Fully automated cognitive screening tool based on assessment of speech and language.
Fully automated cognitive screening tool based on assessment of speech and language.
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基于语音和语言评估的全自动认知筛查工具。
DOI：
10.1136/jnnp-2019-322517
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
O'Malley RPD
中科院分区：
文献类型：
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作者：
O'Malley RPD
近年来，转介到记忆专科诊所的人数几乎增加了七倍。这与功能性认知障碍（FCD）（即非进行性认知主诉）患者比例增加有关。这些患者可能受益于一系列不同于神经退行性认知障碍患者要求的干预措施（如心理治疗）。我们已经开发了一个完全自动化的系统，“CognoSpeak”，它使风险分层的初级-二级保健接口和正在进行的监测患者的记忆concerns.MethodsWe招募了15名参与者的四个组：阿尔茨海默氏病（AD），轻度认知障碍（MCI），FCD和健康对照。参与者回答了计算机呈现的说话头像提出的12个问题。音频和语音数据的自动分析涉及说话人分割，自动语音识别和机器学习classification.ResultsCognoSpeak可以区分参与者在AD或MCI组和FCD或健康对照组的敏感性为86.7%。MCI患者的敏感性为80%.DiscussionOur完全自动化的系统实现了与目前可用的，手动管理的评估的准确性水平。通过对更多的用户进行进一步的系统培训，包括语言流畅性任务和重复评估，应该可以实现更高的准确性。目前的数据支持CognoSpeak作为MCI患者筛查和监测工具的承诺。在确认这些发现之前，它可能允许临床医生为痴呆症低风险患者提供早期保证，并减轻专家记忆服务的压力。
IntroductionRecent years have seen an almost sevenfold rise in referrals to specialist memory clinics. This has been associated with an increased proportion of patients referred with functional cognitive disorder (FCD), that is, non-progressive cognitive complaints. These patients are likely to benefit from a range of interventions (eg, psychotherapy) distinct from the requirements of patients with neurodegenerative cognitive disorders. We have developed a fully automated system, ‘CognoSpeak’, which enables risk stratification at the primary–secondary care interface and ongoing monitoring of patients with memory concerns.MethodsWe recruited 15 participants to each of four groups: Alzheimer’s disease (AD), mild cognitive impairment (MCI), FCD and healthy controls. Participants responded to 12 questions posed by a computer-presented talking head. Automatic analysis of the audio and speech data involved speaker segmentation, automatic speech recognition and machine learning classification.ResultsCognoSpeak could distinguish between participants in the AD or MCI groups and those in the FCD or healthy control groups with a sensitivity of 86.7%. Patients with MCI were identified with a sensitivity of 80%.DiscussionOur fully automated system achieved levels of accuracy comparable to currently available, manually administered assessments. Greater accuracy should be achievable through further system training with a greater number of users, the inclusion of verbal fluency tasks and repeat assessments. The current data supports CognoSpeak’s promise as a screening and monitoring tool for patients with MCI. Pending confirmation of these findings, it may allow clinicians to offer patients at low risk of dementia earlier reassurance and relieve pressures on specialist memory services.