Evidence map›Paper›PMID 38413176›Full record

ArticleBMJ open diabetes research & care2024

Use of machine learning to identify characteristics associated with severe hypoglycemia in older adults with type 1 diabetes: a post-hoc analysis of a case-control study.

Nikki L B Freeman, Rashmi Muthukkumar, Ruth S Weinstock, M Victor Wickerhauser, Anna R Kahkoska

Open access · goldAbstract read
In one paragraph

Article in BMJ open diabetes research & care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.4field-weighted citation impact, top 18% of its field
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

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Observational
  2. Article
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

5 authors at 3 institutions in 1 country.

Nikki L B FreemanDepartment of Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA nlbf@live.unc.edu.ORCID 0000-0002-9905-4855
Rashmi MuthukkumarDepartment of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Ruth S WeinstockDepartment of Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.
M Victor WickerhauserDepartment of Mathematics, Washington University in St Louis, St Louis, Missouri, USA.
Anna R KahkoskaDepartment of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.ORCID 0000-0003-2701-101X
University of North Carolina at Chapel Hill · USSUNY Upstate Medical University · USWashington University in St. Louis · US

Funding

North Carolina Translational and Clinical Science Institute (NC TraCS) KL2KL2TR002490 · NCATS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI WEINBERGER, MORRIS · 2018 to 2022
$11.0M
CTSA K12 Program at UNCK12TR004416 · NCATS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Michelle Hernandez, Jonathan J Juliano · 2023 to 2026
$6.5M
NCATS NIH HHS K12 TR004416NCATS NIH HHS KL2 TR002490
6 · The paper itself

Abstract

introductionSevere hypoglycemia (SH) in older adults (OAs) with type 1 diabetes is associated with profound morbidity and mortality, yet its etiology can be complex and multifactorial. Enhanced tools to identify OAs who are at high risk for SH are needed. This study used machine learning to identify characteristics that distinguish those with and without recent SH, selecting from a range of demographic and clinical, behavioral and lifestyle, and neurocognitive characteristics, along with continuous glucose monitoring (CGM) measures. RESEARCH DESIGN AND

methodsData from a case-control study involving OAs recruited from the T1D Exchange Clinical Network were analyzed. The random forest machine learning algorithm was used to elucidate the characteristics associated with case versus control status and their relative importance. Models with successively rich characteristic sets were examined to systematically incorporate each domain of possible risk characteristics.

resultsData from 191 OAs with type 1 diabetes (47.1% female, 92.1% non-Hispanic white) were analyzed. Across models, hypoglycemia unawareness was the top characteristic associated with SH history. For the model with the richest input data, the most important characteristics, in descending order, were hypoglycemia unawareness, hypoglycemia fear, coefficient of variation from CGM, % time blood glucose below 70 mg/dL, and trail making test B score.

conclusionsMachine learning may augment risk stratification for OAs by identifying key characteristics associated with SH. Prospective studies are needed to identify the predictive performance of these risk characteristics.

Indexed as

Diabetes ComplicationsDiabetes Mellitus, Type 1HypoglycemiaAgedBlood GlucoseBlood Glucose Self-MonitoringCase-Control StudiesFemaleHumansMaleBlood GlucoseAdultCase-Control StudiesDiabetes Mellitus, Type 1Severe Hypoglycemia

Identifiers

PMID38413176
PMCPMC10900355
OpenAlexW4392203904

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.