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      Electronic Health Record Driven Prediction for Gestational Diabetes Mellitus in Early Pregnancy

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          Abstract

          Gestational diabetes mellitus (GDM) is conventionally confirmed with oral glucose tolerance test (OGTT) in 24 to 28 weeks of gestation, but it is still uncertain whether it can be predicted with secondary use of electronic health records (EHRs) in early pregnancy. To this purpose, the cost-sensitive hybrid model (CSHM) and five conventional machine learning methods are used to construct the predictive models, capturing the future risks of GDM in the temporally aggregated EHRs. The experimental data sources from a nested case-control study cohort, containing 33,935 gestational women in West China Second Hospital. After data cleaning, 4,378 cases and 50 attributes are stored and collected for the data set. Through selecting the most feasible method, the cost parameter of CSHM is adapted to deal with imbalance of the dataset. In the experiment, 3940 samples are used for training and the rest 438 samples for testing. Although the accuracy of positive samples is barely acceptable (62.16%), the results suggest that the vast majority (98.4%) of those predicted positive instances are real positives. To our knowledge, this is the first study to apply machine learning models with EHRs to predict GDM, which will facilitate personalized medicine in maternal health management in the future.

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          Most cited references31

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          Deep Patient: An Unsupervised Representation to Predict the Future of Patients from the Electronic Health Records

          Secondary use of electronic health records (EHRs) promises to advance clinical research and better inform clinical decision making. Challenges in summarizing and representing patient data prevent widespread practice of predictive modeling using EHRs. Here we present a novel unsupervised deep feature learning method to derive a general-purpose patient representation from EHR data that facilitates clinical predictive modeling. In particular, a three-layer stack of denoising autoencoders was used to capture hierarchical regularities and dependencies in the aggregated EHRs of about 700,000 patients from the Mount Sinai data warehouse. The result is a representation we name “deep patient”. We evaluated this representation as broadly predictive of health states by assessing the probability of patients to develop various diseases. We performed evaluation using 76,214 test patients comprising 78 diseases from diverse clinical domains and temporal windows. Our results significantly outperformed those achieved using representations based on raw EHR data and alternative feature learning strategies. Prediction performance for severe diabetes, schizophrenia, and various cancers were among the top performing. These findings indicate that deep learning applied to EHRs can derive patient representations that offer improved clinical predictions, and could provide a machine learning framework for augmenting clinical decision systems.
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            Summary and recommendations of the Fourth International Workshop-Conference on Gestational Diabetes Mellitus. The Organizing Committee.

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              A machine learning-based framework to identify type 2 diabetes through electronic health records.

              To discover diverse genotype-phenotype associations affiliated with Type 2 Diabetes Mellitus (T2DM) via genome-wide association study (GWAS) and phenome-wide association study (PheWAS), more cases (T2DM subjects) and controls (subjects without T2DM) are required to be identified (e.g., via Electronic Health Records (EHR)). However, existing expert based identification algorithms often suffer in a low recall rate and could miss a large number of valuable samples under conservative filtering standards. The goal of this work is to develop a semi-automated framework based on machine learning as a pilot study to liberalize filtering criteria to improve recall rate with a keeping of low false positive rate.
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                Author and article information

                Contributors
                yhy188@gmail.com
                tomlsd@163.com
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                27 November 2017
                27 November 2017
                2017
                : 7
                : 16417
                Affiliations
                [1 ]ISNI 0000 0004 0369 4060, GRID grid.54549.39, Big Data Research Center, University of Electronic Science and Technology of China, ; Chengdu, 611731 Sichuan China
                [2 ]ISNI 0000 0004 0369 4060, GRID grid.54549.39, School of Computer Science and Engineering, University of Electronic Science and Technology of China, ; Chengdu, 611731 Sichuan China
                [3 ]ISNI 0000 0001 0381 4112, GRID grid.411587.e, School of Economics and Management, Chongqing University of Posts and Telecommunications, Chongqing, ; 400065 Chongqing, China
                [4 ]ISNI 0000 0001 2097 4281, GRID grid.29857.31, Department of Statistics, The Pennsylvania State University, ; University Park, PA 16802-2111 United States
                [5 ]ISNI 0000 0001 0807 1581, GRID grid.13291.38, Division of Obstetrics, West China Second University Hospital, Sichuan University, ; Chengdu, 610041 Sichuan China
                [6 ]ISNI 0000 0001 0807 1581, GRID grid.13291.38, Division of Information Management, West China Second University Hospital, Sichuan University, ; Chengdu, 610041 Sichuan China
                [7 ]Chengdu Shulianyikang Technology Co., Ltd, Chengdu, 610041 Sichuan China
                [8 ]ISNI 0000 0004 1790 5236, GRID grid.411307.0, School of Computer Science, Chengdu University of Information Technology, ; Chengdu, 610225 Sichuan China
                Article
                16665
                10.1038/s41598-017-16665-y
                5703904
                29180800
                6f2cc422-39b9-430f-a9bf-53f445483b96
                © The Author(s) 2017

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 12 June 2017
                : 16 November 2017
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