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Claims-based algorithms for common chronic conditions were efficiently constructed using machine learning methods

Hara, Konan ; Kobayashi, Yasuki ; Tomio, Jun ; Ito, Yuki ; Svensson, Thomas LU ; Ikesu, Ryo ; Chung, Ung-Il and Svensson, Akiko Kishi LU (2021) In PLoS ONE 16(9). p.1-19
Abstract

Identification of medical conditions using claims data is generally conducted with algorithms based on subject-matter knowledge. However, these claims-based algorithms (CBAs) are highly dependent on the knowledge level and not necessarily optimized for target conditions. We investigated whether machine learning methods can supplement researchers' knowledge of target conditions in building CBAs. Retrospective cohort study using a claims database combined with annual health check-up results of employees' health insurance programs for fiscal year 2016-17 in Japan (study population for hypertension, N = 631,289; diabetes, N = 152,368; dyslipidemia, N = 614,434). We constructed CBAs with logistic regression, k-nearest neighbor, support... (More)

Identification of medical conditions using claims data is generally conducted with algorithms based on subject-matter knowledge. However, these claims-based algorithms (CBAs) are highly dependent on the knowledge level and not necessarily optimized for target conditions. We investigated whether machine learning methods can supplement researchers' knowledge of target conditions in building CBAs. Retrospective cohort study using a claims database combined with annual health check-up results of employees' health insurance programs for fiscal year 2016-17 in Japan (study population for hypertension, N = 631,289; diabetes, N = 152,368; dyslipidemia, N = 614,434). We constructed CBAs with logistic regression, k-nearest neighbor, support vector machine, penalized logistic regression, tree-based model, and neural network for identifying patients with three common chronic conditions: hypertension, diabetes, and dyslipidemia. We then compared their association measures using a completely hold-out test set (25% of the study population). Among the test cohorts of 157,822, 38,092, and 153,608 enrollees for hypertension, diabetes, and dyslipidemia, 25.4%, 8.4%, and 38.7% of them had a diagnosis of the corresponding condition. The areas under the receiver operating characteristic curve (AUCs) of the logistic regression with/without subject-matter knowledge about the target condition were .923/.921 for hypertension, .957/.938 for diabetes, and .739/.747 for dyslipidemia. The logistic lasso, logistic elastic-net, and tree-based methods yielded AUCs comparable to those of the logistic regression with subject-matter knowledge: .923-.931 for hypertension; .958-.966 for diabetes; .747-.773 for dyslipidemia. We found that machine learning methods can attain AUCs comparable to the conventional knowledge-based method in building CBAs.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
PLoS ONE
volume
16
issue
9
article number
e0254394
pages
1 - 19
publisher
Public Library of Science (PLoS)
external identifiers
  • pmid:34570785
  • scopus:85116212749
ISSN
1932-6203
DOI
10.1371/journal.pone.0254394
language
English
LU publication?
yes
id
5288a533-8121-4a2f-98a2-93bfef918a2a
date added to LUP
2021-09-30 05:36:47
date last changed
2024-06-01 16:28:17
@article{5288a533-8121-4a2f-98a2-93bfef918a2a,
  abstract     = {{<p>Identification of medical conditions using claims data is generally conducted with algorithms based on subject-matter knowledge. However, these claims-based algorithms (CBAs) are highly dependent on the knowledge level and not necessarily optimized for target conditions. We investigated whether machine learning methods can supplement researchers' knowledge of target conditions in building CBAs. Retrospective cohort study using a claims database combined with annual health check-up results of employees' health insurance programs for fiscal year 2016-17 in Japan (study population for hypertension, N = 631,289; diabetes, N = 152,368; dyslipidemia, N = 614,434). We constructed CBAs with logistic regression, k-nearest neighbor, support vector machine, penalized logistic regression, tree-based model, and neural network for identifying patients with three common chronic conditions: hypertension, diabetes, and dyslipidemia. We then compared their association measures using a completely hold-out test set (25% of the study population). Among the test cohorts of 157,822, 38,092, and 153,608 enrollees for hypertension, diabetes, and dyslipidemia, 25.4%, 8.4%, and 38.7% of them had a diagnosis of the corresponding condition. The areas under the receiver operating characteristic curve (AUCs) of the logistic regression with/without subject-matter knowledge about the target condition were .923/.921 for hypertension, .957/.938 for diabetes, and .739/.747 for dyslipidemia. The logistic lasso, logistic elastic-net, and tree-based methods yielded AUCs comparable to those of the logistic regression with subject-matter knowledge: .923-.931 for hypertension; .958-.966 for diabetes; .747-.773 for dyslipidemia. We found that machine learning methods can attain AUCs comparable to the conventional knowledge-based method in building CBAs.</p>}},
  author       = {{Hara, Konan and Kobayashi, Yasuki and Tomio, Jun and Ito, Yuki and Svensson, Thomas and Ikesu, Ryo and Chung, Ung-Il and Svensson, Akiko Kishi}},
  issn         = {{1932-6203}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{1--19}},
  publisher    = {{Public Library of Science (PLoS)}},
  series       = {{PLoS ONE}},
  title        = {{Claims-based algorithms for common chronic conditions were efficiently constructed using machine learning methods}},
  url          = {{http://dx.doi.org/10.1371/journal.pone.0254394}},
  doi          = {{10.1371/journal.pone.0254394}},
  volume       = {{16}},
  year         = {{2021}},
}