Kye Won Park1, Eun-Jae Lee1, Jun Seong Lee1, Jinhoon Jeong1, Nari Choi1, Sungyang Jo1, Mina Jung1, Ja Yeon Do1, Dong-Wha Kang1, June-Goo Lee1, Sun Ju Chung2. 1. From the Departments of Neurology (K.W.P., E.-J.L., S.J., M.J., J.Y.D., D.-W.K., S.J.C.) and Convergence Medicine (J.S.L., J.J., J.-G.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul; Electronics and Telecommunications Research Institute (J.S.L.), Gwangju; Promedius Inc (J.J.), Seoul; and Department of Neurology (N.C.), Heavenly Hospital, Goyang, Korea. 2. From the Departments of Neurology (K.W.P., E.-J.L., S.J., M.J., J.Y.D., D.-W.K., S.J.C.) and Convergence Medicine (J.S.L., J.J., J.-G.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul; Electronics and Telecommunications Research Institute (J.S.L.), Gwangju; Promedius Inc (J.J.), Seoul; and Department of Neurology (N.C.), Heavenly Hospital, Goyang, Korea. sjchung@amc.seoul.kr.
Abstract
OBJECTIVE: We developed and investigated the feasibility of a machine learning-based automated rating for the 2 cardinal symptoms of Parkinson disease (PD): resting tremor and bradykinesia. METHODS: Using OpenPose, a deep learning-based human pose estimation program, we analyzed video clips for resting tremor and finger tapping of the bilateral upper limbs of 55 patients with PD (110 arms). Key motion parameters, including resting tremor amplitude and finger tapping speed, amplitude, and fatigue, were extracted to develop a machine learning-based automatic Unified Parkinson's Disease Rating Scale (UPDRS) rating using support vector machine (SVM) method. To evaluate the performance of this model, we calculated weighted κ and intraclass correlation coefficients (ICCs) between the model and the gold standard rating by a movement disorder specialist who is trained and certified by the Movement Disorder Society for UPDRS rating. These values were compared to weighted κ and ICC between a nontrained human rater and the gold standard rating. RESULTS: For resting tremors, the SVM model showed a very good to excellent reliability range with the gold standard rating (κ 0.791; ICC 0.927), with both values higher than that of nontrained human rater (κ 0.662; ICC 0.861). For finger tapping, the SVM model showed a very good reliability range with the gold standard rating (κ 0.700 and ICC 0.793), which was comparable to that for nontrained human raters (κ 0.627; ICC 0.797). CONCLUSION: Machine learning-based algorithms that automatically rate PD cardinal symptoms are feasible, with more accurate results than nontrained human ratings. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that machine learning-based automated rating of resting tremor and bradykinesia in people with PD has very good reliability compared to a rating by a movement disorder specialist.
OBJECTIVE: We developed and investigated the feasibility of a machine learning-based automated rating for the 2 cardinal symptoms of Parkinson disease (PD): resting tremor and bradykinesia. METHODS: Using OpenPose, a deep learning-based human pose estimation program, we analyzed video clips for resting tremor and finger tapping of the bilateral upper limbs of 55 patients with PD (110 arms). Key motion parameters, including resting tremor amplitude and finger tapping speed, amplitude, and fatigue, were extracted to develop a machine learning-based automatic Unified Parkinson's Disease Rating Scale (UPDRS) rating using support vector machine (SVM) method. To evaluate the performance of this model, we calculated weighted κ and intraclass correlation coefficients (ICCs) between the model and the gold standard rating by a movement disorder specialist who is trained and certified by the Movement Disorder Society for UPDRS rating. These values were compared to weighted κ and ICC between a nontrained human rater and the gold standard rating. RESULTS: For resting tremors, the SVM model showed a very good to excellent reliability range with the gold standard rating (κ 0.791; ICC 0.927), with both values higher than that of nontrained human rater (κ 0.662; ICC 0.861). For finger tapping, the SVM model showed a very good reliability range with the gold standard rating (κ 0.700 and ICC 0.793), which was comparable to that for nontrained human raters (κ 0.627; ICC 0.797). CONCLUSION: Machine learning-based algorithms that automatically rate PD cardinal symptoms are feasible, with more accurate results than nontrained human ratings. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that machine learning-based automated rating of resting tremor and bradykinesia in people with PD has very good reliability compared to a rating by a movement disorder specialist.