Predicting adverse outcomes due to diabetes complications with machine learning using administrative health data.


Journal

NPJ digital medicine
ISSN: 2398-6352
Titre abrégé: NPJ Digit Med
Pays: England
ID NLM: 101731738

Informations de publication

Date de publication:
12 Feb 2021
Historique:
received: 18 08 2020
accepted: 11 01 2021
entrez: 13 2 2021
pubmed: 14 2 2021
medline: 14 2 2021
Statut: epublish

Résumé

Across jurisdictions, government and health insurance providers hold a large amount of data from patient interactions with the healthcare system. We aimed to develop a machine learning-based model for predicting adverse outcomes due to diabetes complications using administrative health data from the single-payer health system in Ontario, Canada. A Gradient Boosting Decision Tree model was trained on data from 1,029,366 patients, validated on 272,864 patients, and tested on 265,406 patients. Discrimination was assessed using the AUC statistic and calibration was assessed visually using calibration plots overall and across population subgroups. Our model predicting three-year risk of adverse outcomes due to diabetes complications (hyper/hypoglycemia, tissue infection, retinopathy, cardiovascular events, amputation) included 700 features from multiple diverse data sources and had strong discrimination (average test AUC = 77.7, range 77.7-77.9). Through the design and validation of a high-performance model to predict diabetes complications adverse outcomes at the population level, we demonstrate the potential of machine learning and administrative health data to inform health planning and healthcare resource allocation for diabetes management.

Identifiants

pubmed: 33580109
doi: 10.1038/s41746-021-00394-8
pii: 10.1038/s41746-021-00394-8
pmc: PMC7881135
doi:

Types de publication

Journal Article

Langues

eng

Pagination

24

Références

Diabetes Care. 2013 Nov;36(11):3535-42
pubmed: 23900589
Diabetologia. 2002 Jul;45(7):S13-7
pubmed: 12136406
Diabetes Obes Metab. 2016 Sep;18(9):899-906
pubmed: 27161077
Int J Epidemiol. 2018 Oct 1;47(5):1571-1584
pubmed: 30010781
BMJ. 2018 Apr 30;361:k1479
pubmed: 29712648
J Med Syst. 2019 Dec 9;44(1):16
pubmed: 31820120
Int J Equity Health. 2015 Oct 24;14:101
pubmed: 26496768
Stat Methods Med Res. 2019 Dec;28(12):3667-3682
pubmed: 30474497
BMC Health Serv Res. 2018 May 2;18(1):316
pubmed: 29720153
Diabet Med. 2016 Jan;33(1):111-8
pubmed: 25981183
Can J Cardiol. 2012 Mar-Apr;28(2):152-4
pubmed: 22301469
Nat Med. 2020 Jan;26(1):16-17
pubmed: 31932779
N Engl J Med. 1993 Sep 30;329(14):977-86
pubmed: 8366922
Healthc Q. 2013;16(4):14-7
pubmed: 24485237
BMJ Open Diabetes Res Care. 2020 Jun;8(1):
pubmed: 32565422
Clin Transl Sci. 2019 Sep;12(5):519-528
pubmed: 31112000
Diabetes Res Clin Pract. 2014 Feb;103(2):137-49
pubmed: 24630390
Nat Mach Intell. 2020 Jan;2(1):56-67
pubmed: 32607472
Int J Epidemiol. 2010 Apr;39(2):380-2
pubmed: 20100821
BMC Health Serv Res. 2006 Oct 03;6:124
pubmed: 17018153
JAMA. 2016 May 24-31;315(20):2211-20
pubmed: 27218630
CMAJ. 2016 Feb 16;188(3):182-188
pubmed: 26755672
Front Genet. 2020 Jan 07;10:1076
pubmed: 31969896
N Engl J Med. 2003 Jan 30;348(5):383-93
pubmed: 12556541
Health Aff (Millwood). 2018 Mar;37(3):464-472
pubmed: 29505380
Circulation. 2015 Nov 10;132(19):1795-804
pubmed: 26311724
J Diabetes Sci Technol. 2018 Mar;12(2):295-302
pubmed: 28494618
Diabetes Care. 2019 Dec;42(12):2298-2306
pubmed: 31519694
Diagn Progn Res. 2017 Dec 2;1:19
pubmed: 31093548
PLoS One. 2019 May 15;14(5):e0213653
pubmed: 31091238
Lancet Digit Health. 2019 May;1(1):e13-e14
pubmed: 33323236
Diabetologia. 2013 Aug;56(8):1726-34
pubmed: 23680916
Can J Public Health. 2012 Apr 30;103(8 Suppl 2):S12-6
pubmed: 23618065
Big Data. 2015 Dec;3(4):277-87
pubmed: 27441408
Sci Rep. 2019 Aug 14;9(1):11862
pubmed: 31413285
Diabetes Care. 2002 Mar;25(3):476-81
pubmed: 11874933
Ann Fam Med. 2004 Nov-Dec;2(6):563-8
pubmed: 15576542
Nat Rev Endocrinol. 2014 Aug;10(8):451-3
pubmed: 24913518
Annu Rev Public Health. 2001;22:213-30
pubmed: 11274519
Diabet Med. 2016 Mar;33(3):395-403
pubmed: 26201986
Phys Ther. 2008 Nov;88(11):1254-64
pubmed: 18801858
Ann Intern Med. 1997 Oct 15;127(8 Pt 2):666-74
pubmed: 9382378
JAMA Intern Med. 2014 Feb 1;174(2):251-8
pubmed: 24322595
PLoS One. 2017 Apr 24;12(4):e0176087
pubmed: 28437472
Diabetes Care. 2020 Apr;43(4):852-859
pubmed: 32029638
Am J Manag Care. 2015 Jan 01;21(1):e62-70
pubmed: 25880269
Diabetologia. 2019 Jan;62(1):3-16
pubmed: 30171279
Curr Diab Rep. 2019 Aug 5;19(9):78
pubmed: 31385061
Diabetes Care. 2001 Sep;24(9):1547-55
pubmed: 11522697
JMIR Med Inform. 2020 Jan 31;8(1):e15510
pubmed: 32012067
Nat Med. 2019 Jan;25(1):44-56
pubmed: 30617339
Sci Rep. 2018 Apr 17;8(1):6085
pubmed: 29666385
Ann Epidemiol. 2011 May;21(5):374-81
pubmed: 21458731
Int J Nephrol Renovasc Dis. 2019 Mar 21;12:49-58
pubmed: 30962703
NPJ Digit Med. 2018 May 8;1:18
pubmed: 31304302
JAMA Netw Open. 2019 Oct 2;2(10):e1915997
pubmed: 31651973
Lancet. 2004 Aug 21-27;364(9435):685-96
pubmed: 15325833
Sci Rep. 2019 Sep 24;9(1):13805
pubmed: 31551457
Diabetes Care. 2012 Dec;35(12):2533-9
pubmed: 22912429
Sci Rep. 2020 Feb 4;10(1):1776
pubmed: 32019971
Ann Intern Med. 2014 Nov 18;161(10):681-9
pubmed: 25402511
Diabetes Care. 2002 Mar;25(3):512-6
pubmed: 11874939
Nat Med. 2019 Jul;25(7):1143-1152
pubmed: 31273328
Lancet Diabetes Endocrinol. 2016 Jun;4(6):537-47
pubmed: 27156051
Science. 1988 Jun 3;240(4857):1285-93
pubmed: 3287615
Nature. 2019 Aug;572(7767):116-119
pubmed: 31367026
BMJ. 1998 Sep 12;317(7160):703-13
pubmed: 9732337
Epidemiol Health. 2016 Mar 24;38:e2016011
pubmed: 27032459

Auteurs

Mathieu Ravaut (M)

Layer 6 AI, Toronto, ON, Canada.
Department of Computer Science, University of Toronto, Toronto, ON, Canada.

Hamed Sadeghi (H)

Layer 6 AI, Toronto, ON, Canada.

Kin Kwan Leung (KK)

Layer 6 AI, Toronto, ON, Canada.

Maksims Volkovs (M)

Layer 6 AI, Toronto, ON, Canada.

Kathy Kornas (K)

Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.

Vinyas Harish (V)

Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
MD/PhD Program, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Tristan Watson (T)

Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
ICES, Toronto, ON, Canada.

Gary F Lewis (GF)

Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Alanna Weisman (A)

Lunenfeld-Tanenbaum Research Institute, Mt. Sinai Hospital, Toronto, ON, Canada.
Division of Endocrinology and Metabolism, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Tomi Poutanen (T)

Layer 6 AI, Toronto, ON, Canada.

Laura Rosella (L)

Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. laura.rosella@utoronto.ca.
ICES, Toronto, ON, Canada. laura.rosella@utoronto.ca.
Vector Institute, Toronto, ON, Canada. laura.rosella@utoronto.ca.
Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada. laura.rosella@utoronto.ca.
Department of Laboratory Medicine & Pathology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada. laura.rosella@utoronto.ca.

Classifications MeSH