Evidence map›Paper›PMID 26685993›Full record

ArticleJournal of diabetes science and technology2015

Reverse Engineering and Evaluation of Prediction Models for Progression to Type 2 Diabetes: An Application of Machine Learning Using Electronic Health Records.

Jeffrey P Anderson, Jignesh R Parikh, Daniel K Shenfeld, Vladimir Ivanov, Casey Marks, Bruce W Church, Jason M Laramie, Jack Mardekian, Beth Anne Piper, Richard J Willke and 1 more

Abstract read
In one paragraph

Article in Journal of diabetes science and technology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Jeffrey P AndersonGNS Healthcare, Cambridge, MA, USA janderson@gnshealthcare.com jpa696@mail.harvard.edu.
Jignesh R ParikhGNS Healthcare, Cambridge, MA, USA.
Daniel K ShenfeldGNS Healthcare, Cambridge, MA, USA.
Vladimir IvanovGNS Healthcare, Cambridge, MA, USA.
Casey MarksGNS Healthcare, Cambridge, MA, USA.
Bruce W ChurchGNS Healthcare, Cambridge, MA, USA.
Jason M LaramieGNS Healthcare, Cambridge, MA, USA.
Jack MardekianPfizer Inc, New York, NY, USA.
Beth Anne PiperPfizer Inc, New York, NY, USA.
Richard J WillkePfizer Inc, New York, NY, USA.
Dale A RubleePfizer Inc, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundApplication of novel machine learning approaches to electronic health record (EHR) data could provide valuable insights into disease processes. We utilized this approach to build predictive models for progression to prediabetes and type 2 diabetes (T2D).

methodsUsing a novel analytical platform (Reverse Engineering and Forward Simulation [REFS]), we built prediction model ensembles for progression to prediabetes or T2D from an aggregated EHR data sample. REFS relies on a Bayesian scoring algorithm to explore a wide model space, and outputs a distribution of risk estimates from an ensemble of prediction models. We retrospectively followed 24 331 adults for transitions to prediabetes or T2D, 2007-2012. Accuracy of prediction models was assessed using an area under the curve (AUC) statistic, and validated in an independent data set.

resultsOur primary ensemble of models accurately predicted progression to T2D (AUC = 0.76), and was validated out of sample (AUC = 0.78). Models of progression to T2D consisted primarily of established risk factors (blood glucose, blood pressure, triglycerides, hypertension, lipid disorders, socioeconomic factors), whereas models of progression to prediabetes included novel factors (high-density lipoprotein, alanine aminotransferase, C-reactive protein, body temperature; AUC = 0.70).

conclusionsWe constructed accurate prediction models from EHR data using a hypothesis-free machine learning approach. Identification of established risk factors for T2D serves as proof of concept for this analytical approach, while novel factors selected by REFS represent emerging areas of T2D research. This methodology has potentially valuable downstream applications to personalized medicine and clinical research.

Indexed as

Diabetes Mellitus, Type 2Disease ProgressionElectronic Health RecordsMachine LearningPrediabetic StateAdultArea Under CurveFemaleHumansMaleMedical InformaticsRetrospective StudiesRisk FactorsROC Curvediabetes mellitusdisease progressionelectronic health recordsmedical informaticsprediabetic statetype 2

Identifiers

PMID26685993
PMCPMC4738229

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.