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Prediction of low bone mineral density in postmenopausal women by artificial neural network model compared to logistic regression model.
J Med Assoc Thai. 1997 Aug; 80(8):508-15.JM

Abstract

Measuring bone mineral density (BMD) is currently the best modality to diagnose osteoporosis and predict future fractures. The use of risk factors to predict BMD and fracture risk has been considered to be inadequate for precise diagnostic purpose, but it may be helpful as a screening tool to determine who actually needs BMD assessment. Recently, artificial neural network (ANN), a nonlinear computational model, has been used in clinical diagnosis and classification. In the present study, we evaluated the risk factors associated with low BMD in Thai postmenopausal women and assessed the prediction of low BMD using an ANN model compared to a logistic regression model. The subjects consisted of 129 Thai postmenopausal women divided into 2 groups, 100 subjects in the training set and the remaining 29 subjects in the validation set. The subjects were classified as having either low BMD or normal BMD by using BMD value 1 SD lower than the mean value of young adults as the cutoff point. Decreased body weight, decreased hip circumference and increased years since menopause were found to be associated with low BMD at the lumbar spine by logistic regression. For the femoral neck, increased age and decreased urinary calcium were associated with low BMD. The models had a sensitivity of 85.0 per cent, a specificity of 11.1 per cent and an accuracy of 62.0 per cent for the diagnosis of low BMD at the lumbar spine when tested in the validation group. For the femoral neck, the sensitivity, specificity and accuracy were 90.5 per cent, 12.5 per cent, and 69.0 per cent, respectively. Models based on ANN correctly classified 65.5 per cent of the subjects in the validation group according to BMD at the lumbar spine with a sensitivity of 80.0 per cent and a specificity of 33.3 per cent while it correctly classified 58.6 per cent of the subjects at the femoral neck with a sensitivity of 76.2 per cent and a specificity of 12.5 per cent. There was no significant difference in terms of accuracy, sensitivity and specificity in the prediction of low BMD at the lumbar spine or the femoral neck between ANN model and logistic regression model. We concluded that ANN does not perform better than convention statistical methods in the prediction of low BMD. The less than perfect performance of the prediction rules used in the prediction of low BMD may be due to the lack of adequate association between the commonly used risk factors and BMD rather than the nature of the computational models.

Authors+Show Affiliations

Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9277083

Citation

Ongphiphadhanakul, B, et al. "Prediction of Low Bone Mineral Density in Postmenopausal Women By Artificial Neural Network Model Compared to Logistic Regression Model." Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, vol. 80, no. 8, 1997, pp. 508-15.
Ongphiphadhanakul B, Rajatanavin R, Chailurkit L, et al. Prediction of low bone mineral density in postmenopausal women by artificial neural network model compared to logistic regression model. J Med Assoc Thai. 1997;80(8):508-15.
Ongphiphadhanakul, B., Rajatanavin, R., Chailurkit, L., Piaseu, N., Teerarungsikul, K., Sirisriro, R., Komindr, S., & Pauvilai, G. (1997). Prediction of low bone mineral density in postmenopausal women by artificial neural network model compared to logistic regression model. Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, 80(8), 508-15.
Ongphiphadhanakul B, et al. Prediction of Low Bone Mineral Density in Postmenopausal Women By Artificial Neural Network Model Compared to Logistic Regression Model. J Med Assoc Thai. 1997;80(8):508-15. PubMed PMID: 9277083.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prediction of low bone mineral density in postmenopausal women by artificial neural network model compared to logistic regression model. AU - Ongphiphadhanakul,B, AU - Rajatanavin,R, AU - Chailurkit,L, AU - Piaseu,N, AU - Teerarungsikul,K, AU - Sirisriro,R, AU - Komindr,S, AU - Pauvilai,G, PY - 1997/8/1/pubmed PY - 1997/8/1/medline PY - 1997/8/1/entrez SP - 508 EP - 15 JF - Journal of the Medical Association of Thailand = Chotmaihet thangphaet JO - J Med Assoc Thai VL - 80 IS - 8 N2 - Measuring bone mineral density (BMD) is currently the best modality to diagnose osteoporosis and predict future fractures. The use of risk factors to predict BMD and fracture risk has been considered to be inadequate for precise diagnostic purpose, but it may be helpful as a screening tool to determine who actually needs BMD assessment. Recently, artificial neural network (ANN), a nonlinear computational model, has been used in clinical diagnosis and classification. In the present study, we evaluated the risk factors associated with low BMD in Thai postmenopausal women and assessed the prediction of low BMD using an ANN model compared to a logistic regression model. The subjects consisted of 129 Thai postmenopausal women divided into 2 groups, 100 subjects in the training set and the remaining 29 subjects in the validation set. The subjects were classified as having either low BMD or normal BMD by using BMD value 1 SD lower than the mean value of young adults as the cutoff point. Decreased body weight, decreased hip circumference and increased years since menopause were found to be associated with low BMD at the lumbar spine by logistic regression. For the femoral neck, increased age and decreased urinary calcium were associated with low BMD. The models had a sensitivity of 85.0 per cent, a specificity of 11.1 per cent and an accuracy of 62.0 per cent for the diagnosis of low BMD at the lumbar spine when tested in the validation group. For the femoral neck, the sensitivity, specificity and accuracy were 90.5 per cent, 12.5 per cent, and 69.0 per cent, respectively. Models based on ANN correctly classified 65.5 per cent of the subjects in the validation group according to BMD at the lumbar spine with a sensitivity of 80.0 per cent and a specificity of 33.3 per cent while it correctly classified 58.6 per cent of the subjects at the femoral neck with a sensitivity of 76.2 per cent and a specificity of 12.5 per cent. There was no significant difference in terms of accuracy, sensitivity and specificity in the prediction of low BMD at the lumbar spine or the femoral neck between ANN model and logistic regression model. We concluded that ANN does not perform better than convention statistical methods in the prediction of low BMD. The less than perfect performance of the prediction rules used in the prediction of low BMD may be due to the lack of adequate association between the commonly used risk factors and BMD rather than the nature of the computational models. SN - 0125-2208 UR - https://www.unboundmedicine.com/medline/citation/9277083/Prediction_of_low_bone_mineral_density_in_postmenopausal_women_by_artificial_neural_network_model_compared_to_logistic_regression_model_ L2 - https://medlineplus.gov/bonedensity.html DB - PRIME DP - Unbound Medicine ER -