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糖尿病患者便捷痴呆风险预测工具的开发与验证:一项大型纵向机器学习队列研究

Development and validation of a convenient dementia risk prediction tool for diabetic population: A large and longitudinal machine learning cohort study.

作者信息

Yang Pei, Xiao Xuan, Li Yihui, Cao Xu, Li Maiping, Liu Xinting, Gong Lianggeng, Liu Feng, Dai Xi-Jian

机构信息

Department of Radiology, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Minde Road No. 1, Nanchang 330006, Jiangxi Province, China; Jiangxi Provincial Key Laboratory of Intelligent Medical Imaging, Nanchang 330006, Jiangxi Province, China.

Department of Radiology, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Minde Road No. 1, Nanchang 330006, Jiangxi Province, China; Jiangxi Provincial Key Laboratory of Intelligent Medical Imaging, Nanchang 330006, Jiangxi Province, China.

出版信息

J Affect Disord. 2025 Jul 1;380:298-307. doi: 10.1016/j.jad.2025.03.135. Epub 2025 Mar 25.

DOI:10.1016/j.jad.2025.03.135
PMID:40147608
Abstract

BACKGROUND

Diabetes mellitus has been shown to increase the risk of dementia, with diabetic patients demonstrating twice the dementia incidence rate of non-diabetic populations. We aimed to develop and validate a novel machine learning-based dementia risk prediction tool specifically tailored for diabetic population.

METHODS

Using a prospective from 42,881 diabetic individuals in the UK Biobank, a rigorous multi-stage selection framework was implemented to optimize feature-outcome associations from 190 variables, and 32 predictors were final retained. Subsequently, eight data analysis strategies were used to develop and validate the dementia risk prediction model. Model performance was assessed using area under the curve (AUC) metrics.

RESULTS

During a median follow-up of 9.60 years, 1337 incident dementia cases were identified among diabetic population. The Adaboost classifier demonstrated robust performance across different predictor sets: full model with 32 predictors versus streamlined simplified model with 13 predictors selected through forward feature subset selection algorithm (AUC: 0.805 ± 0.005 vs. 0.801 ± 0.005; p = 0.200) in model development employing an 8:2 data split (5-fold cross-validation for training). To facilitate community generalization and clinical applicability, the simplified model, named DRP-Diabetes, was deployed to a visual interactive web application for individualized dementia risk assessment.

LIMITATIONS

Some variables were based on self-reported.

CONCLUSIONS

A convenient and reliable dementia risk prediction tool was developed and validated for diabetic population, which could help individuals identify their potential risk profile and provide guidance on precise and timely actions to promote dementia delay or prevention.

摘要

背景

糖尿病已被证明会增加患痴呆症的风险,糖尿病患者的痴呆症发病率是非糖尿病人群的两倍。我们旨在开发并验证一种专门为糖尿病患者量身定制的基于机器学习的新型痴呆症风险预测工具。

方法

利用英国生物银行中42881名糖尿病患者的前瞻性数据,实施了一个严格的多阶段选择框架,以优化190个变量与结果之间的关联,最终保留了32个预测因子。随后,使用八种数据分析策略来开发和验证痴呆症风险预测模型。使用曲线下面积(AUC)指标评估模型性能。

结果

在中位随访9.60年期间,在糖尿病患者中确定了1337例新发痴呆症病例。在采用8:2数据分割(5折交叉验证用于训练)的模型开发中,Adaboost分类器在不同的预测因子集上表现出强大的性能:具有32个预测因子的完整模型与通过前向特征子集选择算法选择的具有13个预测因子的简化模型(AUC:0.805±0.005对0.801±0.005;p = 0.200)。为了促进社区推广和临床应用,将简化模型DRP-Diabetes部署到一个视觉交互式网络应用程序中,用于个性化痴呆症风险评估。

局限性

一些变量基于自我报告。

结论

为糖尿病患者开发并验证了一种方便可靠的痴呆症风险预测工具,该工具可以帮助个人识别其潜在风险状况,并为促进痴呆症延迟或预防的精确及时行动提供指导。

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