A Role for Prior Knowledge in Statistical Classification of the Transition from MCI to Alzheimer's Disease

The transition from mild cognitive impairment (MCI) to Alzheimer's disease (AD) is of great interest to clinical researchers. This phenomenon also serves as a valuable data source for quantitative methodological researchers developing new approaches for classification. However, the growth of machine learning (ML) approaches for classification may falsely lead many clinical researchers to underestimate the value of logistic regression (LR), yielding equivalent or superior classification accuracy over other ML methods. Further, in applications with many features that could be used for classifying the transition, clinical researchers are often unaware of the relative value of different selection procedures. In the present study, we sought to investigate the use of automated and theoretically-guided feature selection techniques, and as well as the L-1 norm when applying different classification techniques for predicting conversion from MCI to AD in a highly characterized and studied sample from the Alzheimer's Disease Neuroimaging Initiative (ADNI). We propose an alternative pre-selection technique that utilizes an efficient feature selection based on clinical knowledge of brain regions involved in AD. The present findings demonstrate how similar performance can be achieved using user-guided pre-selection versus algorithmic feature selection techniques. Finally, we compare the performance of a support vector machine (SVM) with that of logistic regression on multi-modal data from ADNI. The present findings show that although SVM and other ML techniques are capable of relatively accurate classification, similar or higher accuracy can often be achieved by LR, mitigating SVM's necessity or value for many clinical researchers.