Evidence map›Paper›PMID 39182632›Full record

ArticleJournal of biomedical informatics2024

A conditional multi-label model to improve prediction of a rare outcome: An illustration predicting autism diagnosis.

Wei A Huang, Matthew Engelhard, Marika Coffman, Elliot D Hill, Qin Weng, Abby Scheer, Gary Maslow, Ricardo Henao, Geraldine Dawson, Benjamin A Goldstein

Abstract read
In one paragraph

Article in Journal of biomedical informatics, 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
–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

2 citing papers in PubMed.

  1. Article
  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

10 authors.

Wei A HuangDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA; AI Health, Duke University School of Medicine, Durham, North Carolina, USA.
Matthew EngelhardDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA; AI Health, Duke University School of Medicine, Durham, North Carolina, USA.
Marika CoffmanDepartment of Psychiatry, Duke University School of Medicine, Durham, NC, USA.
Elliot D HillDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA; AI Health, Duke University School of Medicine, Durham, North Carolina, USA.
Qin WengDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA.
Abby ScheerDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA.
Gary MaslowDepartment of Psychiatry, Duke University School of Medicine, Durham, NC, USA; Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA.
Ricardo HenaoDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA; AI Health, Duke University School of Medicine, Durham, North Carolina, USA.
Geraldine DawsonDepartment of Psychiatry, Duke University School of Medicine, Durham, NC, USA; Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA.
Benjamin A GoldsteinDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA; AI Health, Duke University School of Medicine, Durham, North Carolina, USA; Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA. Electronic address: ben.goldstein@duke.edu.

Funding

Support for QA/QC for Prior Approval ProcessUL1TR002553 · NCATS · DUKE UNIVERSITY · PI LI, JENNIFER S, MCNAMARA, JAMES O. · 2018 to 2023
$58.5M
Recruitment and Assessment CoreP50HD093074 · NICHD · DUKE UNIVERSITY · PI SCOTT N COMPTON · 2017 to 2026
$27.6M
Science CoreP2CHD065563 · NICHD · DUKE UNIVERSITY · PI James Moody · 2015 to 2026
$5.7M
Machine Learning Methods to Develop and Deploy Real-Time Risk Surveillance for Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder from the Electronic Health RecordK01MH127309 · NIMH · DUKE UNIVERSITY · PI Matthew Morrow Engelhard · 2022 to 2026
$842k
NCATS NIH HHS UL1 TR002553NICHD NIH HHS P2C HD065563NICHD NIH HHS P50 HD093074NIMH NIH HHS K01 MH127309
6 · The paper itself

Abstract

objectiveThis study aimed to develop a novel approach using routinely collected electronic health records (EHRs) data to improve the prediction of a rare event. We illustrated this using an example of improving early prediction of an autism diagnosis, given its low prevalence, by leveraging correlations between autism and other neurodevelopmental conditions (NDCs).

methodsTo achieve this, we introduced a conditional multi-label model by merging conditional learning and multi-label methodologies. The conditional learning approach breaks a hard task into more manageable pieces in each stage, and the multi-label approach utilizes information from related neurodevelopmental conditions to learn predictive latent features. The study involved forecasting autism diagnosis by age 5.5 years, utilizing data from the first 18 months of life, and the analysis of feature importance correlations to explore the alignment within the feature space across different conditions.

resultsUpon analysis of health records from 18,156 children, we are able to generate a model that predicts a future autism diagnosis with moderate performance (AUROC=0.76). The proposed conditional multi-label method significantly improves predictive performance with an AUROC of 0.80 (p < 0.001). Further examination shows that both the conditional and multi-label approach alone provided marginal lift to the model performance compared to a one-stage one-label approach. We also demonstrated the generalizability and applicability of this method using simulated data with high correlation between feature vectors for different labels.

conclusionOur findings underscore the effectiveness of the developed conditional multi-label model for early prediction of an autism diagnosis. The study introduces a versatile strategy applicable to prediction tasks involving limited target populations but sharing underlying features or etiology among related groups.

Indexed as

Autistic DisorderElectronic Health RecordsAlgorithmsChildChild, PreschoolFemaleHumansInfantMaleAutism spectrum disorderClinical dataConditional modelingMulti-label classificationNeural networkNeurodevelopmental conditions

Identifiers

PMID39182632
PMCPMC11404748

What OpenQuestion holds

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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.