Introduction: The discovery of causal mechanisms underlying diseases enables better diagnosis, prognosis and treatment selection. Clinical trials have been the gold standard for determining causality, but they are resource intensive, sometimes infeasible or unethical. Electronic Health Records (EHR) contain a wealth of real-world data that holds promise for the discovery of disease mechanisms, yet the existing causal structure discovery (CSD) methods fall short on leveraging them due to the special characteristics of the EHR data. We propose a new data transformation method and a novel CSD algorithm to overcome the challenges posed by these characteristics. Materials and methods: We demonstrated the proposed methods on an application to type-2 diabetes mellitus. We used a large EHR data set from Mayo Clinic to internally evaluate the proposed transformation and CSD methods and used another large data set from an independent health system, Fairview Health Services, as external validation. We compared the performance of our proposed method to Fast Greedy Equivalence Search (FGES), a state-of-the-art CSD method in terms of correctness, stability and completeness. We tested the generalizability of the proposed algorithm through external validation. Results and conclusions: The proposed method improved over the existing methods by successfully incorporating study design considerations, was robust in face of unreliable EHR timestamps and inferred causal effect directions more correctly and reliably. The proposed data transformation successfully improved the clinical correctness of the discovered graph and the consistency of edge orientation across bootstrap samples. It resulted in superior accuracy, stability, and completeness.
The purpose of this Conference is to present the main lines of base projects that are founded on research already begun in previous years. In this sense, this manuscript will present the main lines of research in Diabetes Mellitus type 1 and Machine Learning techniques in an Internet of Things environment, so that we can summarize the future lines to be developed as follows: data collection through biosensors, massive data processing in the cloud, interconnection of biodevices, local computing vs. cloud computing, and possibilities of machine learning techniques to predict blood glucose values…
Chittagong University of Engineering & Technology（吉大港工程技术大学）
Diabetes mellitus is a common disease of human body caused by a group of metabolic disorders where the sugar levels over a prolonged period is very high. It affects different organs of the human body which thus harm a large number of the body's system, in particular the blood veins and nerves. Early prediction in such disease can be controlled and save human life. To achieve the goal, this research work mainly explores various risk factors related to this disease using machine learning techniques. Machine learning techniques provide efficient result to extract knowledge by constructing predict…
Explainable artificial intelligence model predicting the risk of all-cause mortality in patients with type 2 diabetes mellitus
Lobachevsky State University（罗巴切夫斯基国立大学）；Università Politecnica delle Marche（马尔凯理工大学）；IRCCS INRCA（意大利国家养老与老年病研究所）；Mriya Life Institute, National Academy of Active Longevity（国家积极长寿研究院 Mriya Life 研究所）
Leveraging health administrative data (HAD) datasets for predicting the risk of chronic diseases including diabetes has gained a lot of attention in the machine learning community recently. In this paper, we use the largest health records datasets of patients in Ontario,Canada. Provided by the Institute of Clinical Evaluative Sciences (ICES), this database is age, gender and ethnicity-diverse. The datasets include demographics, lab measurements,drug benefits, healthcare system interactions, ambulatory and hospitalizations records. We perform one of the first large-scale machine learning studie…
Faculty of Health Sciences, University of Maribor（马里博尔大学健康科学学院）
Machine Learning (ML) models are often complex and difficult to interpret due to their 'black-box' characteristics. Interpretability of a ML model is usually defined as the degree to which a human can understand the cause of decisions reached by a ML model. Interpretability is of extremely high importance in many fields of healthcare due to high levels of risk related to decisions based on ML models. Calibration of the ML model outputs is another issue often overlooked in the application of ML models in practice. This paper represents an early work in examination of prediction model calibratio…
Secure and Privacy-Preserving Automated Machine Learning Operations into End-to-End Integrated IoT-Edge-Artificial Intelligence-Blockchain Monitoring System for Diabetes Mellitus Prediction
The University of Melbourne（墨尔本大学）；United Arab Emirates University（阿联酋大学）；Mediclinic（Mediclinic医疗集团）；Bhubaneswar Institute of Technology（布巴内斯瓦尔理工学院）；SRM Institute of Science & Technology（SRM科学技术学院）
National Technical University of Athens（雅典国立技术大学）；University of Athens（雅典大学）
Cardiovascular Disease (CVD) is an important cause of disability and death among individuals with Diabetes Mellitus (DM). International clinical guidelines for the management of Type 2 DM (T2DM) are founded on primary and secondary prevention and favor the evaluation of CVD related risk factors towards appropriate treatment initiation. CVD risk prediction models can provide valuable tools for optimizing the frequency of medical visits and performing timely preventive and therapeutic interventions against CVD events. The integration of explainability modalities in these models can enhance human…
Improving Early Prediction of Type 2 Diabetes Mellitus with ECG-DiaNet: A Multimodal Neural Network Leveraging Electrocardiogram and Clinical Risk Factors
College of Science and Engineering, Hamad Bin Khalifa University（哈马德·本·哈利法大学科学与工程学院）
Machine Learning Prediction of Cardiovascular Risk in Type 1 Diabetes Mellitus Using Radiomics Features from Multimodal Retinal Images
Universitat Politècnica de Catalunya (UPC)（加泰罗尼亚理工大学）；Institut Clínic d´Oftalmología (ICOF)（眼科临床研究所）；Hospital Clínic de Barcelona（巴塞罗那临床医院）；Intelligent Data Science and Artificial Intelligence (IDEAI-UPC) Research Center（智能数据科学与人工智能研究中心）；August Pi i Sunyer Biomedical Research Institute (IDIBAPS)（奥古斯特·皮伊·苏涅尔生物医学研究所）；School of Medicine, Universitat de Barcelona（巴塞罗那大学医学院）
CardioMeta: Calibrated Multi-Task Prediction of Diabetes, Hypertension, and Cardiovascular Disease Across Population and EHR Data
School of Computing, Wichita State University（威奇托州立大学计算学院）；Department of Computer Science and Engineering, American International University-Bangladesh（孟加拉国美国国际大学计算机科学与工程系）；School of Computer Science and Engineering, The University of Aizu（会津大学计算机科学与工程学院）
United Arab Emirates University（阿联酋大学）；The University of Melbourne（墨尔本大学）
Diabetes Mellitus has no permanent cure to date and is one of the leading causes of death globally. The alarming increase in diabetes calls for the need to take precautionary measures to avoid/predict the occurrence of diabetes. This paper proposes HealthEdge, a machine learning-based smart healthcare framework for type 2 diabetes prediction in an integrated IoT-edge-cloud computing system. Numerical experiments and comparative analysis were carried out between the two most used machine learning algorithms in the literature, Random Forest (RF) and Logistic Regression (LR), using two real-life …
KenSci Inc.（KenSci公司）；University of Washington（华盛顿大学）
Prediction of diabetes and its various complications has been studied in a number of settings, but a comprehensive overview of problem setting for diabetes prediction and care management has not been addressed in the literature. In this document we seek to remedy this omission in literature with an encompassing overview of diabetes complication prediction as well as situating this problem in the context of real world healthcare management. We illustrate various problems encountered in real world clinical scenarios via our own experience with building and deploying such models. In this manuscri…
Harvard Medical School（哈佛医学院）；Brigham and Women’s Hospital（布莱根妇女医院）
Health professionals can use natural language processing (NLP) technologies when reviewing electronic health records (EHR). Machine learning free-text classifiers can help them identify problems and make critical decisions. We aim to develop deep learning neural network algorithms that identify EHR progress notes pertaining to diabetes and validate the algorithms at two institutions. The data used are 2,000 EHR progress notes retrieved from patients with diabetes and all notes were annotated manually as diabetic or non-diabetic. Several deep learning classifiers were developed, and their perfo…
Electronic Health Records-Based Data-Driven Diabetes Knowledge Unveiling and Risk Prognosis
Georgia Institute of Technology（佐治亚理工学院）；McGill University（麦吉尔大学）；Carnegie Mellon University（卡内基梅隆大学）；Oregon State University（俄勒冈州立大学）；University of Pennsylvania（宾夕法尼亚大学）；Northeastern University（东北大学）；University of California, San Diego（加州大学圣地亚哥分校）
Diabetes is currently one of the most common, dangerous, and costly diseases in the world that is caused by an increase in blood sugar or a decrease in insulin in the body. Diabetes can have detrimental effects on people's health if diagnosed late. Today, diabetes has become one of the challenges for health and government officials. Prevention is a priority, and taking care of people's health without compromising their comfort is an essential need. In this study, the Ensemble training methodology based on genetic algorithms are used to accurately diagnose and predict the outcomes of diabetes m…
CureMD Research and Development（CureMD研发部）；University of the Punjab（旁遮普大学）
Type 2 diabetes mellitus (T2DM) is one of the most common diseases and a leading cause of death. The problem of early diagnosis of T2DM is challenging and necessary to prevent serious complications. This study proposes a novel neural network architecture for early T2DM prediction using multi-headed self-attention and dense layers to extract features from historic diagnoses, patient vitals, and demographics. The proposed technique is called the Self-Attention for Comorbid Disease Net (SACDNet), achieving an accuracy of 89.3% and an F1-Score of 89.1%, having a 1.6% increased accuracy and 1.3% in…
The imperative for early detection of type 2 diabetes mellitus (T2DM) is challenged by its asymptomatic onset and dependence on suboptimal clinical diagnostic tests, contributing to its widespread global prevalence. While research into noninvasive T2DM screening tools has advanced, conventional machine learning approaches remain limited to unimodal inputs due to extensive feature engineering requirements. In contrast, deep learning models can leverage multimodal data for a more holistic understanding of patients' health conditions. However, the potential of chest X-ray (CXR) imaging, one of th…
Institute for Basic Science (IBS)（基础科学研究院）；Seoul National University（首尔大学）；Pohang University of Science and Technology（浦项科技大学）
Machine learning shows remarkable success for recognizing patterns in data. Here we apply the machine learning (ML) for the diagnosis of early stage diabetes, which is known as a challenging task in medicine. Blood glucose levels are tightly regulated by two counter-regulatory hormones, insulin and glucagon, and the failure of the glucose homeostasis leads to the common metabolic disease, diabetes mellitus. It is a chronic disease that has a long latent period the complicates detection of the disease at an early stage. The vast majority of diabetics result from that diminished effectiveness of…
Artificial Intelligence-Based Methods for Precision Medicine: Diabetes Risk Prediction
College of Science and Engineering, Hamad Bin Khalifa University（哈马德·本·哈利法大学科学与工程学院）；Weill Cornell Medicine-Qatar（威尔康奈尔医学院卡塔尔分校）；College of Health and Life Sciences, Hamad Bin Khalifa University（哈马德·本·哈利法大学健康与生命科学学院）
Developing A Fair Individualized Polysocial Risk Score (iPsRS) for Identifying Increased Social Risk of Hospitalizations in Patients with Type 2 Diabetes (T2D)
University of Florida（佛罗里达大学）；University of Florida College of Medicine（佛罗里达大学医学院）
Multi-Modal Machine Learning for Population- and Subject-Specific lncRNA-Type 2 Diabetes Association Analysis
Department of Electronics and Communication Engineering, IIITDM Jabalpur（IIITDM Jabalpur电子与通信工程系）；Department of Electronics and Communication Engineering, Central University of Jammu（Jammu中央大学电子与通信工程系）
A Structural FHMM for Interpretable Disease Trajectories in T2DM
Swiss Data Science Center (SDSC)（瑞士数据科学中心（SDSC））；Ecole Polytechnique Fédérale de Lausanne (EPFL)（洛桑联邦理工学院）；ETH Zürich（苏黎世联邦理工学院）；Institute of Pharmaceutical Sciences（药学院）
Managing patients with chronic diseases is a major and growing healthcare challenge in several countries. A chronic condition, such as diabetes, is an illness that lasts a long time and does not go away, and often leads to the patient's health gradually getting worse. While recent works involve raw electronic health record (EHR) from hospitals, this work uses only financial records from health plan providers (medical claims) to predict diabetes disease evolution with a self-attentive recurrent neural network. The use of financial data is due to the possibility of being an interface to internat…
Explainable Retinal Imaging for Prediction of Multi-Organ Dysfunction in Type 2 Diabetes
Faculty of Computer Science and Artificial Intelligence（计算机科学与人工智能学院）；Frontier Science Computing Center（前沿科学计算中心）；Chinese Academy of Sciences（中国科学院）；Chinese University of Hong Kong（香港中文大学）；Zhuhai People's Hospital（珠海人民医院）；Beijing Institute of Technology（北京理工大学）；Jinan University（暨南大学）；Lampang Inter-Tech College
Amazon Web Services Inc（亚马逊网络服务公司）；Cerner Corporation（塞纳公司）
Chronic disease progression is emerging as an important area of investment for healthcare providers. As the quantity and richness of available clinical data continue to increase along with advances in machine learning, there is great potential to advance our approaches to caring for patients. An ideal approach to this problem should generate good performance on at least three axes namely, a) perform across many clinical conditions without requiring deep clinical expertise or extensive data scientist effort, b) generalization across populations, and c) be explainable (model interpretability). W…
The increase in availability of longitudinal electronic health record (EHR) data is leading to improved understanding of diseases and discovery of novel phenotypes. The majority of clustering algorithms focus only on patient trajectories, yet patients with similar trajectories may have different outcomes. Finding subgroups of patients with different trajectories and outcomes can guide future drug development and improve recruitment to clinical trials. We develop a recurrent neural network autoencoder to cluster EHR data using reconstruction, outcome, and clustering losses which can be weighted…
Electronic health records (EHR) offer unprecedented opportunities for in-depth clinical phenotyping and prediction of clinical outcomes. Combining multiple data sources is crucial to generate a complete picture of disease prevalence, incidence and trajectories. The standard approach to combining clinical data involves collating clinical terms across different terminology systems using curated maps, which are often inaccurate and/or incomplete. Here, we propose sEHR-CE, a novel framework based on transformers to enable integrated phenotyping and analyses of heterogeneous clinical datasets witho…
Context-Aware Optimization of Follow-Up Intervals for Type 2 Diabetes Care Using Markov Decision Processes
University of Massachusetts Amherst（马萨诸塞大学阿默斯特分校）；National Center for Human Factors in Healthcare（医疗人因国家中心）；Georgetown University School of Medicine（乔治城大学医学院）；Medstar Georgetown University Hospital（Medstar乔治城大学医院）
McGill University（麦吉尔大学）；McGill Adult Unit for Congenital Heart Disease Excellence（麦吉尔大学成人先天性心脏病卓越中心）
Motivation: Electronic health record (EHR) data provides a new venue to elucidate disease comorbidities and latent phenotypes for precision medicine. To fully exploit its potential, a realistic data generative process of the EHR data needs to be modelled. We present MixEHR-S to jointly infer specialist-disease topics from the EHR data. As the key contribution, we model the specialist assignments and ICD-coded diagnoses as the latent topics based on patient's underlying disease topic mixture in a novel unified supervised hierarchical Bayesian topic model. For efficient inference, we developed a…
Georgia Institute of Technology（佐治亚理工学院）；Health at Scale；INOVA；Sutter Health（萨特医疗）；Emory University（埃默里大学）
Phenotyping electronic health records (EHR) focuses on defining meaningful patient groups (e.g., heart failure group and diabetes group) and identifying the temporal evolution of patients in those groups. Tensor factorization has been an effective tool for phenotyping. Most of the existing works assume either a static patient representation with aggregate data or only model temporal data. However, real EHR data contain both temporal (e.g., longitudinal clinical visits) and static information (e.g., patient demographics), which are difficult to model simultaneously. In this paper, we propose Te…
University of Virginia（弗吉尼亚大学）；University of California Los Angeles（加州大学洛杉矶分校）
Chronic kidney disease (CKD) is a gradual loss of renal function over time, and it increases the risk of mortality, decreased quality of life, as well as serious complications. The prevalence of CKD has been increasing in the last couple of decades, which is partly due to the increased prevalence of diabetes and hypertension. To accurately detect CKD in diabetic patients, we propose a novel framework to learn sparse longitudinal representations of patients' medical records. The proposed method is also compared with widely used baselines such as Aggregated Frequency Vector and Bag-of-Pattern in…
