Abstract
The American Heart Association (AHA) has recommended a 12-element questionnaire for pre-participation screening of athletes, in order to reduce and hopefully prevent sudden cardiac death in young athletes. This screening procedure is widely used throughout the United States, but its efficacy for discriminating Normal from Non-normal heart condition is unclear. As part of a larger study on cardiovascular disorders in young athletes, we set out to train machine-learning-based classifiers to automatically categorize athletes into risk-levels based on their answers to the AHA-questionnaire. We also conducted information-based and probabilistic analysis of each question to identify the ones that may best predict athletes’ heart condition. However, surprisingly, the results indicate that the AHA-recommended screening procedure itself does not effectively distinguish between Normal and Non-normal heart as identified by cardiologists using Electro- and Echo-cardiogram examinations. Our results suggest that ECG and Echo, rather than the questionnaire, should be considered for screening young athletes.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Similar content being viewed by others
References
Corrado, D., et al.: Cardiovascular Pre-Participation Screening of Young Competitive Athletes for Prevention of Sudden Death: Proposal for A Common European Protocol. Consensus statement of the study grp. of Sport Cardiology, of the wrk. grp. of Cardiac Rehabilitation and Exercise Physiology and the wrk. grp. of Myocardial and Pericardial Disease of the European Society of Cardiology. European Heart J. 26(5), 516–524 (2005)
Maron, B.J.: Sudden Death in Young Athletes. New England J. of Medicine 349(11), 1064–1075 (2003)
Pigozzi, F., Rizzo, M.: Sudden Death in Competitive Athletes. Clinics in Sports Medicine 27(1), 153–181 (2008)
Wever-Pinzon, O.E., et al.: Sudden Cardiac Death in Young Competitive Athletes Due to Genetic Cardiac Abnormalities. Anadolu Kardiyol Derg. 9(suppl. 2), 17–23 (2009)
Corrado, D., et al.: Screening for Hypertrophic Cardiomyopathy in Young Athletes. New England J. of Medicine 339(6), 364–369 (1998)
Maron, B.J., et al.: Cardiovascular Preparticipation Screening of Competitive Athletes: A Statement for Health Professionals From the Sudden Death Committee (Clinical Cardiology) and Congenital Cardiac Defects Committee (Cardiovascular Disease in the Young). Circulation 94(4), 850–856 (1996)
Glover, D.W., Maron, B.J.: Evolution in the Process of Screening United States High School Student-athletes for Cardiovascular Disease. American J. of Cardiology 100(11), 1709–1712 (2007)
Maron, B.J., et al.: Recommendations and Considerations Related to Preparticipation Screening for Cardiovascular Abnormalities in Competitive Athletes: 2007 Update: A Scientific Statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabol. Circulation 115(12), 1643–1655 (2007)
Kanagalingam, J., et al.: Efficacy of the American Heart Association Questionnaire in Identifying Electrocardiographic and Echocardiographic Abnormalities in Young Athletes During Community-based Screening. Circulation 122(21), A19765 (2010)
Mitchell, T.M.: Machine Learning. McGraw-Hill (1997)
Melgani, F., Bazi, Y.: Classification of Electrocardiogram Signals with Support Vector Machines and Particle Swarm Optimization. IEEE Trans. on Information Technology in Biomedicine 12(5), 667–677 (2008)
Osowski, S., Hoai, L.T., Markiewicz, T.: Support Vector Machine-Based Expert System for Reliable Heartbeat Recognition. IEEE Trans. on Biomedical Eng. 51(4), 582–589 (2004)
Chazal, P.D., et al.: Automatic Classification of Heartbeats using ECG Morphology and Heartbeat Interval Features. IEEE Trans. on Biomedical Eng. 51(7), 1196–1206 (2004)
Yu, S., Chou, K.: Integration of Independent Component Analysis and Neural Networks for ECG Beat Classification. Expert Systems with Applications 34(4), 2841–2846 (2008)
Qu, L., et al.: A Naïve Bayes Classifier for Differential Diagnosis of Long QT Syndrome in Children. In: Int. Conf. on Bioinformatics and Biomedicine, pp. 433–437 (2010)
Akay, M.F.: Support Vector Machines Combined with Feature Selection for Breast Cancer Diagnosis. Expert Systems with Applications 36(2), 3240–3247 (2009)
Chhatwal, J., et al.: A Logistic Regression Model Based on the National Mammography Database Format to Aid Breast Cancer Diagnosis. American J. of Roentgenology 192(4), 1117–1127 (2009)
Statnikov, A., Wang, L.: A Comprehensive Comparison of Random Forests and Support Vector Machines for Microarray-Based Cancer Classification. BMC Bioinformatics 9(1), 319 (2008)
Breiman, L.: Random forests. Machine Learning 45(1), 5–32 (2001)
Cortes, C., Vapnik, V.: Support-vector Networks. Machine Learning 20(3), 273–297 (1995)
Hall, M., et al.: The WEKA Data Mining Software: an Update. ACM SIGKDD Explorations Newsletter 11(1), 10–18 (2009)
Walpole, R., et al.: Probability and Statistics for Engineers and Scientists. Prentice Hall (2002)
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer International Publishing Switzerland
About this paper
Cite this paper
Rahman, Q.A., Kanagalingam, S., Pinheiro, A., Abraham, T., Shatkay, H. (2013). What We Found on Our Way to Building a Classifier: A Critical Analysis of the AHA Screening Questionnaire. In: Imamura, K., Usui, S., Shirao, T., Kasamatsu, T., Schwabe, L., Zhong, N. (eds) Brain and Health Informatics. BHI 2013. Lecture Notes in Computer Science(), vol 8211. Springer, Cham. https://doi.org/10.1007/978-3-319-02753-1_23
Download citation
DOI: https://doi.org/10.1007/978-3-319-02753-1_23
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-02752-4
Online ISBN: 978-3-319-02753-1
eBook Packages: Computer ScienceComputer Science (R0)