Individualized prediction of chronic kidney disease for the elderly in longevity areas in China: Machine learning approaches

Wu, NN (通讯作者),Capital Med Univ, Sch Publ Hlth, Dept Hlth Management & Policy, Beijing, Peoples R China.
2022-10-21
Background: Chronic kidney disease (CKD) has become a major public health problem worldwide and has caused a huge social and economic burden, especially in developing countries. No previous study has used machine learning (ML) methods combined with longitudinal data to predict the risk of CKD development in 2 years amongst the elderly in China. Methods: This study was based on the panel data of 925 elderly individuals in the 2012 baseline survey and 2014 follow-up survey of the Healthy Aging and Biomarkers Cohort Study (HABCS) database. Six ML models, logistic regression (LR), lasso regression, random forests (RF), gradient-boosted decision tree (GBDT), support vector machine (SVM), and deep neural network (DNN), were developed to predict the probability of CKD amongst the elderly in 2 years (the year of 2014). The decision curve analysis (DCA) provided a range of threshold probability of the outcome and the net benefit of each ML model. Results: Amongst the 925 elderly in the HABCS 2014 survey, 289 (18.8%) had CKD. Compared with the other models, LR, lasso regression, RF, GBDT, and DNN had no statistical significance of the area under the receiver operating curve (AUC) value (>0.7), and SVM exhibited the lowest predictive performance (AUC = 0.633, p-value = 0.057). DNN had the highest positive predictive value (PPV) (0.328), whereas LR had the lowest (0.287). DCA results indicated that within the threshold ranges of similar to 0-0.03 and 0.37-0.40, the net benefit of GBDT was the largest. Within the threshold ranges of similar to 0.03-0.10 and 0.26-0.30, the net benefit of RF was the largest. Age was the most important predictor variable in the RF and GBDT models. Blood urea nitrogen, serum albumin, uric acid, body mass index (BMI), marital status, activities of daily living (ADO/instrumental activities of daily living (IADL) and gender were crucial in predicting CKD in the elderly. Conclusion: The ML model could successfully capture the linear and nonlinear relationships of risk factors for CKD in the elderly. The decision support system based on the predictive model in this research can help medical staff detect and intervene in the health of the elderly early.
FRONTIERS IN PUBLIC HEALTH
卷号:10
收录类别:SCIE
语种
英语
来源机构
Capital Medical University; University of Michigan System; University of Michigan; Pennsylvania Commonwealth System of Higher Education (PCSHE); University of Pittsburgh; University of Michigan System; University of Michigan; Huazhong University of Science & Technology
资助信息
This study was supported by Michigan Institute for Clinical and Health Research (MICHR No. UL1TR002240) and National Natural Science Foundation of China (No. 71974134).
被引频次(WOS)
0
被引频次(其他)
0
180天使用计数
8
2013以来使用计数
8
EISSN
2296-2565
出版年
2022-10-21
DOI
10.3389/fpubh.2022.998549
WOS学科分类
Public, Environmental & Occupational Health
学科领域
循证公共卫生
关键词
prediction chronic kidney disease elderly machine learning longevity areas China
资助机构
Michigan Institute for Clinical and Health Research (MICHR) National Natural Science Foundation of China(National Natural Science Foundation of China (NSFC))