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We investigated several aspects of using neural networks as a diagnostic tool: the design of an optimal network, the amount of patients' data needed to train the network, the question of training the network optimally while avoiding overfitting, and the influence of redundant variables. The specific clinical problem chosen for illustration was the diagnosis of acute myocardial infarction, given only the electrocardiogram and the concentration of potassium in serum at the time of admission. We found that, in contrast to usual practice, the termination of the training process should be based on the generalization performance and not on the training performance. We also found that a principal component analysis can be used to eliminate redundant variables, thereby reducing the data space. The diagnostic performance of the neural network we used was 78%--superior to that of linear discriminant function analysis but similar to that of quadratic discriminant function analysis.

Use of neural networks to diagnose acute myocardial infarction. I. Methodology