Abstract

Large-scale data sources, remote sensing technologies, and superior computing power have tremendously benefitted to environmental health study. Recently, various machine-learning algorithms were introduced to provide mechanistic insights about the heterogeneity of clustered data pertaining to the symptoms of each asthma patient and potential environmental risk factors. However, there is limited information on the performance of these machine learning tools. In this study, we compared the performance of ten machine-learning techniques. Using an advanced method of imbalanced sampling (IS), we improved the performance of nine conventional machine learning techniques predicting the association between exposure level to indoor air quality and change in patients’ peak expiratory flow rate (PEFR). We then proposed a deep learning method of transfer learning (TL) for further improvement in prediction accuracy. Our selected final prediction techniques (TL1_IS or TL2-IS) achieved a balanced accuracy median (interquartile range) of 66(56~76) % for TL1_IS and 68(63~78) % for TL2_IS. Precision levels for TL1_IS and TL2_IS were 68(62~72) % and 66(62~69) % while sensitivity levels were 58(50~67) % and 59(51~80) % from 25 patients which were approximately 1.08 (accuracy, precision) to 1.28 (sensitivity) times increased in terms of performance outcomes, compared to NN_IS. Our results indicate that the transfer machine learning technique with imbalanced sampling is a powerful tool to predict the change in PEFR due to exposure to indoor air including the concentration of particulate matter of 2.5 μm and carbon dioxide. This modeling technique is even applicable with small-sized or imbalanced dataset, which represents a personalized, real-world setting.

Highlights

  • Asthma is a major public health problem for health care systems worldwide because of its high prevalence and rising socioeconomic burden [1,2,3]

  • We evaluated the performance of two transfer learning models (TL1_IS and TL2_IS) and compared the results with those of a 1-layer neural network model with imbalanced sampling (NN_IS)

  • This study was conducted using daily data of indoor air quality and peak expiratory flow rate (PEFR) collected from adult asthma patients and their home environments

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Summary

Introduction

Asthma is a major public health problem for health care systems worldwide because of its high prevalence and rising socioeconomic burden [1,2,3]. It is one of the primary caresensitive conditions whose symptoms can be controlled by effective care management and prompt treatment [4]. One study that evaluated the time activity pattern in asthma patients showed that they spent almost 83% of their time indoors, mostly at home [13] Because such a large amount of time is spent indoors, a proper indoor air quality control with advance prediction techniques can contribute to improving the symptoms of asthma patients [14,15,16]. Machine learning algorithms are one promising approach to accomplish this task

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