title: Unsupervised machine-learning method for improving the performance of ambulatory fall-detection systems.
abstract: BACKGROUND
  Falls can cause trauma, disability and death among older people. Ambulatory accelerometer devices are currently capable of detecting falls in a controlled environment. However, research suggests that most current approaches can tend to have insufficient sensitivity and specificity in non-laboratory environments, in part because impacts can be experienced as part of ordinary daily living activities.
  
  
  METHODS
  We used a waist-worn wireless tri-axial accelerometer combined with digital signal processing, clustering and neural network classifiers. The method includes the application of Discrete Wavelet Transform, Regrouping Particle Swarm Optimization, Gaussian Distribution of Clustered Knowledge and an ensemble of classifiers including a multilayer perceptron and Augmented Radial Basis Function (ARBF) neural networks.
  
  
  RESULTS
  Preliminary testing with 8 healthy individuals in a home environment yields 98.6% sensitivity to falls and 99.6% specificity for routine Activities of Daily Living (ADL) data. Single ARB and MLP classifiers were compared with a combined classifier. The combined classifier offers the greatest sensitivity, with a slight reduction in specificity for routine ADL and an increased specificity for exercise activities. In preliminary tests, the approach achieves 100% sensitivity on in-group falls, 97.65% on out-group falls, 99.33% specificity on routine ADL, and 96.59% specificity on exercise ADL.
  
  
  CONCLUSIONS
  The pre-processing and feature-extraction steps appear to simplify the signal while successfully extracting the essential features that are required to characterize a fall. The results suggest this combination of classifiers can perform better than MLP alone. Preliminary testing suggests these methods may be useful for researchers who are attempting to improve the performance of ambulatory fall-detection systems.
authors.affiliation: Faculty of Engineering and IT, University of Technology Sydney, NSW, 2007, Australia.
authors.forename: Mitchell
authors.initials: M
authors.lastname: Yuwono
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Moulton
authors.forename: Steven W
authors.initials: SW
authors.lastname: Su
authors.forename: Branko G
authors.initials: BG
authors.lastname: Celler
authors.forename: Hung T
authors.initials: HT
authors.lastname: Nguyen
mesh_terms: D000054:Acceleration; D000058:Accidental Falls; D000203:Activities of Daily Living; D000328:Adult; D000465:Algorithms; D001185:Artificial Intelligence; D005260:Female; D006801:Humans; D008297:Male; D018670:Monitoring, Ambulatory / Q000295:instrumentation* / Q000379:methods; D009068:Movement / Q000502:physiology; D016571:Neural Networks, Computer; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted