Tremor assessment using smartphone sensor data and fuzzy reasoning

Background Tremor severity assessment is an important step for the diagnosis and treatment decision-making of essential tremor (ET) patients. Traditionally, tremor severity is assessed by using questionnaires (e.g., ETRS and QUEST surveys). In this work we assume the possibility of assessing tremor severity using sensor data and computerized analyses. The goal of this work is to assess severity of tremor objectively, to be better able to asses improvement in ET patients due to deep brain stimulation or other treatments. Methods We collect tremor data by strapping smartphones to the wrists of ET patients. The resulting raw sensor data is then pre-processed to remove any artifact due to patient's intentional movement. Finally, this data is exploited to automatically build a transparent, interpretable, and succinct fuzzy model for the severity assessment of ET. For this purpose, we exploit pyFUME, a tool for the data-driven estimation of fuzzy models. It leverages the FST-PSO swarm intelligence meta-heuristic to identify optimal clusters in data, reducing the possibility of a premature convergence in local minima which would result in a sub-optimal model. pyFUME was also combined with GRABS, a novel methodology for the automatic simplification of fuzzy rules. Results Our model is able to assess tremor severity of patients suffering from Essential Tremor, notably without the need for subjective questionnaires nor interviews. The fuzzy model improves the mean absolute error (MAE) metric by 78-81% compared to linear models and by 71-74% compared to a model based on decision trees. Conclusion This study confirms that tremor data gathered using the smartphones is useful for the constructing of machine learning models that can be used to support the diagnosis and monitoring of patients who suffer from Essential Tremor. The model produced by our methodology is easy to inspect and, notably, characterized by a lower error with respect to approaches based on linear models or decision trees.