Hidden Markov Models and Self-Organizing Maps Applied to Stroke Incidence

Several studies were devoted to investigating the effects of meteorological factors on the occurrence of stroke. Regression models had been mostly used to assess the correlation between weather and stroke incidence. However, these methods could not describe the process proceeding in the background of stroke incidence. The purpose of this study was to provide a new approach based on Hidden Markov Models (HMMs) and self-organizing maps (SOM), interpreting the background from the viewpoint of weather variability. Based on meteorological data, SOM was performed to classify weather patterns. Using these classes by SOM as randomly changing “states”, our Hidden Markov Models were constructed with “observation data” that were extracted from the daily data of emergency transport at Nagoya City in Japan. We showed that SOM was an effective method to get weather patterns that would serve as “states” of Hidden Markov Models. Our Hidden Markov Models provided effective models to clarify background process for stroke incidence. The effectiveness of these Hidden Markov Models was estimated by stochastic test for root mean square errors (RMSE). “HMMs with states by SOM” would serve as a description of the background process of stroke incidence and were useful to show the influence of weather on stroke onset. This finding will contribute to an improvement of our understanding for links between weather variability and stroke incidence.