Distinguishing preeclampsia using the falling scaled slope (FSS) --- a novel photoplethysmographic morphological parameter

ABSTRACT

Background

Preeclampsia (PE) presence could lead to hemodynamic changes. Previous research suggested that morphological parameters based on photoplethysmographic pulse waves (PPGW) could help diagnose PE.

Aim

To investigate the performance of a novel PPGPW-based parameter, falling scaled slope (FSS), in distinguishing PE. To investigate the advantages of the machine learning algorithm over the conventional statistical methods in the analysis.

Methods

Eighty-one pieces of PPGPW data were acquired for the study (PE, n = 44; normotensive, n = 37). The FSS values were calculated and used to construct a PE classifier using the K-nearest neighbors (KNN) algorithm. A predicted PE state varying from 0 to 1 was also calculated. The classifier’s performance in distinguishing PE was evaluated using the ROC and AUC. A comparison was conducted with previously published PPGPW-based models.

Result

Compared to the previous PPGPW-based parameters, FSS showed a better performance in distinguishing PE with an AUC value of 0.924, the best threshold of 0.498 could predict PE with a sensitivity of 84.1% and a specificity of 89.2%. As for the analysis method, training a classifier using the KNN algorithm had an advantage over the conventional statistical methods with the AUC values of 0.878 and 0.749, respectively.

Conclusion

The result indicated that FSS might be an effective tool for identifying PE. Moreover, the machine learning algorithm could further help the data analysis and improve performance.

KEYWORDS:

• characteristics extraction
• machine learning
• morphology
• preeclampsia
• photoplethysmographic pulse wave

Acknowledgments

The authors wish to express their gratitude and appreciation for the medical staff in the Women’s Hospital School of Medicine Zhejiang University for the PPGPW data acquisition and John K-J. Li, the Distinguished Professor of Biomedical Engineering at Rutgers University (NJ, USA) for the language help.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the [National Natural Science Foundation of China] under Grant [number 81870868]; [Major Scientific Project of Zhejiang Lab] under Grant [number 2020ND8AD01].