PREDICTING THE EVOLUTION OF PRESSURE ULCERS
Francisco J. Veredas, Héctor Mesa, Juan C. Morilla, Laura Morente
2010
Abstract
A pressure ulcer is a clinical pathology of localized damage to the skin and underlying tissue caused by pressure, shear or friction. Diagnosis, treatment and care of pressure ulcers are costly for health services. Accurate wound evaluation is a critical task for optimizing the efficacy of treatment and care. Prediction of wound evolution helps the effective management of health resources and planning of pharmacological treatment and health-care decisions. In this paper, different machine learning approaches have been designed and used to predict the evolution of pressure ulcers. These predictive systems are based on local features extracted from wound images which were weekly taken in uncontrolled lighting conditions. The images were automatically segmented by the mean-shift procedure. A group of clinical experts manually classified the segmented regions into five different tissue types, and a set of local descriptors based on area measurements of these tissues was extracted. The one-week evolution of two different indicators for pressure ulcer evaluation is predicted: the ratio between granulation and devitalized tissue, and the percentage of wound-bed border consisting of granulation tissue. Of the tens of machine learning approaches and architectures tested in this study, support vector machines, naive Bayes classifiers, neural networks and decision trees achieved the highest accuracy rates in the prediction of the two indicators above, with also acceptable sensitivity and positive predictive value rates. Feature selection significantly reduced the number of input features needed for prediction. Neural networks and decision trees gave the best performance results, and the C4.5 algorithm achieved the highest accuracy rate (∼ 81%) in the prediction of the granulation/devitalized ratio from a small number of input features.
References
- Comaniciu, D. and Meer, P. (2002). Mean shift: A robust approach toward feature space analysis. IEEE Trans. Pattern Analysis Machine Intell., 24(5):603-619.
- Dowsett, C. (2008). Using the TIME framework in wound bed preparation. Br J Community Nurs, 13(6):S15-6, S18, S20 passim.
- Drucker, H., Burges, C. J., Kaufman, L., Smola, A., and Vapnik, V. (1997). Support vector regression machines. Advances in Neural Information Processing Systems, 9:155-161.
- Edsberg, L. E. (2007). Pressure ulcer tissue histology: An appraisal of current knowledge. Ostomy/Wound Management, 53(10):40-49.
- European Pressure Ulcer Advisory Panel (EPUAP) (1999). Guidelines on treatment of pressure ulcers. EPUAP Review, 1:31-33.
- Freund, Y. and Mason, L. (1999). The alternating decision tree algorithm. In Proceedings of the 16th International Conference on Machine Learning.
- Gawlitta, D., Li, W., Oomens, C. W. J., Baaijens, F. P. T., Bader, D. L., and Bouten, C. V. C. (2007). The relative contributions of compression and hypoxia to development of muscle tissue damage: An in vitro study. Annals of Biomedical Engineering, 35(2):273-284.
- Günes, U. Y. (2009). A prospective study evaluating the Pressure Ulcer Scale for Healing to assess stage II, stage III, and stage IV pressure ulcers. Ostomy Wound Management, 55(5):48-52.
- Gunningberg, L. (2004). Risk, prevalence and prevention of pressure ulcers in three swedish healthcare settings. Journal of Wound Care, 13(7):286-290.
- Haykin, S. (1999). Neural networks a comprehesive foundation. Prentice Hall, New Jersey, USA, second edition.
- Horn, S. D., Bender, S. A., Bergstrom, N., Cook, A. S., Ferguson, M. L., Rimmasch, H. L., Sharkey, S. S., Smout, R. J., Taler, G. A., and Voss, A. C. (2002). Description of the national pressure ulcer long-term care study. Journal of the American Geriatrics Society, 50(11):1816-1825.
- Kottner, J., Raeder, K., Halfens, R., and Dassen, T. (2009). A systematic review of interrater reliability of pressure ulcer classification systems. Journal of Clinical Nursing, 18(3):315-336.
- Landi, F., Onder, G., Russo, A., and Bernabei, R. (2007). Pressure ulcer and mortality in frail elderly people living in community. Archives of Gerontology and Geriatrics, 44(Supplement 1):217 - 223.
- Mierswa, I., Wurst, M., Klinkenberg, R., Scholz, M., and Euler, T. (2006). Yale: Rapid prototyping for complex data mining tasks. In Ungar, L., Craven, M., Gunopulos, D., and Eliassi-Rad, T., editors, KDD 7806: Proceedings of the 12th ACM SIGKDD international conference on Knowledge discovery and data mining, pages 935-940, New York, NY, USA. ACM.
- National Pressure Ulcer Advisory Panel, Cuddigan, J., Ayello, E., and Sussman, C., editors (2001). Pressure ulcers in America: Prevalence, incidence, and implications for the future. Reston, VA: NPUAP.
- Quinlan, R. (1993). C4.5: Programs for Machine Learning. Morgan Kaufmann Publishers.
- Redelings, M. D., Lee, N. E., and Sorvillo, F. (2005). Pressure ulcers: More lethal than we thought? Advances in Skin & Wound Care, 18(7):367-372.
- Shi, H. (2007). Best-first decision tree learning. PhD thesis, University of Waikato, Hamilton, NZ. COMP594.
- Stratton, R., Green, C., and Elia, M. (2003). Diseaserelated Malnutrition: An evidence-based approach to treatment. CABI Publishing, Wallingford, United Kingdom.
- Sussman, C. and Bates-Jensen, B., editors (2001). Wound Care: A Collaborative Practice Manual for Physical Therapists and Nurses. Lippincott Williams & Wilkins.
- Tannen, A., Dassen, T., Bours, G., and Halfens, R. (2004). A comparison of pressure ulcer prevalence: concerted data collection in the netherlands and germany. International Journal of Nursing Studies, 41(6):607-612.
- Veredas, F. J., Mesa, H., and Morente, L. (2009). A hybrid learning approach to tissue recognition in wound images. International Journal of Intelligent Computing and Cybernetics, 2(2):327-347.
- Wannous, H., Treuillet, S., and Lucas, Y. (2007). Supervised tissue classification from color images for a complete wound assessment tool. In Proceedings of the 29th Annual International Conference of the IEEE EMBS, pages 6031-6034, Cit Internationale, Lyon, France.
- Woodbury, M. and Houghton, P. (2004). Prevalence of pressure ulcers in canadian healthcare settings. Ostomy Wound Management, 50(10):22-38.
- Zhang, H. (2004). The optimality of Nave Bayes. In Proc. 17th Internat. FLAIRS Conf., pages 562-567, Florida, USA.
- Zulkowski, K. (1999). MDS+ items not contained in the pressure ulcer RAP associated with pressure ulcer prevalence in newly institutionalized elderly. Ostomy Wound Management, 45(1):24-33.
Paper Citation
in Harvard Style
J. Veredas F., Mesa H., C. Morilla J. and Morente L. (2010). PREDICTING THE EVOLUTION OF PRESSURE ULCERS . In Proceedings of the Third International Conference on Health Informatics - Volume 1: HEALTHINF, (BIOSTEC 2010) ISBN 978-989-674-016-0, pages 5-12. DOI: 10.5220/0002690700050012
in Bibtex Style
@conference{healthinf10,
author={Francisco J. Veredas and Héctor Mesa and Juan C. Morilla and Laura Morente},
title={PREDICTING THE EVOLUTION OF PRESSURE ULCERS},
booktitle={Proceedings of the Third International Conference on Health Informatics - Volume 1: HEALTHINF, (BIOSTEC 2010)},
year={2010},
pages={5-12},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0002690700050012},
isbn={978-989-674-016-0},
}
in EndNote Style
TY - CONF
JO - Proceedings of the Third International Conference on Health Informatics - Volume 1: HEALTHINF, (BIOSTEC 2010)
TI - PREDICTING THE EVOLUTION OF PRESSURE ULCERS
SN - 978-989-674-016-0
AU - J. Veredas F.
AU - Mesa H.
AU - C. Morilla J.
AU - Morente L.
PY - 2010
SP - 5
EP - 12
DO - 10.5220/0002690700050012