1.Explainability Enhanced Machine Learning Model for Classifying Intellectual Disability and AttentionDeficit/Hyperactivity Disorder With Psychological Test Reports
Tong Min KIM ; Young-Hoon KIM ; Sung-Hee SONG ; In-Young CHOI ; Dai-Jin KIM ; Taehoon KO
Journal of Korean Medical Science 2025;40(11):e26-
Background:
Psychological test reports are essential in assessing intellectual functioning, aiding in diagnosing and treating intellectual disability (ID) and attention-deficit/ hyperactivity disorder (ADHD). However, these reports can have several problems because they are diverse, unstructured, subjective, and involve human errors. Additionally, physicians often do not read the entire report, and the number of reports is lower than that of diagnoses.
Methods:
We developed explainable predictive models for classifying IDs and ADHDs based on written reports to address these issues. The reports of 1,475 patients with IDs and ADHDs who underwent intelligence tests were used for the models. These models were developed by analyzing reports using natural language processing (NLP) and incorporating the physician’s diagnosis for each report. We selected n-gram features from the models’ results by extracting important features using SHapley Additive exPlanations and permutation importance to make the models explainable. Developing the n-gram feature-based original text search system compensated for the lack of human readability caused by NLP and enabled the reconstruction of human-readable texts from the selected n-gram features.
Results:
The maximum model accuracy was 0.92, and the 80 human-readable texts were restored from four models.
Conclusion
The results showed that the models could accurately classify IDs and ADHDs, even with a few reports. The models were also able to explain their predictions. The explainability-enhanced model can help physicians understand the classification process of IDs and ADHDs and provide evidence-based insights.
2.Dementia Overdiagnosis in Younger, Higher Educated Individuals Based on MMSE Alone: Analysis Using Deep Learning Technology
Hye-Geum KIM ; Dai-Seg BAI ; Bon-Hoon KOO ; Eun-Jin CHEON ; Seokho YUN ; So Hye JO ; Byoungyoung GU
Journal of Korean Medical Science 2025;40(9):e20-
Background:
Dementia is a multifaceted disorder that affects cognitive function, necessitating accurate diagnosis for effective management and treatment. Although the Mini-Mental State Examination (MMSE) is widely used to assess cognitive impairment, its standalone efficacy is debated. This study examined the effectiveness of the MMSE alone versus in combination with other cognitive assessments in predicting dementia diagnosis, with the aim of refining the diagnostic accuracy for dementia.
Methods:
A total of 2,863 participants with subjective cognitive complaints who underwent comprehensive neuropsychological assessments were included. We developed two random forest models: one using only the MMSE and another incorporating additional cognitive tests.These models were evaluated based on their accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC) on a 70:30 training-to-testing split.
Results:
The MMSE-alone model predicted dementia with an accuracy of 86% and AUC of 0.872. The expanded model demonstrated increased accuracy (88%) and an AUC of 0.934.Notably, 17.46% of the cases were reclassified from dementia to non-dementia category upon including additional tests. Higher educational level and younger age were associated with these shifts.
Conclusion
The findings suggest that although the MMSE is a valuable screening tool, it should not be used in isolation to determine dementia severity. The addition of diverse cognitive assessments can significantly enhance diagnostic precision, particularly in younger and more educated populations. Future diagnostic protocols should integrate multifaceted cognitive evaluations to reflect the complexity of dementia accurately.
3.Explainability Enhanced Machine Learning Model for Classifying Intellectual Disability and AttentionDeficit/Hyperactivity Disorder With Psychological Test Reports
Tong Min KIM ; Young-Hoon KIM ; Sung-Hee SONG ; In-Young CHOI ; Dai-Jin KIM ; Taehoon KO
Journal of Korean Medical Science 2025;40(11):e26-
Background:
Psychological test reports are essential in assessing intellectual functioning, aiding in diagnosing and treating intellectual disability (ID) and attention-deficit/ hyperactivity disorder (ADHD). However, these reports can have several problems because they are diverse, unstructured, subjective, and involve human errors. Additionally, physicians often do not read the entire report, and the number of reports is lower than that of diagnoses.
Methods:
We developed explainable predictive models for classifying IDs and ADHDs based on written reports to address these issues. The reports of 1,475 patients with IDs and ADHDs who underwent intelligence tests were used for the models. These models were developed by analyzing reports using natural language processing (NLP) and incorporating the physician’s diagnosis for each report. We selected n-gram features from the models’ results by extracting important features using SHapley Additive exPlanations and permutation importance to make the models explainable. Developing the n-gram feature-based original text search system compensated for the lack of human readability caused by NLP and enabled the reconstruction of human-readable texts from the selected n-gram features.
Results:
The maximum model accuracy was 0.92, and the 80 human-readable texts were restored from four models.
Conclusion
The results showed that the models could accurately classify IDs and ADHDs, even with a few reports. The models were also able to explain their predictions. The explainability-enhanced model can help physicians understand the classification process of IDs and ADHDs and provide evidence-based insights.
4.Dementia Overdiagnosis in Younger, Higher Educated Individuals Based on MMSE Alone: Analysis Using Deep Learning Technology
Hye-Geum KIM ; Dai-Seg BAI ; Bon-Hoon KOO ; Eun-Jin CHEON ; Seokho YUN ; So Hye JO ; Byoungyoung GU
Journal of Korean Medical Science 2025;40(9):e20-
Background:
Dementia is a multifaceted disorder that affects cognitive function, necessitating accurate diagnosis for effective management and treatment. Although the Mini-Mental State Examination (MMSE) is widely used to assess cognitive impairment, its standalone efficacy is debated. This study examined the effectiveness of the MMSE alone versus in combination with other cognitive assessments in predicting dementia diagnosis, with the aim of refining the diagnostic accuracy for dementia.
Methods:
A total of 2,863 participants with subjective cognitive complaints who underwent comprehensive neuropsychological assessments were included. We developed two random forest models: one using only the MMSE and another incorporating additional cognitive tests.These models were evaluated based on their accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC) on a 70:30 training-to-testing split.
Results:
The MMSE-alone model predicted dementia with an accuracy of 86% and AUC of 0.872. The expanded model demonstrated increased accuracy (88%) and an AUC of 0.934.Notably, 17.46% of the cases were reclassified from dementia to non-dementia category upon including additional tests. Higher educational level and younger age were associated with these shifts.
Conclusion
The findings suggest that although the MMSE is a valuable screening tool, it should not be used in isolation to determine dementia severity. The addition of diverse cognitive assessments can significantly enhance diagnostic precision, particularly in younger and more educated populations. Future diagnostic protocols should integrate multifaceted cognitive evaluations to reflect the complexity of dementia accurately.
5.Explainability Enhanced Machine Learning Model for Classifying Intellectual Disability and AttentionDeficit/Hyperactivity Disorder With Psychological Test Reports
Tong Min KIM ; Young-Hoon KIM ; Sung-Hee SONG ; In-Young CHOI ; Dai-Jin KIM ; Taehoon KO
Journal of Korean Medical Science 2025;40(11):e26-
Background:
Psychological test reports are essential in assessing intellectual functioning, aiding in diagnosing and treating intellectual disability (ID) and attention-deficit/ hyperactivity disorder (ADHD). However, these reports can have several problems because they are diverse, unstructured, subjective, and involve human errors. Additionally, physicians often do not read the entire report, and the number of reports is lower than that of diagnoses.
Methods:
We developed explainable predictive models for classifying IDs and ADHDs based on written reports to address these issues. The reports of 1,475 patients with IDs and ADHDs who underwent intelligence tests were used for the models. These models were developed by analyzing reports using natural language processing (NLP) and incorporating the physician’s diagnosis for each report. We selected n-gram features from the models’ results by extracting important features using SHapley Additive exPlanations and permutation importance to make the models explainable. Developing the n-gram feature-based original text search system compensated for the lack of human readability caused by NLP and enabled the reconstruction of human-readable texts from the selected n-gram features.
Results:
The maximum model accuracy was 0.92, and the 80 human-readable texts were restored from four models.
Conclusion
The results showed that the models could accurately classify IDs and ADHDs, even with a few reports. The models were also able to explain their predictions. The explainability-enhanced model can help physicians understand the classification process of IDs and ADHDs and provide evidence-based insights.
6.Dementia Overdiagnosis in Younger, Higher Educated Individuals Based on MMSE Alone: Analysis Using Deep Learning Technology
Hye-Geum KIM ; Dai-Seg BAI ; Bon-Hoon KOO ; Eun-Jin CHEON ; Seokho YUN ; So Hye JO ; Byoungyoung GU
Journal of Korean Medical Science 2025;40(9):e20-
Background:
Dementia is a multifaceted disorder that affects cognitive function, necessitating accurate diagnosis for effective management and treatment. Although the Mini-Mental State Examination (MMSE) is widely used to assess cognitive impairment, its standalone efficacy is debated. This study examined the effectiveness of the MMSE alone versus in combination with other cognitive assessments in predicting dementia diagnosis, with the aim of refining the diagnostic accuracy for dementia.
Methods:
A total of 2,863 participants with subjective cognitive complaints who underwent comprehensive neuropsychological assessments were included. We developed two random forest models: one using only the MMSE and another incorporating additional cognitive tests.These models were evaluated based on their accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC) on a 70:30 training-to-testing split.
Results:
The MMSE-alone model predicted dementia with an accuracy of 86% and AUC of 0.872. The expanded model demonstrated increased accuracy (88%) and an AUC of 0.934.Notably, 17.46% of the cases were reclassified from dementia to non-dementia category upon including additional tests. Higher educational level and younger age were associated with these shifts.
Conclusion
The findings suggest that although the MMSE is a valuable screening tool, it should not be used in isolation to determine dementia severity. The addition of diverse cognitive assessments can significantly enhance diagnostic precision, particularly in younger and more educated populations. Future diagnostic protocols should integrate multifaceted cognitive evaluations to reflect the complexity of dementia accurately.
7.Explainability Enhanced Machine Learning Model for Classifying Intellectual Disability and AttentionDeficit/Hyperactivity Disorder With Psychological Test Reports
Tong Min KIM ; Young-Hoon KIM ; Sung-Hee SONG ; In-Young CHOI ; Dai-Jin KIM ; Taehoon KO
Journal of Korean Medical Science 2025;40(11):e26-
Background:
Psychological test reports are essential in assessing intellectual functioning, aiding in diagnosing and treating intellectual disability (ID) and attention-deficit/ hyperactivity disorder (ADHD). However, these reports can have several problems because they are diverse, unstructured, subjective, and involve human errors. Additionally, physicians often do not read the entire report, and the number of reports is lower than that of diagnoses.
Methods:
We developed explainable predictive models for classifying IDs and ADHDs based on written reports to address these issues. The reports of 1,475 patients with IDs and ADHDs who underwent intelligence tests were used for the models. These models were developed by analyzing reports using natural language processing (NLP) and incorporating the physician’s diagnosis for each report. We selected n-gram features from the models’ results by extracting important features using SHapley Additive exPlanations and permutation importance to make the models explainable. Developing the n-gram feature-based original text search system compensated for the lack of human readability caused by NLP and enabled the reconstruction of human-readable texts from the selected n-gram features.
Results:
The maximum model accuracy was 0.92, and the 80 human-readable texts were restored from four models.
Conclusion
The results showed that the models could accurately classify IDs and ADHDs, even with a few reports. The models were also able to explain their predictions. The explainability-enhanced model can help physicians understand the classification process of IDs and ADHDs and provide evidence-based insights.
8.Dementia Overdiagnosis in Younger, Higher Educated Individuals Based on MMSE Alone: Analysis Using Deep Learning Technology
Hye-Geum KIM ; Dai-Seg BAI ; Bon-Hoon KOO ; Eun-Jin CHEON ; Seokho YUN ; So Hye JO ; Byoungyoung GU
Journal of Korean Medical Science 2025;40(9):e20-
Background:
Dementia is a multifaceted disorder that affects cognitive function, necessitating accurate diagnosis for effective management and treatment. Although the Mini-Mental State Examination (MMSE) is widely used to assess cognitive impairment, its standalone efficacy is debated. This study examined the effectiveness of the MMSE alone versus in combination with other cognitive assessments in predicting dementia diagnosis, with the aim of refining the diagnostic accuracy for dementia.
Methods:
A total of 2,863 participants with subjective cognitive complaints who underwent comprehensive neuropsychological assessments were included. We developed two random forest models: one using only the MMSE and another incorporating additional cognitive tests.These models were evaluated based on their accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC) on a 70:30 training-to-testing split.
Results:
The MMSE-alone model predicted dementia with an accuracy of 86% and AUC of 0.872. The expanded model demonstrated increased accuracy (88%) and an AUC of 0.934.Notably, 17.46% of the cases were reclassified from dementia to non-dementia category upon including additional tests. Higher educational level and younger age were associated with these shifts.
Conclusion
The findings suggest that although the MMSE is a valuable screening tool, it should not be used in isolation to determine dementia severity. The addition of diverse cognitive assessments can significantly enhance diagnostic precision, particularly in younger and more educated populations. Future diagnostic protocols should integrate multifaceted cognitive evaluations to reflect the complexity of dementia accurately.
9.Age-related impact on liver regeneration in older donors after living-donor right hepatectomy: a propensity score-matched cohort study
Na Reum KIM ; Gi Hong CHOI ; Jin Sub CHOI ; Dai Hoon HAN
Annals of Surgical Treatment and Research 2025;109(1):27-34
Purpose:
Given the widening of the donor pool to include patients with steatosis, small-for-size grafts, and older patients, this study examined the effect of age on liver volumetric regeneration after a donor right hepatectomy.
Methods:
We enrolled 33 older (≥55 years) and 277 younger (<30 years) donors who underwent donor right hepatectomy between March 2012 and December 2022. After propensity score-matched analysis, the perioperative surgical outcomes and growth rates of the remnant liver in 63 younger and 32 older donors were compared. Liver regeneration was assessed using CT volumetry for up to 6 months after surgery. Poor liver regeneration was defined as restoration of less than 80% of the original liver volume. The risk factors for poor liver regeneration were analyzed using a binary logistic regression model.
Results:
The mean age of older and younger donors was 58.0 and 24.3 years, respectively. Despite comparable preoperative factors, older donors showed significantly lower regeneration rates at all observed time points (1 month:75.5% vs. 82.3%, P = 0.001; 3 months: 80.4% vs. 90.5%, P < 0.001; and 6 months: 87.9% vs. 95.8, P = 0.006, compared to total liver volume). A large total liver volume and older age were identified as risk factors for poor liver regeneration.
Conclusion
Older donors showed a reduced capacity for liver regeneration. This finding suggests the need for the development of more conservative criteria for residual liver volume in older donors than for younger donors to ensure donor safety.
10.Serum Cocaine- and Amphetamine-Regulated Transcript Levels and Cooperativeness in Adolescents With Internet Gaming Disorder
Hyunho LEE ; Dong Huey CHEON ; Heejin LEE ; Arom PYEON ; Ji-Won CHUN ; Ji Hyun BACK ; Yae Eun PARK ; Hong CHOI ; Dai-Jin KIM ; Ji Eun LEE ; Jung-Seok CHOI
Psychiatry Investigation 2025;22(12):1416-1421
Objective:
Internet gaming disorder (IGD) is a growing problem, particularly among adolescents. Although cocaine- and amphetamine- regulated transcript (CART) has been explored as a potential biomarker for addictive disorders, its relationship with IGD remains poorly understood. This study investigated the differences in serum CART levels between adolescents with IGD and healthy controls (HCs) in order to find potential biomarkers as a therapeutic target in IGD. Additionally, we investigated correlations of serum CART levels with personality traits within the IGD group.
Methods:
A total of 114 adolescents participated in this study (43 in the IGD group and 71 in the HC group). Blood samples (10 mL) were collected and serum CART concentrations were determined using an enzyme-linked immunosorbent assay. Participants also completed the Junior Temperament and Character Inventory.
Results:
Serum CART levels in the IGD group were significantly lower than those in the HC group (p<0.05). IGD participants had higher novelty-seeking and harm-avoidance traits, accompanied by reduced persistence, self-directedness, and cooperativeness. Notably, a significant correlation emerged between serum CART levels and cooperativeness within the IGD group. Lower cooperativeness trait scores could indicate reduced social interaction.
Conclusion
The present findings suggest serum CART levels might serve as a neurobiological marker for cooperativeness function in adolescents with IGD.

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