Subscribe to the gold package and get unlimited access to Shamra Academy
Register a new userBehavioral-clinical phenotyping with type 2 diabetes self-monitoring data
324
0
0.0
(
0
)
Added by
Matthew Levine
Publication date
2018
fields
Mathematical Statistics
and research's language is
English
Ask ChatGPT about the research
No Arabic abstract
Objective: To evaluate unsupervised clustering methods for identifying individual-level behavioral-clinical phenotypes that relate personal biomarkers and behavioral traits in type 2 diabetes (T2DM) self-monitoring data. Materials and Methods: We used hierarchical clustering (HC) to identify groups of meals with similar nutrition and glycemic impact for 6 individuals with T2DM who collected self-monitoring data. We evaluated clusters on: 1) correspondence to gold standards generated by certified diabetes educators (CDEs) for 3 participants; 2) face validity, rated by CDEs, and 3) impact on CDEs ability to identify patterns for another 3 participants. Results: Gold standard (GS) included 9 patterns across 3 participants. Of these, all 9 were re-discovered using HC: 4 GS patterns were consistent with patterns identified by HC (over 50% of meals in a cluster followed the pattern); another 5 were included as sub-groups in broader clusers. 50% (9/18) of clusters were rated over 3 on 5-point Likert scale for validity, significance, and being actionable. After reviewing clusters, CDEs identified patterns that were more consistent with data (70% reduction in contradictions between patterns and participants records). Discussion: Hierarchical clustering of blood glucose and macronutrient consumption appears suitable for discovering behavioral-clinical phenotypes in T2DM. Most clusters corresponded to gold standard and were rated positively by CDEs for face validity. Cluster visualizations helped CDEs identify more robust patterns in nutrition and glycemic impact, creating new possibilities for visual analytic solutions. Conclusion: Machine learning methods can use diabetes self-monitoring data to create personalized behavioral-clinical phenotypes, which may prove useful for delivering personalized medicine.
rate research
Read More
Diabetes is a major public health challenge worldwide. Abnormal physiology in diabetes, particularly hypoglycemia, can cause driver impairments that affect safe driving. While diabetes driver safety has been previously researched, few studies link real-time physiologic changes in drivers with diabetes to objective real-world driver safety, particularly at high-risk areas like intersections. To address this, we investigated the role of acute physiologic changes in drivers with type 1 diabetes mellitus (T1DM) on safe stopping at stop intersections. 18 T1DM drivers (21-52 years, mean = 31.2 years) and 14 controls (21-55 years, mean = 33.4 years) participated in a 4-week naturalistic driving study. At induction, each participants vehicle was fitted with a camera and sensor system to collect driving data. Video was processed with computer vision algorithms detecting traffic elements. Stop intersections were geolocated with clustering methods, state intersection databases, and manual review. Videos showing driver stop intersection approaches were extracted and manually reviewed to classify stopping behavior (full, rolling, and no stop) and intersection traffic characteristics. Mixed-effects logistic regression models determined how diabetes driver stopping safety (safe vs. unsafe stop) was affected by 1) disease and 2) at-risk, acute physiology (hypo- and hyperglycemia). Diabetes drivers who were acutely hyperglycemic had 2.37 increased odds of unsafe stopping (95% CI: 1.26-4.47, p = 0.008) compared to those with normal physiology. Acute hypoglycemia did not associate with unsafe stopping (p = 0.537), however the lower frequency of hypoglycemia (vs. hyperglycemia) warrants a larger sample of drivers to investigate this effect. Critically, presence of diabetes alone did not associate with unsafe stopping, underscoring the need to evaluate driver physiology in licensing guidelines.
Prediction of diabetes and its various complications has been studied in a number of settings, but a comprehensive overview of problem setting for diabetes prediction and care management has not been addressed in the literature. In this document we seek to remedy this omission in literature with an encompassing overview of diabetes complication prediction as well as situating this problem in the context of real world healthcare management. We illustrate various problems encountered in real world clinical scenarios via our own experience with building and deploying such models. In this manuscript we illustrate a Machine Learning (ML) framework for addressing the problem of predicting Type 2 Diabetes Mellitus (T2DM) together with a solution for risk stratification, intervention and management. These ML models align with how physicians think about disease management and mitigation, which comprises these four steps: Identify, Stratify, Engage, Measure.
Leveraging health administrative data (HAD) datasets for predicting the risk of chronic diseases including diabetes has gained a lot of attention in the machine learning community recently. In this paper, we use the largest health records datasets of patients in Ontario,Canada. Provided by the Institute of Clinical Evaluative Sciences (ICES), this database is age, gender and ethnicity-diverse. The datasets include demographics, lab measurements,drug benefits, healthcare system interactions, ambulatory and hospitalizations records. We perform one of the first large-scale machine learning studies with this data to study the task of predicting diabetes in a range of 1-10 years ahead, which requires no additional screening of individuals.In the best setup, we reach a test AUC of 80.3 with a single-model trained on an observation window of 5 years with a one-year buffer using all datasets. A subset of top 15 features alone (out of a total of 963) could provide a test AUC of 79.1. In this paper, we provide extensive machine learning model performance and feature contribution analysis, which enables us to narrow down to the most important features useful for diabetes forecasting. Examples include chronic conditions such as asthma and hypertension, lab results, diagnostic codes in insurance claims, age and geographical information.
Throughout the COVID-19 pandemic, government policy and healthcare implementation responses have been guided by reported positivity rates and counts of positive cases in the community. The selection bias of these data calls into question their validity as measures of the actual viral incidence in the community and as predictors of clinical burden. In the absence of any successful public or academic campaign for comprehensive or random testing, we have developed a proxy method for synthetic random sampling, based on viral RNA testing of patients who present for elective procedures within a hospital system. We present here an approach under multilevel regression and poststratification (MRP) to collecting and analyzing data on viral exposure among patients in a hospital system and performing statistical adjustment that has been made publicly available to estimate true viral incidence and trends in the community. We apply our MRP method to track viral behavior in a mixed urban-suburban-rural setting in Indiana. This method can be easily implemented in a wide variety of hospital settings. Finally, we provide evidence that this model predicts the clinical burden of SARS-CoV-2 earlier and more accurately than currently accepted metrics.
This work is motivated by the Obepine French system for SARS-CoV-2 viral load monitoring in wastewater. The objective of this work is to identify, from time-series of noisy measurements, the underlying auto-regressive signals, in a context where the measurements present numerous missing data, censoring and outliers. We propose a method based on an auto-regressive model adapted to censored data with outliers. Inference and prediction are produced via a discretised smoother. This method is both validated on simulations and on real data from Obepine. The proposed method is used to denoise measurements from the quantification of the SARS-CoV-2 E gene in wastewater by RT-qPCR. The resulting smoothed signal shows a good correlation with other epidemiological indicators and an estimate of the whole system noise is produced.
suggested questions
Log in to be able to interact and post comments
comments
Fetching comments
Sign in to be able to follow your search criteria
