Cost-aware architecture improves diagnostic performance in Parkinson's disease, suggesting efficient resource use.
Optimizing healthcare resources in neurodegenerative diseases requires balancing diagnostic performance with cost constraints. We introduce AHN-BudgetNet—a tiered, cost-aware assessment framework for Parkinson’s disease motor severity prediction—evaluated on 1387 simulated PPMI subjects via patient-level GroupKFold validation. Our analysis tested seven tier combinations encompassing demographic, self-reported, and clinical features. The baseline (T0) yields AUC = 0.65 (95% CI [0.629, 0.681]) at no cost. Self-assessments (T1) alone achieved an AUC = 0.69 (95% CI [0.643, 0.733]) at USD 75, with an efficiency of 1.07. The combined T0 + T1 set reached AUC = 0.75 (95% CI [0.729, 0.772]) at USD 75, with efficiency 1.43. T2 alone obtained AUC = 0.53 (95% CI [0.517, 0.542]) at USD 300 and efficiency 0.07. The full T0+T1+T2 set achieved the highest performance—AUC = 0.76 (95% CI [0.735, 0.774])—at USD 375, with efficiency 0.54, reflecting diminishing returns beyond T1. High-cost tiers (T3/T4) could not be empirically validated due to over 88% missing data, emphasizing the value of accessible assessments. Gaussian Mixture on Tier 0 features yielded a silhouette score of 0.54, compared to 0.53 for K-means, confirming that patient-reported outcomes can support clinical stratification. Our results underpin evidence-based resource allocation: budgets USD ≤75 prioritize T1, while budgets USD ≤375 justify a comprehensive assessment. This confirms that structured tier prioritization supports robust, resource-efficient diagnosis in resource-limited clinical environments.
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Hani et al. (2025) studied this question.
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