Prediction model for cardiovascular disease in patients with diabetes using machine learning derived and validated in two independent Korean cohorts.

Journal: Scientific reports
Published Date:

Abstract

This study aimed to develop and validate a machine learning (ML) model tailored to the Korean population with type 2 diabetes mellitus (T2DM) to provide a superior method for predicting the development of cardiovascular disease (CVD), a major chronic complication in these patients. We used data from two cohorts, namely the discovery (one hospital; n = 12,809) and validation (two hospitals; n = 2019) cohorts, recruited between 2008 and 2022. The outcome of interest was the presence or absence of CVD at 3 years. We selected various ML-based models with hyperparameter tuning in the discovery cohort and performed area under the receiver operating characteristic curve (AUROC) analysis in the validation cohort. CVD was observed in 1238 (10.2%) patients in the discovery cohort. The random forest (RF) model exhibited the best overall performance among the models, with an AUROC of 0.830 (95% confidence interval [CI] 0.818-0.842) in the discovery dataset and 0.722 (95% CI 0.660-0.783) in the validation dataset. Creatinine and glycated hemoglobin levels were the most influential factors in the RF model. This study introduces a pioneering ML-based model for predicting CVD in Korean patients with T2DM, outperforming existing prediction tools and providing a groundbreaking approach for early personalized preventive medicine.

Authors

  • Hyunji Sang
    Department of Endocrinology and Metabolism, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, South Korea.
  • Hojae Lee
    Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
  • Myeongcheol Lee
    Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.
  • Jaeyu Park
    Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.
  • Sunyoung Kim
    Department of Family Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea.
  • Ho Geol Woo
    Department of Neurology, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.
  • Masoud Rahmati
    Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France.
  • Ai Koyanagi
    Research and Development Unit, Parc Sanitari Sant Joan de Deu, Barcelona, Spain.
  • Lee Smith
    Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
  • Sihoon Lee
    Department of Internal Medicine, Gachon University College of Medicine, Incheon, South Korea.
  • You-Cheol Hwang
    Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong and Kyung Hee University School of Medicine, Seoul, South Korea.
  • Tae Sun Park
    Division of Endocrinology and Metabolism, Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University and Jeonbuk National University Hospital, Jeonju, South Korea.
  • Hyunjung Lim
    Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin, South Korea.
  • Dong Keon Yon
    Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.
  • Sang Youl Rhee
    Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea.