Predictive utilities of lipid traits, lipoprotein subfractions and other risk factors for incident diabetes: a machine learning approach in the Diabetes Prevention Program

IntroductionAlthough various lipid and non-lipid analytes measured by nuclear magnetic resonance (NMR) spectroscopy have been associated with type 2 diabetes, a structured comparison of the ability of NMR-derived biomarkers and standard lipids to predict individual diabetes risk has not been undertaken in larger studies nor among individuals at high risk of diabetes.Research design and methodsCumulative discriminative utilities of various groups of biomarkers including NMR lipoproteins, related non-lipid biomarkers, standard lipids, and demographic and glycemic traits were compared for short-term (3.2 years) and long-term (15 years) diabetes development in the Diabetes Prevention Program, a multiethnic, placebo-controlled, randomized controlled trial of individuals with pre-diabetes in the USA (N=2590). Logistic regression, Cox proportional hazards model and six different hyperparameter-tuned machine learning algorithms were compared. The Matthews Correlation Coefficient (MCC) was used as the primary measure of discriminative utility.ResultsModels with baseline NMR analytes and their changes did not improve the discriminative utility of simpler models including standard lipids or demographic and glycemic traits. Across all algorithms, models with baseline 2-hour glucose performed the best (max MCC=0.36). Sophisticated machine learning algorithms performed similarly to logistic regression in this study.ConclusionsNMR lipoproteins and related non-lipid biomarkers were associated but did not augment discrimination of diabetes risk beyond traditional diabetes risk factors except for 2-hour glucose. Machine learning algorithms provided no meaningful improvement for discrimination compared with logistic regression, which suggests a lack of influential latent interactions among the analytes assessed in this study.Trial registration numberDiabetes Prevention Program: NCT00004992; Diabetes Prevention Program Outcomes Study: NCT00038727.

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Predicting the Risk of Hypertension Based on Several Easy-to-Collect Risk Factors: A Machine Learning Method

Frontiers in Public Health ◽

10.3389/fpubh.2021.619429 ◽

2021 ◽

Vol 9 ◽

Author(s):

Huanhuan Zhao ◽

Xiaoyu Zhang ◽

Yang Xu ◽

Lisheng Gao ◽

Zuchang Ma ◽

...

Keyword(s):

Machine Learning ◽

Risk Factors ◽

Logistic Regression ◽

Risk Prediction ◽

Disease Risk ◽

Learning Algorithms ◽

Large Population ◽

Machine Learning Algorithms ◽

Hypertension Risk ◽

Model Training

Hypertension is a widespread chronic disease. Risk prediction of hypertension is an intervention that contributes to the early prevention and management of hypertension. The implementation of such intervention requires an effective and easy-to-implement hypertension risk prediction model. This study evaluated and compared the performance of four machine learning algorithms on predicting the risk of hypertension based on easy-to-collect risk factors. A dataset of 29,700 samples collected through a physical examination was used for model training and testing. Firstly, we identified easy-to-collect risk factors of hypertension, through univariate logistic regression analysis. Then, based on the selected features, 10-fold cross-validation was utilized to optimize four models, random forest (RF), CatBoost, MLP neural network and logistic regression (LR), to find the best hyper-parameters on the training set. Finally, the performance of models was evaluated by AUC, accuracy, sensitivity and specificity on the test set. The experimental results showed that the RF model outperformed the other three models, and achieved an AUC of 0.92, an accuracy of 0.82, a sensitivity of 0.83 and a specificity of 0.81. In addition, Body Mass Index (BMI), age, family history and waist circumference (WC) are the four primary risk factors of hypertension. These findings reveal that it is feasible to use machine learning algorithms, especially RF, to predict hypertension risk without clinical or genetic data. The technique can provide a non-invasive and economical way for the prevention and management of hypertension in a large population.

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The Impact of a Yearlong Diabetes Prevention Program-Based Lifestyle Intervention on Cardiovascular Health Metrics

Journal of Primary Care & Community Health ◽

10.1177/21501327211029816 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110298

Author(s):

Susan M. Devaraj ◽

Bonny Rockette-Wagner ◽

Rachel G. Miller ◽

Vincent C. Arena ◽

Jenna M. Napoleone ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Lifestyle Intervention ◽

Prevention Program ◽

Diabetes Prevention ◽

Cardiovascular Health ◽

Diabetes Prevention Program ◽

Behavioral Risk ◽

Community Based ◽

The Impact

Introduction The American Heart Association created “Life’s Simple Seven” metrics to estimate progress toward improving US cardiovascular health in a standardized manner. Given the widespread use of federally funded Diabetes Prevention Program (DPP)-based lifestyle interventions such as the Group Lifestyle Balance (DPP-GLB), evaluation of change in health metrics within such a program is of national interest. This study examined change in cardiovascular health metric scores during the course of a yearlong DPP-GLB intervention. Methods Data were combined from 2 similar randomized trials offering a community based DPP-GLB lifestyle intervention to overweight/obese individuals with prediabetes and/or metabolic syndrome. Pre/post lifestyle intervention participation changes in 5 of the 7 cardiovascular health metrics were examined at 6 and 12 months (BMI, blood pressure, total cholesterol, fasting plasma glucose, physical activity). Smoking was rare and diet was not measured. Results Among 305 participants with complete data (81.8% of 373 eligible adults), significant improvements were demonstrated in all 5 risk factors measured continuously at 6 and 12 months. There were significant positive shifts in the “ideal” and “total” metric scores at both time points. Also noted were beneficial shifts in the proportion of participants across categories for BMI, activity, and blood pressure. Conclusion AHA-metrics could have clinical utility in estimating an individual’s cardiovascular health status and in capturing improvement in cardiometabolic/behavioral risk factors resulting from participation in a community-based translation of the DPP lifestyle intervention.

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Employing Machine Learning Algorithms to Discover Risk Factors of Glaucoma

10.1109/prai53619.2021.9551082 ◽

2021 ◽

Author(s):

Abdulkawi Yahya Radman Al-Shamiri

Keyword(s):

Machine Learning ◽

Risk Factors ◽

Learning Algorithms ◽

Machine Learning Algorithms

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Predicting hospitalization following psychiatric crisis care using machine learning

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-020-01361-1 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Matthijs Blankers ◽

Louk F. M. van der Post ◽

Jack J. M. Dekker

Keyword(s):

Machine Learning ◽

Logistic Regression ◽

Prediction Models ◽

Learning Algorithms ◽

Nearest Neighbors ◽

Machine Learning Algorithms ◽

Gradient Boosting ◽

Ensemble Model ◽

K Nearest Neighbors ◽

Crisis Care

Abstract Background Accurate prediction models for whether patients on the verge of a psychiatric criseis need hospitalization are lacking and machine learning methods may help improve the accuracy of psychiatric hospitalization prediction models. In this paper we evaluate the accuracy of ten machine learning algorithms, including the generalized linear model (GLM/logistic regression) to predict psychiatric hospitalization in the first 12 months after a psychiatric crisis care contact. We also evaluate an ensemble model to optimize the accuracy and we explore individual predictors of hospitalization. Methods Data from 2084 patients included in the longitudinal Amsterdam Study of Acute Psychiatry with at least one reported psychiatric crisis care contact were included. Target variable for the prediction models was whether the patient was hospitalized in the 12 months following inclusion. The predictive power of 39 variables related to patients’ socio-demographics, clinical characteristics and previous mental health care contacts was evaluated. The accuracy and area under the receiver operating characteristic curve (AUC) of the machine learning algorithms were compared and we also estimated the relative importance of each predictor variable. The best and least performing algorithms were compared with GLM/logistic regression using net reclassification improvement analysis and the five best performing algorithms were combined in an ensemble model using stacking. Results All models performed above chance level. We found Gradient Boosting to be the best performing algorithm (AUC = 0.774) and K-Nearest Neighbors to be the least performing (AUC = 0.702). The performance of GLM/logistic regression (AUC = 0.76) was slightly above average among the tested algorithms. In a Net Reclassification Improvement analysis Gradient Boosting outperformed GLM/logistic regression by 2.9% and K-Nearest Neighbors by 11.3%. GLM/logistic regression outperformed K-Nearest Neighbors by 8.7%. Nine of the top-10 most important predictor variables were related to previous mental health care use. Conclusions Gradient Boosting led to the highest predictive accuracy and AUC while GLM/logistic regression performed average among the tested algorithms. Although statistically significant, the magnitude of the differences between the machine learning algorithms was in most cases modest. The results show that a predictive accuracy similar to the best performing model can be achieved when combining multiple algorithms in an ensemble model.

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Predicting Hospitalization following Psychiatric Crisis Care using Machine Learning

10.21203/rs.2.12338/v1 ◽

2019 ◽

Author(s):

Matthijs Blankers ◽

Louk F. M. van der Post ◽

Jack J. M. Dekker

Keyword(s):

Machine Learning ◽

Logistic Regression ◽

Learning Algorithms ◽

Nearest Neighbors ◽

Machine Learning Algorithms ◽

Predictor Variables ◽

Gradient Boosting ◽

K Nearest Neighbors ◽

Psychiatric Crisis ◽

Crisis Care

Abstract Background: It is difficult to accurately predict whether a patient on the verge of a potential psychiatric crisis will need to be hospitalized. Machine learning may be helpful to improve the accuracy of psychiatric hospitalization prediction models. In this paper we evaluate and compare the accuracy of ten machine learning algorithms including the commonly used generalized linear model (GLM/logistic regression) to predict psychiatric hospitalization in the first 12 months after a psychiatric crisis care contact, and explore the most important predictor variables of hospitalization. Methods: Data from 2,084 patients with at least one reported psychiatric crisis care contact included in the longitudinal Amsterdam Study of Acute Psychiatry were used. The accuracy and area under the receiver operating characteristic curve (AUC) of the machine learning algorithms were compared. We also estimated the relative importance of each predictor variable. The best and least performing algorithms were compared with GLM/logistic regression using net reclassification improvement analysis. Target variable for the prediction models was whether or not the patient was hospitalized in the 12 months following inclusion in the study. The 39 predictor variables were related to patients’ socio-demographics, clinical characteristics and previous mental health care contacts. Results: We found Gradient Boosting to perform the best (AUC=0.774) and K-Nearest Neighbors performing the least (AUC=0.702). The performance of GLM/logistic regression (AUC=0.76) was above average among the tested algorithms. Gradient Boosting outperformed GLM/logistic regression and K-Nearest Neighbors, and GLM outperformed K-Nearest Neighbors in a Net Reclassification Improvement analysis, although the differences between Gradient Boosting and GLM/logistic regression were small. Nine of the top-10 most important predictor variables were related to previous mental health care use. Conclusions: Gradient Boosting led to the highest predictive accuracy and AUC while GLM/logistic regression performed average among the tested algorithms. Although statistically significant, the magnitude of the differences between the machine learning algorithms was modest. Future studies may consider to combine multiple algorithms in an ensemble model for optimal performance and to mitigate the risk of choosing suboptimal performing algorithms.

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