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      The novel application of artificial neural network on bioelectrical impedance analysis to assess the body composition in elderly

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          Abstract

          Background

          This study aims to improve accuracy of Bioelectrical Impedance Analysis (BIA) prediction equations for estimating fat free mass (FFM) of the elderly by using non-linear Back Propagation Artificial Neural Network (BP-ANN) model and to compare the predictive accuracy with the linear regression model by using energy dual X-ray absorptiometry (DXA) as reference method.

          Methods

          A total of 88 Taiwanese elderly adults were recruited in this study as subjects. Linear regression equations and BP-ANN prediction equation were developed using impedances and other anthropometrics for predicting the reference FFM measured by DXA (FFM DXA) in 36 male and 26 female Taiwanese elderly adults. The FFM estimated by BIA prediction equations using traditional linear regression model (FFM LR) and BP-ANN model (FFM ANN) were compared to the FFM DXA. The measuring results of an additional 26 elderly adults were used to validate than accuracy of the predictive models.

          Results

          The results showed the significant predictors were impedance, gender, age, height and weight in developed FFM LR linear model (LR) for predicting FFM (coefficient of determination, r 2 = 0.940; standard error of estimate (SEE) = 2.729 kg; root mean square error (RMSE) = 2.571kg, P < 0.001). The above predictors were set as the variables of the input layer by using five neurons in the BP-ANN model (r 2 = 0.987 with a SD = 1.192 kg and relatively lower RMSE = 1.183 kg), which had greater (improved) accuracy for estimating FFM when compared with linear model. The results showed a better agreement existed between FFM ANN and FFM DXA than that between FFM LR and FFM DXA.

          Conclusion

          When compared the performance of developed prediction equations for estimating reference FFM DXA, the linear model has lower r 2 with a larger SD in predictive results than that of BP-ANN model, which indicated ANN model is more suitable for estimating FFM.

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          Most cited references35

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          Clinical prediction rules. Applications and methodological standards.

          The objective of clinical prediction rules is to reduce the uncertainty inherent in medical practice by defining how to use clinical findings to make predictions. Clinical prediction rules are derived from systematic clinical observations. They can help physicians identify patients who require diagnostic tests, treatment, or hospitalization. Before adopting a prediction rule, clinicians must evaluate its applicability to their patients. We describe methodological standards that can be used to decide whether a prediction rule is suitable for adoption in a clinician's practice. We applied these standards to 33 reports of prediction rules; 42 per cent of the reports contained an adequate description of the prediction rules, the patients, and the clinical setting. The misclassification rate of the rule was measured in only 34 per cent of reports, and the effects of the rule on patient care were described in only 6 per cent of reports. If the objectives of clinical prediction rules are to be fully achieved, authors and readers need to pay close attention to basic principles of study design.
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            Decreased muscle mass and increased central adiposity are independently related to mortality in older men.

            Aging is associated with significant changes in body composition. Body mass index (BMI; in kg/m(2)) is not an accurate indicator of overweight and obesity in the elderly. We examined the relation between other anthropometric indexes of body composition (both muscle mass and body fat) and all-cause mortality in men aged 60-79 y. The study was a prospective study of 4107 men aged 60-79 y with no diagnosis of heart failure and who were followed for a mean period of 6 y, during which time there were 713 deaths. Underweight men (BMI 102 cm) and waist-to-hip ratio (top quartile), were associated with increased mortality. A composite measure of MAMC and WC most effectively predicted mortality. Men with low WC ( 102 cm and above-median muscle mass showed significantly increased mortality [age-adjusted relative risk: 1.36; 95% CI: 1.07, 1.74), and this increased to 1.55 (95% CI: 1.01, 2.39) in those with WC > 102 and low MAMC. The findings suggest that the combined use of both WC and MAMC provides simple measures of body composition to assess mortality risk in older men.
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              Application of artificial neural networks to clinical medicine.

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                Author and article information

                Contributors
                Journal
                Nutr J
                Nutr J
                Nutrition Journal
                BioMed Central
                1475-2891
                2013
                6 February 2013
                : 12
                : 21
                Affiliations
                [1 ]Research Center, Charder Electronic Co., LTD, Taichung, Taiwan
                [2 ]Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan
                [3 ]Sport Science Research Center, National Taiwan University of Physical Education and Sport, Taichung, Taiwan
                [4 ]Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan
                [5 ]Department of Physical Education, National Taiwan University of Physical Education and Sport, 16, Sec. 1, Shuan-Shih Rd, Taichung, 40404, Taiwan
                Article
                1475-2891-12-21
                10.1186/1475-2891-12-21
                3662169
                23388042
                46b1b3c8-fd0b-4cc1-a9b8-59aeb3b2e267
                Copyright ©2013 Hsieh et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 July 2012
                : 22 January 2013
                Categories
                Research

                Nutrition & Dietetics
                back propagation artificial neural network (bp-ann),body composition,bioelectrical impedance analysis (bia),elderly,dual-energy x-ray absorptiometry

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