Machine learning applications in healthcare

Abstract: Healthcare is an important and high cost sector that involves many decision-making tasks based on the analysis of data, from its primary activities up till management itself. A technology that can be useful in an environment as data-intensive as healthcare is machine learning. This thesis investigates the application of machine learning in healthcare contexts as an applied health technology (AHT). AHT refers to application of scientific methods for the development of interventions targeting practical problems related to health and healthcare.The two research contexts in this thesis regard two pivotal activities in the healthcare systems: diagnosis and prognosis. The diagnosis research context regards the age assessment of the young individuals, which aims to address the drawbacks in the bone age assessment research, investigating new age assessment methods. The prognosis research context regards the prognosis of dementia, which aims to investigate prognostic estimates for older individuals who came to develop the dementia disorder, in a time frame of 10 years. Machine learning applications were shown to be useful in both research contexts.In the diagnosis research context, study I summarized the state of the art evidence in the area of bone age assessment with the use of machine learning, identifying both automated and non-automated approaches for age assessment. Study II investigated a non-automated approach based on the radiologists' assessment and study III investigated an automated approach based on deep learning. Both studies used magnetic resonance imaging. The results showed that the radiologists' assessment as input was not precise enough for the estimation of age. However, the deep learning method was able to extract more useful features from the images and provided better diagnostic performance for the age assessment.In the research context of prognosis, study IV conducted a review on the relevant evidence in on the prognosis of dementia with machine learning techniques, identifying a focus on the research on neuroimaging studies dedicated to validating biomarkers for pharmaceutical research. Study V proposed a multifactorial decision tree approach for the prognosis of dementia in older individuals as to their development or not of dementia in 10 years. Achieving consistent performance results, it provided an interpretable prognostic model identifying possible modifiable and non-modifiable risk factors and possible patient subgroups of importance for the dementia research.