Application of GUHA data mining method in cohort data to explore paths associated with premature death: a 29-year follow-up study.

Abstract

Background and method: This study set out to identify the factors and combinations of factors associated with the individual's premature death, using data from the Finnish Longitudinal Study on Ageing Municipal Employees (FLAME) which involved 6,257 participants over a 29-year follow-up period. Exact dates of death were obtained from the Finnish population register. Premature death was defined as a death occurring earlier than the age- and sex-specific actuarial life expectancy indicated by life tables for 1981, as the baseline, with the threshold period of nine months. Explanatory variables encompassed sociodemographic characteristics, health and functioning, health behaviors, subjective experiences, working conditions, and work abilities. Data were mined using the General Unary Hypothesis Automaton (GUHA) method, implemented with LISp-Miner software. GUHA involves an active dialogue between the user and the LISp-Miner software, with parameters tailored to the data and user interests. The parameters used are not absolute but depend on the data to be mined and the user's interests.

Results: Over the follow-up period, 2,196 deaths were recorded, of which 70.4% were premature. Seven single factors and 67 sets of criteria (paths) were statistically significantly associated with premature mortality, passing the one-sided Fisher test. Single predicates of premature death included smoking, consuming alcohol a few times a month or once a week, poor self-rated fitness, incompetence to work and poor assured workability in two years' time, and diseases causing work disability. Notably, most of the factors selected as single predicates of premature mortality did not appear in the multi-predicate paths. Factors appearing in the paths were smoking more than 20 cigarettes a day, symptoms that impaired functioning, past smoking, absence of musculoskeletal diseases, poor self-rated health, having pain, male sex, being married, use of medication, more physical strain compared to others, and high life satisfaction, intention to retire due to reduced work ability caused by diseases and demanding work. Sex-specific analysis revealed similar findings.

Conclusion: The findings indicate that associations between single predictors and premature mortality should be interpreted with caution, even when adjusted for a limited number of other factors. This highlights the complexity of premature mortality and the need for comprehensive models considering multiple interacting factors.