期刊
COMPUTERS IN BIOLOGY AND MEDICINE
卷 103, 期 -, 页码 109-115出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.compbiomed.2018.10.017
关键词
Machine learning; Decision support systems; Clinical; Precision medicine; Diabetes mellitus
类别
资金
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery
- National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health [K23DK114497]
Objective: Metformin is the preferred first-line medication for management of type 2 diabetes and prediabetes. However, over a third of patients experience primary or secondary therapeutic failure. We developed machine learning models to predict which patients initially prescribed metformin will achieve and maintain control of their blood glucose after one year of therapy. Materials and methods: We performed a retrospective analysis of administrative claims data for 12,147 commercially-insured adults and Medicare Advantage beneficiaries with prediabetes or diabetes. Several machine learning models were trained using variables available at the time of metformin initiation to predict achievement and maintenance of hemoglobin A(1c) (HbA(1c)) < 7.0% after one year of therapy. Results: AUC performances based on five-fold cross-validation ranged from 0.58 to 0.75. The most influential variables driving the predictions were baseline HbA(1c), starting metformin dosage, and presence of diabetes with complications. Conclusions: Machine learning models can effectively predict primary or secondary metformin treatment failure within one year. This information can help identify effective individualized treatment strategies. Most of the implemented models outperformed traditional logistic regression, highlighting the potential for applying machine learning to problems in medicine.
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