of Abdominal Pain: Further Report with Emphasis on Performance of Clinicians. Br. Med. J. 1(5904), 376–380 (1974)
de Dombal, F.T., Leaper, D.J., Staniland, J.R., McCann, A.P., Horrocks, J.C. Computer-aided Diagnosis of Acute Abdominal Pain. Br Med J. 1, 2(5804), 9–13 (1972)
Weydert, J.A., Shapiro, D.B., Acra, S.A., Monheim, C.J., Chambers, A.S., Ball, T.M.: Evaluation of guided imagery as treatment for recurrent abdominal pain in children: a randomized controlled trial. BMC Pediatr. 6, 29 (2006)
Gardikis, S., Touloupidis, S., Dimitriadis, G., Limas, C., Antypas, S., Dolatzas, T., Polychronidis, A., Simopoulos, C.: Urological Symptoms of Acute Appendicitis in Childhood and Early Adolescence. Int. Urol. Nephrol. 34, 189–192 (2002)
Mantzaris, D., Anastassopoulos, G., Adamopoulos, A., Gardikis, S.: A non-symbolic implementation for abdominal pain estimation in childhood. Information Sciences 178(20), 3860–3866 (2008)
Kononenko, I.: Machine Learning for Medical Diagnosis: History, State of the Art and Perspective. University of Ljubljana Faculty of Computer and Information Science
Boinee, P., de Angelis, A., Foresti, G.L.: Meta Random Forests. International Journal of Computational Intelligence 2, 3 (2006)
Tsirogiannis, G.L., Frossyniotis, D., Stoitsis, J., Golemati, S., Stafylopatis, A., Nikita, A.S.: Classification of Medical Data with a Robust Multi-Level Combination Scheme. School of Electrical and Computer Engineering National Technical University of Athens
Rubin, A.D.: Artificial Intelligence approaches to medical diagnosis. MIT Press, Cambridge
McCollough, M., Sharieff, G.Q.: Abdominal Pain in Children. University of California, San Diego, Pediatr Clin. N Am. 53, 107–137 (2006)
de Edelenyi, F.S., Goumidi, L., Bertrans, S., Phillips Ross McManus, C., Roche, H., Planells, R., Lairon, D. Springer, Heidelberg (2008)
Bailey, S.: Lawrence Berkeley National Laboratory (University of California), Paper LBNL-696E (2008)
Breiman, L.: Technical Report 670, Statistics Department University of California, Berkeley, September 9 (2004)
Liaw, A., Wiener, M.: Classification and Regression by Random Forest. The Newsletter of the R Project, vol. 2/3 (December 2002)
Holland, J.H.: Adaptation in Natural and Artificial Systems. Univ. Michigan Press, Ann Arbor (1975)
Goldberg, D.: Genetic Algorithms in Search, Optimization, and Machine Learning. Addison-Wesley, Reading (1989)
Li, B.U.: Recurrent abdominal pain in childhood: an approach to common disorders. Comprehensive Therapy 13, 46–53 (1987)
Gislason, P.A., Benediktsson, J.A., Sveinsson, J.R.: Random Forests for land cover classification. Pattern Recognition Letters 27, 294–300 (2006)
Bandyopadhyay, S., Pal, S.K.: Classification and learning using genetic algorithms. Springer, Heidelberg (2007)
Tseng, L., Yang, S.: Genetic Algorithms for clustering, feature selection, and classification. In: Proceedings of the IEEE International Conference on Neural Networks, Houston, pp. 1612–1616 (1997)
Bhuyan, N.J., Raghavan, V.V., Venkatesh, K.E.: Genetic algorithms for clustering with an ordered representation. In: Proceedings of the Fourth International Conference Genetic Algorithms, pp. 408–415 (1991)
Maulik, U., Bandyopadhyay, S.: Genetic algorithm based clustering technique. Pattern Recognition 33, 1455–1465 (2000)
Jain, A.K., Dubes, R.C.: Algorithms for clustering data. Prentice-Hall, Englewood Cliffs (1988)
Tou, J.T., Gonzalez, R.C.: Pattern Recognition Principles. Addison-Wesley, Reading (1974)
Karalic, A., Pirnat, V.: Significance Level Based Classification with Multiple Trees. Informatica 15(1), 54–58 (1991)
Muggleton, S.: Inductive Acquisition of Expert Knowledge. Turing Institute Press &Addison_Wesley (1990)
Bratko, I., Kononenko, I.: Learning Rules from Incomplete and Noisy Data. In: Phelps, B. (ed.) Interactions in Artificial Intelligence and Statistical Methods. Technical Press, Hampshire (1987)
Nunez, M.: Decision Tree Induction Using Domain Knowledge. In: Wielinga, B., et al. (eds.) Current Trends in Knowledge Acquisition. IOS Press, Amsterdam (1990)
Prasad, A.M., Iverson, L.R., Liaw, A.: Newer Classification and Regression Tree Techniques: Bagging and Random Forests for Ecological Prediction. Ecosystems 9, 181–199 (2006)
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Adamopoulos, A., Ntasi, M., Mavroudi, S., Likothanassis, S., Iliadis, L., Anastassopoulos, G. (2009). Revealing the Structure of Childhood Abdominal Pain Data and Supporting Diagnostic Decision Making. In: Palmer-Brown, D., Draganova, C., Pimenidis, E., Mouratidis, H. (eds) Engineering Applications of Neural Networks. EANN 2009. Communications in Computer and Information Science, vol 43. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-03969-0_16
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DOI: https://doi.org/10.1007/978-3-642-03969-0_16
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