STREAMLINING CLINICAL DETECTION OF ALZHEIMER’S DISEASE USING ELECTRONIC HEALTH RECORDS AND MACHINE LEARNING TECHNIQUES

Alzheimer’s disease is typically detected using a combination of cognitive-behavioral assessment exams and interviews of both the patient and a family member or caregiver, both administered and interpreted by a trained physician. This procedure, while standard in medical practice, can be time consuming and expensive for both the patient and the diagnostician especially because proper training is required to interpret the collected information and determine an appropriate diagnosis. The use of machine learning techniques to augment diagnostic procedures has been previously examined in limited capacity but to date no research examines real-world medical applications of predictive analytics for health records and cognitive exam scores. This dissertation seeks to examine the efficacy of detecting cognitive impairment due to Alzheimer’s disease using machine learning, including multi-modal neural network architectures, with a real-world clinical dataset used to determine the accuracy and applicability of the generated models. An in-depth analysis of each type of data (e.g. cognitive exams, questionnaires, demographics) as well as the cognitive domains examined (e.g. memory, attention, language) is performed to identify the most useful targets, with cognitive exams and questionnaires being found to be the most useful features and short-term memory, attention, and language found to be the most important cognitive domains. In an effort to reduce medical costs and streamline procedures, optimally predictive and efficient groups of features were identified and selected, with the best performing and economical group containing only three questions and one cognitive exam component, producing an accuracy of 85%. The most effective diagnostic scoring procedure was examined, with simple threshold counting based on medical documentation being identified as the most useful. Overall predictive analysis found that Alzheimer’s disease can be detected most accurately using a bimodal multi-input neural network model using separated cognitive domains and questionnaires, with a detection accuracy of 88% using the real-world testing set, and that the technique of analyzing domains separately serves to significantly improve model efficacy compared to models that combine them.