在医疗管理数据库中识别1/2型糖尿病以改善糖尿病的健康监测、医学研究和预防:算法开发和应用

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Sonsoles Fuentes , Rok Hrzic , Romana Haneef , Sofiane Kab , Emmanuel Cosson , Sandrine Fosse-Edorh
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引用次数: 0

摘要

大数据源为糖尿病研究提供了机遇。一个例子是法国国家卫生数据系统(SNDS),该系统收集了整个法国人口(6600万)的院外医疗保健和住院医疗索赔信息。目前,一种基于抗糖尿病药物报销的有效算法能够识别SNDS中接受药物治疗的糖尿病患者。但它无法区分1型糖尿病和2型糖尿病。区分1型和2型糖尿病对糖尿病监测至关重要,因为它们在预防、高危人群、疾病自然史、病理生理学、管理和并发症风险方面存在差异。本文研究了一种基于人工智能的1型/ 2型糖尿病分类算法的发展及其在估计法国1型和2型糖尿病患病率中的应用。方法最终数据集包括来自constance队列的所有糖尿病患者(n = 951)。采用基于八个步骤的监督式机器学习方法:最终数据集选择、目标定义(类型1)、特征编码、最终数据集分割为训练和测试数据集、特征选择和训练以及算法的验证和选择。将选择的算法应用于SNDS数据,估计18-70岁成人中1型和2型糖尿病的患病率。结果在3481个SNDS特征中,选择了14个特征来训练不同的算法。最终算法是基于前一年速效胰岛素、长效胰岛素和双胍类药物报销次数的线性判别分析模型(特异性97%,敏感性100%)。2016年,在对算法性能进行调整后,法国1型和2型糖尿病患病率估计分别为0.3%和4.4%。结论1型/ 2型分类算法性能良好,适用于国外处方或医疗索赔数据库。人工智能为研究和糖尿病预防开辟了新的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Identifying type 1 / type 2 diabetes in medico-administrative database to improve health surveillance, medical research and prevention in diabetes: Algorithm development and application

Introduction

Big data sources represent an opportunity for diabetes research. One example is the French national health data system (SNDS), gathering information on medical claims of out-of-hospital health care and hospitalizations for the entire French population (66 million). Currently, a validated algorithm based on antidiabetic drug reimbursement is able to identify people with pharmacologically-treated diabetes in the SNDS. But it cannot distinguish type 1 from type 2 diabetes. Differentiating type 1 and type 2 diabetes is crucial in diabetes surveillance, because they carry differences in their prevention, populations at risk, disease natural history, pathophysiology, management and risk of complications.

This article investigates the development of a type 1/type 2 diabetes classification algorithm using artificial intelligence and its application to estimate the prevalence of type 1 and type 2 diabetes in France.

Methods

The final data set comprised all diabetes cases from the CONSTANCES cohort (n = 951). A supervised machine learning method based on eight steps was used: final data set selection, target definition (type 1), coding features, final data set splitting into training and testing data sets, feature selection and training and validation and selection of algorithms. The selected algorithm was applied to SNDS data to estimate the type 1 and type 2 diabetes prevalence among adults 18–70 years of age.

Results

Among the 3481 SNDS features, 14 were selected to train the different algorithms. The final algorithm was a linear discriminant analysis model based on the number of reimbursements for fast-acting insulin, long-acting insulin and biguanides over the previous year (specificity 97% and sensitivity 100%). In 2016, after adjusting for algorithm performance, type 1 and type 2 diabetes prevalence in France was estimated to be 0.3% and 4.4%, respectively.

Conclusion

Our type 1/type 2 classification algorithm was found to perform well and to be applicable to any prescription or medical claims database from other countries. Artificial intelligence opens new possibilities for research and diabetes prevention.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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