Abstract

BackgroundScreening for influenza in primary care is challenging due to the low sensitivity of rapid antigen tests and the lack of proper screening tests.ObjectiveThe aim of this study was to develop a machine learning–based screening tool using patient-generated health data (PGHD) obtained from a mobile health (mHealth) app.MethodsWe trained a deep learning model based on a gated recurrent unit to screen influenza using PGHD, including each patient’s fever pattern and drug administration records. We used meteorological data and app-based surveillance of the weekly number of patients with influenza. We defined a single episode as the set of consecutive days, including the day the user was diagnosed with influenza or another disease. Any record a user entered 24 hours after his or her last record was considered to be the start of a new episode. Each episode contained data on the user’s age, gender, weight, and at least one body temperature record. The total number of episodes was 6657. Of these, there were 3326 episodes within which influenza was diagnosed. We divided these episodes into 80% training sets (2664/3330) and 20% test sets (666/3330). A 5-fold cross-validation was used on the training set.ResultsWe achieved reliable performance with an accuracy of 82%, a sensitivity of 84%, and a specificity of 80% in the test set. After the effect of each input variable was evaluated, app-based surveillance was observed to be the most influential variable. The correlation between the duration of input data and performance was not statistically significant (P=.09).ConclusionsThese findings suggest that PGHD from an mHealth app could be a complementary tool for influenza screening. In addition, PGHD, along with traditional clinical data, could be used to improve health conditions.

Highlights

  • With the increasing popularity of mobile health, a considerable amount of health-related data are generated and accumulated outside of hospitals [1,2,3]

  • These findings suggest that patient-generated health data (PGHD) from an mobile health (mHealth) app could be a complementary tool for influenza screening

  • We propose a deep learning method for influenza screening by combining epidemiological information and PGHD from an mHealth app

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Summary

Introduction

With the increasing popularity of mobile health (mHealth), a considerable amount of health-related data are generated and accumulated outside of hospitals [1,2,3]. Some research has shown that influenza [13,14,15] and Middle East respiratory syndrome (MERS) [16] outbreaks could be predicted using search engine query data, including Google Flu Trends and social media posts. In addition to these indirect methods, a website or smartphone app through which patients directly report their symptoms can be used to detect epidemics [17,18]. Screening for influenza in primary care is challenging due to the low sensitivity of rapid antigen tests and the lack of proper screening tests

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