Early prediction of Alzheimer's disease and related dementias using real-world electronic health records

被引:26
作者
Li, Qian [1 ]
Yang, Xi [1 ]
Xu, Jie [1 ]
Guo, Yi [1 ]
He, Xing [1 ]
Hu, Hui [2 ,3 ]
Lyu, Tianchen [1 ]
Marra, David [4 ]
Miller, Amber [5 ]
Smith, Glenn [6 ]
DeKosky, Steven [5 ]
Boyce, Richard D. [7 ]
Schliep, Karen [8 ]
Shenkman, Elizabeth [1 ]
Maraganore, Demetrius [9 ]
Wu, Yonghui [1 ]
Bian, Jiang [1 ,10 ]
机构
[1] Univ Florida, Coll Med, Dept Hlth Outcomes & Biomed Informat, Gainesville, FL USA
[2] Brigham & Womens Hosp, Channing Div Network Med, Boston, MA USA
[3] Harvard Med Sch, Boston, MA USA
[4] VA Boston Healthcare Syst, Dept Psychol, Boston, MA USA
[5] Univ Florida, Coll Med, Dept Neurol, Gainesville, FL USA
[6] Univ Florida, Dept Clin & Hlth Psychol, Gainesville, FL USA
[7] Univ Pittsburgh, Dept Biomed Informat, Pittsburgh, PA USA
[8] Univ Utah, Dept Family & Prevent Med, Salt Lake City, UT USA
[9] Tulane Univ, Sch Med, Dept Neurol, New Orleans, LA USA
[10] Univ Florida, Coll Med, Dept Hlth Outcomes & Biomed Informat, 2197 Mowry Rd,POB 100177, Gainesville, FL 32610 USA
关键词
Alzheimer's disease (AD); Alzheimer's disease and related dementias (ADRD); data-driven approach; machine learning; real-world data; risk prediction; DEFINITIONS; DIAGNOSIS; MODELS; DRUGS; CARE;
D O I
10.1002/alz.12967
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
IntroductionThis study aims to explore machine learning (ML) methods for early prediction of Alzheimer's disease (AD) and related dementias (ADRD) using the real-world electronic health records (EHRs). MethodsA total of 23,835 ADRD and 1,038,643 control patients were identified from the OneFlorida+ Research Consortium. Two ML methods were used to develop the prediction models. Both knowledge-driven and data-driven approaches were explored. Four computable phenotyping algorithms were tested. ResultsThe gradient boosting tree (GBT) models trained with the data-driven approach achieved the best area under the curve (AUC) scores of 0.939, 0.906, 0.884, and 0.854 for early prediction of ADRD 0, 1, 3, or 5 years before diagnosis, respectively. A number of important clinical and sociodemographic factors were identified. DiscussionWe tested various settings and showed the predictive ability of using ML approaches for early prediction of ADRD with EHRs. The models can help identify high-risk individuals for early informed preventive or prognostic clinical decisions.
引用
收藏
页码:3506 / 3518
页数:13
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