A machine learning tool for identifying patients with newly diagnosed diabetes in primary care

IF 2.6 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Primary Care Diabetes Pub Date : 2024-06-28 DOI:10.1016/j.pcd.2024.06.010
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Abstract

Background and aim

It is crucial to identify a diabetes diagnosis early. Create a predictive model utilizing machine learning (ML) to identify new cases of diabetes in primary health care (PHC).

Methods

A case-control study utilizing data on PHC visits for sex-, age, and PHC-matched controls. Stochastic gradient boosting was used to construct a model for predicting cases of diabetes based on diagnostic codes from PHC consultations during the year before index (diagnosis) date and number of consultations. Variable importance was estimated using the normalized relative influence (NRI) score. Risks of having diabetes were calculated using odds ratios of marginal effects (ORME). Four groups by age and sex were studied, age-groups 35–64 years and ≥ 65 years in men and women, respectively.

Results

The most important predictive factors were hypertension with NRI 21.4–29.7 %, and obesity 4.8–15.2 %. The NRI for other top ten diagnoses and administrative codes generally ranged 1.0–4.2 %.

Conclusions

Our data confirm the known risk patterns for predicting a new diagnosis of diabetes, and the need to test blood glucose frequently. To assess the full potential of ML for risk prediction purposes in clinical practice, future studies could include clinical data on life-style patterns, laboratory tests and prescribed medication.

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在初级医疗中识别新诊断糖尿病患者的机器学习工具。
背景和目的:早期发现糖尿病诊断至关重要。利用机器学习(ML)创建一个预测模型,以识别初级卫生保健(PHC)中的糖尿病新病例:方法:一项病例对照研究,利用初级卫生保健就诊数据对性别、年龄和初级卫生保健匹配对照进行分析。根据指数(诊断)日期前一年初级保健中心就诊的诊断代码和就诊次数,采用随机梯度提升法构建糖尿病病例预测模型。变量重要性采用归一化相对影响(NRI)评分进行估算。患糖尿病的风险采用边际效应几率比(ORME)进行计算。研究按年龄和性别分为四组,男性年龄组为 35-64 岁,女性年龄组为≥ 65 岁:最重要的预测因素是高血压(NRI 为 21.4-29.7%)和肥胖(4.8-15.2%)。其他十大诊断和行政代码的 NRI 一般为 1.0-4.2%:我们的数据证实了预测糖尿病新诊断的已知风险模式,以及经常检测血糖的必要性。为了评估 ML 在临床实践中用于风险预测的全部潜力,未来的研究可以包括有关生活方式、实验室检查和处方药的临床数据。
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来源期刊
Primary Care Diabetes
Primary Care Diabetes ENDOCRINOLOGY & METABOLISM-PRIMARY HEALTH CARE
CiteScore
5.00
自引率
3.40%
发文量
134
审稿时长
47 days
期刊介绍: The journal publishes original research articles and high quality reviews in the fields of clinical care, diabetes education, nutrition, health services, psychosocial research and epidemiology and other areas as far as is relevant for diabetology in a primary-care setting. The purpose of the journal is to encourage interdisciplinary research and discussion between all those who are involved in primary diabetes care on an international level. The Journal also publishes news and articles concerning the policies and activities of Primary Care Diabetes Europe and reflects the society''s aim of improving the care for people with diabetes mellitus within the primary-care setting.
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