Online Submissions:http://www.journaltcm.com J Tradit Chin Med 2012 September 15; 32(3): 1-2 [email protected] ISSN 0255-2922 © 2012 JTCM. All rights reserved. CLINICAL OBERVATION Data mining-based detection of acupuncture treatment on juvenile myopia Xuming Yang, Lingyu Xu, Fei Zhong, Ying Zhu aa Xuming Yang, College of Acupuncture and Massage, Shang- consistent with the understandings of the ophthal- hai University of TCM, Shanghai 201203, China mic circles. The duration of using the Internet and Lingyu Xu, Fei Zhong, College of Computer Engineering watching TV every day was the main factor that af- and Science, Shanghai University, Shanghai 200072, China fected vision. Acupuncture feelings and therapeu- Ying Zhu, Department of Ophthalmology, Shanghai of TCM tic effect have a strong correlativity. A good or hospital, Shanghai 200071, China Supported by National Natural Science Foundation grant above experience's score of acupuncture could NO.40976108 and Public Projects of Science and Technolo- slow the progression of juvenile myopia. gy Ministry grant NO. 201105033 Correspondence to: Prof. Lingyu Xu, College of Computer CONCLUSION: Collecting data from patients with Engineering and Science, Shanghai University, Shanghai juvenile myopia by using data mining can extract 200072, China. [email protected] hidden potential rules and knowledge from the re- Telephone: +86-21-56337465, +86-13122852765 search evidence. The decision support can be pro- Accepted: June 25, 2012 vided to improve the doctor's clinical acupuncture treatment effects. © 2012 JTCM. All rights reserved. Abstract OBJECTIVE: We applied data mining techniques to Key words: Acupuncture therapy; Myopia; Algo- the study of acupuncture as a treatment for juve- rithms; Data mining nile myopia, with the aim of identifying hidden pat- terns in the data. INTRODUCTION METHODS: Fifty patients with juvenile myopia According to recent surveys at home and abroad, Chi- were selected and treated with acupuncture, and na has one of the highest incidences of myopia, and data mining was used to analyze the effects of the incidence of juvenile myopia is increasing.1 Previ- treatment and the influence of behavioral vari- ous studies of myopia have been limited to modern evi- ables. Clustering analysis was used to divide myo- dence-based ophthalmology. So far, modern medicine has not only failed to find a cure for myopia, but it has pia patients into two classifications before acupunc- also failed to find a feasible way of controlling its devel- ture treatment. Artificial neural network BP algo- opment.2-4 Therefore, it is important to explore the ef- rithm was adopted to analyze the roles of different fectiveness of treatments and prevention methods for factors in changes in diopters. An association algo- true myopia, especially high myopia, which has impor- rithm was used to analyze factors associated with tant medical and social consequences.5-8 Acupuncture the subjective experience of acupuncture and aver- can treat a variety of eye disease; the theoretical basis of age diopter. this treatment is the relationship of the eyes to the 12 meridians.9-10 In acupuncture, clinical evidence-based RESULTS: The two classification results were fully diagnosis and treatment decision-making analysis have JTCM | www. journaltcm. com 372 September 15, 2012 | volume 32 | Issue 3 | Yang XM et al. Data mining-based detection of acupuncture treatment on juvenile myopia focused on two aspects. The first is based on the pa- Data mining algorithms tient's signs and symptoms for diagnosis, resulting in a Knowledge of the association is to reflect the knowl- dialectic treatment decision. The second relies on analy- edge of the dependence or association between events sis of the known rules of acupoints and efficacy of acu- in a data set. The important feature of association rules puncture, thorn moxibustion, treatment time, and oth- is an "association natural combination", which found er relevant factors, to decide on the optimal treatment that a subset that existed mode of all the attributes is solution.11 The foreign ophthalmic industry has used very useful.16,17 The purpose of clustering is reasonable decision tree analysis to find patterns regarding risk fac- according to certain rules of classification or clustering, tors for eye deterioration in large datasets.12 The domes- and with the explicit or implicit method to describe tic ophthalmic industry using Chinese medicine re- the different categories. By digging the hidden implicit gards ophthalmology as "one of the hardest parts in knowledge in the treatment of information, it can pro- TCM", and believes in the use of data mining methods vide decision support for the improvement of the doc- to study the effectiveness of TCM in ophthalmology.13 tor's clinical acupuncture treatment. An artificial neu- In this study, we used the association rule learning ral network BP algorithm can approximate any nonlin- method of data mining using data acquired during acu- ear curve. To identify which factors are associated with puncture treatment of juvenile myopia. We aimed to the patient's average diopter change, the network is giv- find hidden associations within the data, in terms of en a set of inputs and corresponding outputs and deter- treatment options, treatment efficacy, and influence of mines the parameters of each neuron by analyzing the co-existing medical conditions. We verified through ex- relationship between the input and output.18 In previ- periments the effectiveness of acupuncture treatment ous research, multiple stepwise regression analysis has in juvenile myopia, and explored new information on been applied to the quantitative analysis of factors in- how to further optimize treatment and prevention mea- fluencing the response to treatment in patients receiv- sures. ing acupuncture for juvenile myopia. Each patient has a unique optimal equation, and by studying the model, we can obtain the weights of factors determining visual METHODS AND ALGORITHMS acuity.19-22 Acupuncture doctors need as much informa- tion as possible about the patients and treatment, so that they can adjust the acupuncture treatment or Patient selection and data collection adopt other effective measures based on the relevant Fifty patients with true juvenile myopia were selected factors in the optimal equation of each patient. This according to the textbook Chinese medicine Ophthal- provides a more targeted way of selecting an appropri- mology 14. The treatments were chosen based on the fol- ate acupuncture treatment program early on in the clin- lowing principle: promoting flow of Qi and blood cir- ical course, and also provides a more reliable means of culation, relaxing muscle and tendons, and improving tracking the progress of treatment and assessing the the eyesight. Stimulation of eye acupoints can regulate therapeutic effect. the functions of meridians of eyes and zang-fu organs.15 The acupuncture points Cuanzhu (BL 2), Taiyang (EX-HN5), Qiuhou (EX-HN7) and Sibai (ST 2) are DATA MINING ANALYSIS located around the eye area, and their stimulation can clear blockages and regulate the blood flow and meridi- ans. Hegu (LI 4) is the original acupoint of the large in- Questionnaire on the impact of juvenile myopia testine meridian of hand-yangming. Needling can agi- during acupuncture treatment tate Qi and blood in the face near the eye area, promot- During acupuncture treatment of juvenile myopia, pa- ing Qi and blood flow and improving eyesight. Baihui tients were required to complete "the focus on object (GV 20) belongs to the Dumai (Governor Vessel) and tracking questionnaire". Questions were related to meets with the bladder meridian of foot-taiyang. Thus, whether the parents suffered from myopia, the daily acupuncture stimulation of Cuanzhu, Taiyang, Qi- burden on the eye, amount of time spent on the Inter- uhou, Sibai, Baihui and Hegu has an effect in the treat- net and watching television each day, reading time, ment of juvenile myopia. We collected clinical data at writing time, reading posture of the patients, usual 1, 2, 3 and 4 months from the start of the treatment, time spent on homework, the subjective experience of using several eye examination tests, including visual acupuncture, whether the patient likes sweets and fried acuity, intraocular pressure, refraction, horizontal cor- food, and other questions. The extracted information neal curvature, vertical corneal curvature, axial length, was encoded in the table as follows. Parental myopia: " lens thickness and depth of anterior chamber and vitre- 0" indicates "no myopia", "1" indicates "myopia"; ous matter. Other indices based on self-designed "acu- learning environment: "0" indicates "good", "1" means puncture treatment of juvenile myopia focus on the ob- "poor "; reading position: "0" indicates "good", "1" ject of study follow-up survey table" were collected as means "poor"; eating habits: "0" indicates "good", "1" the source data for data mining. means "poor"; time spent on the Internet and watch- JTCM | www. journaltcm. com 373 September 15, 2012 | volume 32 | Issue 3 | Yang XM et al. Data mining-based detection of acupuncture treatment on juvenile myopia ing TV: the number of hours/day, such as "1", "2", patients were divided into two classifications, with 24 etc.; subjective experience of acupuncture: rated on a patients in classification 1, and 26 patients in classifica- scale from 0 to 4, where "4" means "very good", "3" tion 2. means "good", "2" means "effective", "1" means "neu- In the Microsoft SQL Server 2008 Analysis Services tral" and "0" means "poor"; time spent reading/writ- (SSAS), before acupuncture treatment, cluster analysis ing: the number of hours/days, such as "1", "2", etc. algorithm can get classification's characteristics as fol- Assessment of the learning environment and reading low. The main variables impacted by myopia were: posture was based on the Shanghai Municipal Educa- "reading position" (94% ), "parents' myopia" (80% ) tion Commission promulgated "two requirements for and "eating habits" (72%). The classification and com- do" and "another two requirements for donot" of "pro- parison is shown below.