All-Cause Mortality Prediction in Subjects with Diabetes Mellitus Using a Machine Learning Model and Shapley Values.

Background/Objectives: Diabetes mellitus (DM) is a prevalent disease with an increased risk of complications. Identifying risk factors for mortality in these patients is crucial, as early recognition can facilitate prompt therapeutic intervention. Machine learning (ML) models have proved to be valua...

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Publicado en:Diabetology Vol. 6; no. 1; pp. 5 - 17
Autores principales: Mirea, Oana, Oghli, Mostafa Ghelich, Neagoe, Oana, Berceanu, Mihaela, Țieranu, Eugen, Moraru, Liviu, Raicea, Victor, Donoiu, Ionuț
Formato: research tables/charts Journal Article
Publicado: MDPI Jan2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2025
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      pub: MDPI
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        atl: All-Cause Mortality Prediction in Subjects with Diabetes Mellitus Using a Machine Learning Model and Shapley Values.
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        au:
          Mirea, Oana
          Oghli, Mostafa Ghelich
          Neagoe, Oana
          Berceanu, Mihaela
          Țieranu, Eugen
          Moraru, Liviu
          Raicea, Victor
          Donoiu, Ionuț
        affil: Department of Cardiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
      sug:
        subj:
          Diabetes Mellitus Complications
          Diabetic Patients
          Mortality Risk Factors
          Risk Assessment
          Machine Learning
          Prediction Models Evaluation
          Human
          Romania
          Male
          Female
          Middle Age
          Aged
          Aged, 80 and Over
          Sensitivity and Specificity
          ROC Curve
          Glomerular Filtration Rate
          Insulin Therapeutic Use
          Treatment Duration
          Hemoglobins Blood
          Retrospective Design
          Record Review
          Descriptive Statistics
          Data Analysis Software
          T-Tests
          Validity
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Background/Objectives: Diabetes mellitus (DM) is a prevalent disease with an increased risk of complications. Identifying risk factors for mortality in these patients is crucial, as early recognition can facilitate prompt therapeutic intervention. Machine learning (ML) models have proved to be valuable tools in different scenarios of healthcare decision making. We aimed to develop and test an ML model to predict all-cause mortality in a large cohort of subjects with DM. Methods: We included 1969 consecutive patients with DM type 1 (T1DM, n = 255) and type 2 (T2DM, n = 1714). eXtreme Gradient Boosting (XGBoost) was used for the prediction of all-cause mortality in this cohort and the Shapley additive explanation (SHAP) was used to assess the importance of each feature of the classifier. The missing values were imputed using the Missforest methodology. Results: The all-cause mortality rate was 21% during 5.5 ± 1.1 years of follow-up. The ML model achieved 90% sensitivity and 87% specificity with an AUC of 0.88 and an accuracy of 88% for predicting all-cause mortality. The SHAP analysis identified a lower glomerular filtration rate (eGFR), duration of insulin therapy, and a lower level of hemoglobin as the first three factors that contribute to the higher mortality rate. Conclusions: ML models can become valuable tools in clinical practice due to their unique ability to simultaneously assess the cumulative influence of multiple parameters and discover high-order interactions. The application of such models in clinical practice could improve the early identification of subjects at risk for complications and mortality and prompt early therapeutical interventions.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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