Dataset Information

Predicting malnutrition from longitudinal patient trajectories with deep learning.

ABSTRACT: Malnutrition is common, morbid, and often correctable, but subject to missed and delayed diagnosis. Better screening and prediction could improve clinical, functional, and economic outcomes. This study aimed to assess the predictability of malnutrition from longitudinal patient records, and the external generalizability of a predictive model. Predictive models were developed and validated on statewide emergency department (ED) and hospital admission databases for California, Florida and New York, including visits from October 1, 2015 to December 31, 2018. Visit features included patient demographics, diagnosis codes, and procedure categories. Models included long short-term memory (LSTM) recurrent neural networks trained on longitudinal trajectories, and gradient-boosted tree and logistic regression models trained on cross-sectional patient data. The dataset used for model training and internal validation (California and Florida) included 62,811 patient trajectories (266,951 visits). Test sets included 63,997 (California), 63,112 (Florida), and 62,472 (New York) trajectories, such that each cohort's composition was proportional to the prevalence of malnutrition in that state. Trajectories contained seven patient characteristics and up to 2,008 diagnosis categories. Area under the receiver-operating characteristic (AUROC) and precision-recall curves (AUPRC) were used to characterize prediction of first malnutrition diagnoses in the test sets. Data analysis was performed from September 2020 to May 2021. Between 4.0% (New York) and 6.2% (California) of patients received malnutrition diagnoses. The longitudinal LSTM model produced the most accurate predictions of malnutrition, with comparable predictive performance in California (AUROC 0.854, AUPRC 0.258), Florida (AUROC 0.869, AUPRC 0.234), and New York (AUROC 0.869, AUPRC 0.190). Deep learning models can reliably predict malnutrition from existing longitudinal patient records, with better predictive performance and lower data-collection requirements than existing instruments. This approach may facilitate early nutritional intervention via automated screening at the point of care.

SUBMITTER: Jin BT

PROVIDER: S-EPMC9333236 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:Abstract Objective Hypertension has long been recognized as one of the most important predisposing factors for cardiovascular diseases and mortality. In recent years, machine learning methods have shown potential in diagnostic and predictive approaches in chronic diseases. Electronic health records (EHRs) have emerged as a reliable source of longitudinal data. The aim of this study is to predict the onset of hypertension using modern deep learning (DL) architectures, specifically long short-term memory (LSTM) networks, and longitudinal EHRs. Materials and Methods We compare this approach to the best performing models reported from previous works, particularly XGboost, applied to aggregated features. Our work is based on data from 233 895 adult patients from a large health system in the United States. We divided our population into 2 distinct longitudinal datasets based on the diagnosis date. To ensure generalization to unseen data, we trained our models on the first dataset (dataset A “train and validation”) using cross-validation, and then applied the models to a second dataset (dataset B “test”) to assess their performance. We also experimented with 2 different time-windows before the onset of hypertension and evaluated the impact on model performance. Results With the LSTM network, we were able to achieve an area under the receiver operating characteristic curve value of 0.98 in the “train and validation” dataset A and 0.94 in the “test” dataset B for a prediction time window of 1 year. Lipid disorders, type 2 diabetes, and renal disorders are found to be associated with incident hypertension. Conclusion These findings show that DL models based on temporal EHR data can improve the identification of patients at high risk of hypertension and corresponding driving factors. In the long term, this work may support identifying individuals who are at high risk for developing hypertension and facilitate earlier intervention to prevent the future development of hypertension.

Project description:BackgroundHigh-value cancer care balances effective treatment with preservation of quality of life. Chemotherapy is known to affect patients' physical and psychological well-being negatively. Patient-reported outcomes (PROs) provide a means to monitor declines in a patients' well-being during treatment.MethodsWe identified 741 oncology patients undergoing chemotherapy in our electronic health record (EHR) system who completed Patient-Reported Outcomes Measurement Information System (PROMIS) surveys during treatment at a comprehensive cancer center, 2013-2018. PROMIS surveys were collected before, during, and after chemotherapy treatment. Linear mixed-effects models were performed to identify predictors of physical and mental health scores over time. A k-mean cluster analysis was used to group patient PROMIS score trajectories.ResultsMean global physical health (GPH) scores were 48.7 (SD 9.3), 47.7 (8.8), and 48.6 (8.9) and global mental health (GMH) scores were 50.4 (8.6), 49.5 (8.8), and 50.6 (9.1) before, during, and after chemotherapy, respectively. Asian race, Hispanic ethnicity, public insurance, anxiety/depression, stage III cancer, and palliative care were predictors of GPH and GMH decline. The treatment time period was also a predictor of both GPH and GMH decline relative to pre-treatment. Trajectory clustering identified four distinct PRO clusters associated with chemotherapy treatment.ConclusionsPatient-reported outcomes are increasingly used to help monitor cancer treatment and are now a part of care reimbursement. This study leveraged routinely collected PROMIS surveys linked to EHRs to identify novel patient trajectories of physical and mental well-being in oncology patients undergoing chemotherapy and potential predictors. Supportive care interventions in high-risk populations identified by our study may optimize resource deployment.Novelty and impactThis study leveraged routinely collected patient-reported outcome (PROMIS) surveys linked to electronic health records to characterize oncology patients' quality of life during chemotherapy. Important clinical and demographic predictors of declines in quality of life were identified and four novel trajectories to guide personalized interventions and support. This work highlights the utility of monitoring patient-reported outcomes not only before and after, but during chemotherapy to help advert adverse patient outcomes and improve treatment adherence.

Project description:Fusarium head blight (FHB) incited by Fusarium graminearum Schwabe is a devastating disease of barley and other cereal crops worldwide. Fusarium head blight is associated with trichothecene mycotoxins such as deoxynivalenol (DON), where contaminated grains are unfit for malting or animal feed industries. While genetically resistant cultivars offer the best economic and environmentally responsible means to mitigate disease, parent lines with adequate resistance are limited in barley. Resistancebreeding based upon quantitative genetic gains has been slow to date, due to intensive labour requirements of disease nurseries. The development of high throughput genome-wide molecular markers, allow application in genomic prediction models. A diverse genomic panel consisting of 400 two-row spring barley lines was assembled to focus on Canadian barley breeding programs. The panel was evaluated for FHB and DON content in three environments and over two years. Moreover, it was genotyped using an Illumina Infinium HTS iSelect custom beadchip array of single nucleotide polymorphic molecular markers (50K SNP), where over 23K molecular markers were polymorphic. Genomic prediction has been successfully demonstrated for reducing FHB and DON content in cereals using various statistically-based models of different underlying assumptions. Herein, we have studied an alternative method basedon machine learning and compare it with a statistical approach. Two encoding techniques were utilized (categorical or Hardy-Weinberg frequencies), followed by selecting essential genomic markers for phenotype prediction. Subsequently, we applied a transformer-based deep learning algorithm to predict FHB and DON. Apart from the transformer method, we also implemented a Residual Fully Connected Neural Network (RFCNN). Pearson correlation coefficients were calculated to compare true vs. predicted outputs. Under most model scenarios, the use of all markers vs. selected markers marginally improved prediction performance except for RFCNN method for FHB (27.6%). Hardy-Weinberg encoding generally improved correlation for FHB (6.9%) and DON (9.6%) for transformer. This study suggests the potential of the transformer based method for genomic prediction of complex traits such as FHB or DON, having performed better or equally compared with existing machine learning and statistical method. To genomic prediction in barley for Fusarium head blight and deoxynivalenol content using a custom Illumina Infinium array (BarleySNP50-JHI) (www.illumina.com). Sample types included leaves from 400 barley genotypes mostly of Canadian origin. This series includes 400 genotypes assayed on an Illumina infinium HTS platform 50K BeadChip.

Project description:MOTIVATION:Alternative splicing generates multiple isoforms from a single gene, greatly increasing the functional diversity of a genome. Although gene functions have been well studied, little is known about the specific functions of isoforms, making accurate prediction of isoform functions highly desirable. However, the existing approaches to predicting isoform functions are far from satisfactory due to at least two reasons: (i) unlike genes, isoform-level functional annotations are scarce. (ii) The information of isoform functions is concealed in various types of data including isoform sequences, co-expression relationship among isoforms, etc. RESULTS:In this study, we present a novel approach, DIFFUSE (Deep learning-based prediction of IsoForm FUnctions from Sequences and Expression), to predict isoform functions. To integrate various types of data, our approach adopts a hybrid framework by first using a deep neural network (DNN) to predict the functions of isoforms from their genomic sequences and then refining the prediction using a conditional random field (CRF) based on co-expression relationship. To overcome the lack of isoform-level ground truth labels, we further propose an iterative semi-supervised learning algorithm to train both the DNN and CRF together. Our extensive computational experiments demonstrate that DIFFUSE could effectively predict the functions of isoforms and genes. It achieves an average area under the receiver operating characteristics curve of 0.840 and area under the precision-recall curve of 0.581 over 4184 GO functional categories, which are significantly higher than the state-of-the-art methods. We further validate the prediction results by analyzing the correlation between functional similarity, sequence similarity, expression similarity and structural similarity, as well as the consistency between the predicted functions and some well-studied functional features of isoform sequences. AVAILABILITY AND IMPLEMENTATION:https://github.com/haochenucr/DIFFUSE. SUPPLEMENTARY INFORMATION:Supplementary data are available at Bioinformatics online.

Dataset Information

Predicting malnutrition from longitudinal patient trajectories with deep learning.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets