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ABSTRACT: Background and objectives
We aim to explore the additional discriminative accuracy of a deep learning (DL) algorithm using repeated-measures data for identifying people at high risk for cardiovascular disease (CVD), compared to Cox hazard regression.Methods
Two CVD prediction models were developed from National Health Insurance Service-Health Screening Cohort (NHIS-HEALS): a Cox regression model and a DL model. Performance of each model was assessed in the internal and 2 external validation cohorts in Koreans (National Health Insurance Service-National Sample Cohort; NHIS-NSC) and in Europeans (Rotterdam Study). A total of 412,030 adults in the NHIS-HEALS; 178,875 adults in the NHIS-NSC; and the 4,296 adults in Rotterdam Study were included.Results
Mean ages was 52 years (46% women) and there were 25,777 events (6.3%) in NHIS-HEALS during the follow-up. In internal validation, the DL approach demonstrated a C-statistic of 0.896 (95% confidence interval, 0.886-0.907) in men and 0.921 (0.908-0.934) in women and improved reclassification compared with Cox regression (net reclassification index [NRI], 24.8% in men, 29.0% in women). In external validation with NHIS-NSC, DL demonstrated a C-statistic of 0.868 (0.860-0.876) in men and 0.889 (0.876-0.898) in women, and improved reclassification compared with Cox regression (NRI, 24.9% in men, 26.2% in women). In external validation applied to the Rotterdam Study, DL demonstrated a C-statistic of 0.860 (0.824-0.897) in men and 0.867 (0.830-0.903) in women, and improved reclassification compared with Cox regression (NRI, 36.9% in men, 31.8% in women).Conclusions
A DL algorithm exhibited greater discriminative accuracy than Cox model approaches.Trial registration
ClinicalTrials.gov Identifier: NCT02931500.
SUBMITTER: Cho IJ
PROVIDER: S-EPMC6923233 | biostudies-literature | 2020 Jan
REPOSITORIES: biostudies-literature
Cho In Jeong IJ Sung Ji Min JM Kim Hyeon Chang HC Lee Sang Eun SE Chae Myeong Hun MH Kavousi Maryam M Rueda-Ochoa Oscar L OL Ikram M Arfan MA Franco Oscar H OH Min James K JK Chang Hyuk Jae HJ
Korean circulation journal 20190819 1
<h4>Background and objectives</h4>We aim to explore the additional discriminative accuracy of a deep learning (DL) algorithm using repeated-measures data for identifying people at high risk for cardiovascular disease (CVD), compared to Cox hazard regression.<h4>Methods</h4>Two CVD prediction models were developed from National Health Insurance Service-Health Screening Cohort (NHIS-HEALS): a Cox regression model and a DL model. Performance of each model was assessed in the internal and 2 external ...[more]