AML-DECODER: Advanced Machine Learning for HD-sEMG Signal Classification-Decoding Lateral Epicondylitis in Forearm Muscles.

Background: Innovative algorithms for wearable devices and garments are critical for diagnosing and monitoring disease (such as lateral epicondylitis (LE)) progression. LE affects individuals across various professions and causes daily problems.

Methods: We analyzed signals from the forearm muscles of 14 healthy controls and 14 LE patients using high-density surface electromyography. We discerned significant differences between groups by employing phase-amplitude coupling (PAC) features. Our study leveraged PAC, Daubechies wavelet with four vanishing moments (db4), and state-of-the-art techniques to train a neural network for the subject's label prediction.

Results: Remarkably, PAC features achieved 100% specificity and sensitivity in predicting unseen subjects, while state-of-the-art features lagged with only 35.71% sensitivity and 28.57% specificity, and db4 with 78.57% sensitivity and 85.71 specificity. PAC significantly outperformed the state-of-the-art features (-value < 0.001) with a large effect size. However, no significant difference was found between PAC and db4 (-value = 0.147). Also, the Jeffries-Matusita (JM) distance of the PAC was significantly higher than other features (-value < 0.001), with a large effect size, suggesting PAC features as robust predictors of neuromuscular diseases, offering a profound understanding of disease pathology and new avenues for interpretation. We evaluated the generalization ability of the PAC model using 99.9% confidence intervals and Bayesian credible intervals to quantify prediction uncertainty across subjects. Both methods demonstrated high reliability, with an expected accuracy of 89% in larger, more diverse populations.

Conclusions: This study's implications might extend beyond LE, paving the way for enhanced diagnostic tools and deeper insights into the complexities of neuromuscular disorders.