Remote clinical decision support tool for Parkinson’s disease assessment using a novel approach that combines AI and clinical knowledge

Abstract Background Early diagnosis of Parkinson’s disease (PD) can assist in designing efficient treatments. Reduced facial expressions are considered a hallmark of PD, making advanced artificial intelligence (AI) image processing a potential non-invasive clinical decision support tool for PD detec...

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Main Authors: Harel Rom, Ori Peleg, Yovel Rom, Anat Mirelman, Gaddi Blumrosen, Inbal Maidan
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Medical Informatics and Decision Making
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Online Access:https://doi.org/10.1186/s12911-025-03104-6
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author Harel Rom
Ori Peleg
Yovel Rom
Anat Mirelman
Gaddi Blumrosen
Inbal Maidan
author_facet Harel Rom
Ori Peleg
Yovel Rom
Anat Mirelman
Gaddi Blumrosen
Inbal Maidan
author_sort Harel Rom
collection DOAJ
description Abstract Background Early diagnosis of Parkinson’s disease (PD) can assist in designing efficient treatments. Reduced facial expressions are considered a hallmark of PD, making advanced artificial intelligence (AI) image processing a potential non-invasive clinical decision support tool for PD detection. This study aims to determine the sensitivity of image-to-text AI, which matches facial frames recorded in home settings with descriptions of PD facial expressions, in identifying patients with PD. Methods Facial image of 67 PD patients and 52 healthy-controls (HCs) were collected via standard video recording. Using clinical knowledge, we compiled descriptive sentences detailing facial characteristics associated with PD. The facial images were analyzed with OpenAI’s CLIP model to generate probability scores, indicating the likelihood of each image matching the PD-related descriptions. These scores were used in an XGBoost model to identify PD patients based on the total, motor, and facial-expression item of the MDS-UPDRS, a common scale for assessing disease severity. Results The image-to-text AI technology showed the best results in identifying PD patients based on the facial expression item (AUC = 0.78 ± 0.05), especially for those with ‘mild’ facial symptoms (AUC = 0.87 ± 0.04). The motor MDS-UPDRS score followed (AUC = 0.69 ± 0.05), while the total MDS-UPDRS score showed the lowest performance in identifying PD patients (AUC = 0.59 ± 0.05). PD matching probabilities between facial images and sentences revealed significant correlations across all MDS-UPDRS components (r > 0.23, p < 0.0001). Conclusions Our results demonstrate the feasibility of using advanced AI in a clinical decision support tool for PD diagnosis, suggesting a novel approach for home-based screening to identify PD patients. This method represents a significant innovation, transforming clinical knowledge into practical algorithms that can serve as effective screening tools. Clinical trial number MOH_2023-04-16_012535
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institution Kabale University
issn 1472-6947
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publishDate 2025-08-01
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spelling doaj-art-3e1bfa0da7144bfba0c8b5a1a4093cda2025-08-20T03:42:57ZengBMCBMC Medical Informatics and Decision Making1472-69472025-08-012511710.1186/s12911-025-03104-6Remote clinical decision support tool for Parkinson’s disease assessment using a novel approach that combines AI and clinical knowledgeHarel Rom0Ori Peleg1Yovel Rom2Anat Mirelman3Gaddi Blumrosen4Inbal Maidan5Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical CenterLaboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical CenterAEYE HealthLaboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical CenterFaculty of Digital Medical Technologies, Holon Institute of Technology (HIT)Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical CenterAbstract Background Early diagnosis of Parkinson’s disease (PD) can assist in designing efficient treatments. Reduced facial expressions are considered a hallmark of PD, making advanced artificial intelligence (AI) image processing a potential non-invasive clinical decision support tool for PD detection. This study aims to determine the sensitivity of image-to-text AI, which matches facial frames recorded in home settings with descriptions of PD facial expressions, in identifying patients with PD. Methods Facial image of 67 PD patients and 52 healthy-controls (HCs) were collected via standard video recording. Using clinical knowledge, we compiled descriptive sentences detailing facial characteristics associated with PD. The facial images were analyzed with OpenAI’s CLIP model to generate probability scores, indicating the likelihood of each image matching the PD-related descriptions. These scores were used in an XGBoost model to identify PD patients based on the total, motor, and facial-expression item of the MDS-UPDRS, a common scale for assessing disease severity. Results The image-to-text AI technology showed the best results in identifying PD patients based on the facial expression item (AUC = 0.78 ± 0.05), especially for those with ‘mild’ facial symptoms (AUC = 0.87 ± 0.04). The motor MDS-UPDRS score followed (AUC = 0.69 ± 0.05), while the total MDS-UPDRS score showed the lowest performance in identifying PD patients (AUC = 0.59 ± 0.05). PD matching probabilities between facial images and sentences revealed significant correlations across all MDS-UPDRS components (r > 0.23, p < 0.0001). Conclusions Our results demonstrate the feasibility of using advanced AI in a clinical decision support tool for PD diagnosis, suggesting a novel approach for home-based screening to identify PD patients. This method represents a significant innovation, transforming clinical knowledge into practical algorithms that can serve as effective screening tools. Clinical trial number MOH_2023-04-16_012535https://doi.org/10.1186/s12911-025-03104-6Parkinson’s disease (PD)Facial-expressionArtificial intelligence (AI)
spellingShingle Harel Rom
Ori Peleg
Yovel Rom
Anat Mirelman
Gaddi Blumrosen
Inbal Maidan
Remote clinical decision support tool for Parkinson’s disease assessment using a novel approach that combines AI and clinical knowledge
BMC Medical Informatics and Decision Making
Parkinson’s disease (PD)
Facial-expression
Artificial intelligence (AI)
title Remote clinical decision support tool for Parkinson’s disease assessment using a novel approach that combines AI and clinical knowledge
title_full Remote clinical decision support tool for Parkinson’s disease assessment using a novel approach that combines AI and clinical knowledge
title_fullStr Remote clinical decision support tool for Parkinson’s disease assessment using a novel approach that combines AI and clinical knowledge
title_full_unstemmed Remote clinical decision support tool for Parkinson’s disease assessment using a novel approach that combines AI and clinical knowledge
title_short Remote clinical decision support tool for Parkinson’s disease assessment using a novel approach that combines AI and clinical knowledge
title_sort remote clinical decision support tool for parkinson s disease assessment using a novel approach that combines ai and clinical knowledge
topic Parkinson’s disease (PD)
Facial-expression
Artificial intelligence (AI)
url https://doi.org/10.1186/s12911-025-03104-6
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AT anatmirelman remoteclinicaldecisionsupporttoolforparkinsonsdiseaseassessmentusinganovelapproachthatcombinesaiandclinicalknowledge
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