Identification of individuals at risk of developing disease comorbidities represents an important task in tackling the growing personal and societal burdens associated with chronic diseases. We employed machine learning techniques to investigate to what extent data from longitudinal, nationwide Danish health registers can be used to predict individuals at high risk of developing type 2 diabetes (T2D) comorbidities. Leveraging logistic regression-, random forest- and gradient boosting models and register data spanning hospitalizations, drug prescriptions and contacts with primary care contractors from >200,000 individuals newly diagnosed with T2D, we predicted five-year risk of heart failure (HF), myocardial infarction (MI), stroke (ST), cardiovascular disease (CVD) and chronic kidney disease (CKD). For HF, MI, CVD, and CKD, register-based models outperformed a reference model leveraging canonical individual characteristics by achieving area under the receiver operating characteristic curve improvements of 0.06, 0.03, 0.04, and 0.07, respectively. The top 1,000 patients predicted to be at highest risk exhibited observed incidence ratios exceeding 4.99, 3.52, 1.97 and 4.71 respectively. In summary, prediction of T2D comorbidities utilizing Danish registers led to consistent albeit modest performance improvements over reference models, suggesting that register data could be leveraged to systematically identify individuals at risk of developing disease comorbidities.

译文

识别有患疾病合并症风险的个体是应对与慢性疾病相关的日益增长的个人和社会负担的一项重要任务。我们采用机器学习技术来调查来自丹麦全国范围内的纵向健康登记册的数据在多大程度上可以用于预测罹患2型糖尿病 (T2D) 合并症的高风险个体。利用逻辑回归、随机森林和梯度提升模型,并登记来自> 200,000名新诊断为T2D的个体的住院、药物处方和初级保健承包商接触的数据,我们预测了心力衰竭 (HF) 、心肌梗死 (MI) 、中风 (ST) 的五年风险,心血管疾病 (CVD) 和慢性肾脏疾病 (CKD)。对于HF、MI、CVD和CKD,基于寄存器的模型通过分别实现0.06、0.03、0.04和0.07的接收器工作特性曲线下的面积改进而优于利用规范个体特性的参考模型。预计风险最高的前1,000名患者的发生率分别超过4.99、3.52、1.97和4.71。总之,利用丹麦寄存器对T2D合并症的预测导致了与参考模型相比持续的尽管适度的性能改善,这表明可以利用寄存器数据来系统地识别有发生疾病合并症风险的个体。

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