In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

Member Benefit

This content is only available year-round to ESC Professional Members, Fellows of the ESC, and Young Combined Members

Deep and machine learning models to improve risk prediction of cardiovascular disease using data extraction from electronic health records.

Session Artificial intelligence M-health

Speaker Assistant Professor Igor Korsakov

Event : ESC Congress 2019

  • Topic : e-cardiology/digital health. public health. health economics. research methodology
  • Sub-topic : Big Data and Digital Twin
  • Session type : Moderated Posters

Authors : I Korsakov (Petrozavodsk,RU), A Gusev (Petrozavodsk,RU), T Kuznetsova (Petrozavodsk,RU), D Gavrilov (Petrozavodsk,RU), R Novitskiy (Petrozavodsk,RU)

Authors:
I. Korsakov1 , A. Gusev1 , T. Kuznetsova2 , D. Gavrilov3 , R. Novitskiy1 , 1Complex Medical Information Systems Company (K-MIS) - Petrozavodsk - Russian Federation , 2Petrozavodsk State University, Medical Institute - Petrozavodsk - Russian Federation , 3Petrozavodsk Emergency Care Hospital - Petrozavodsk - Russian Federation ,

Topic(s):
Digital Health: Big Data Analysis

Citation:
European Heart Journal ( 2019 ) 40 ( Supplement ), 1213

Abstract

Background: Advances in precision medicine will require an increasingly individualized prognostic evaluation of patients in order to provide the patient with appropriate therapy. The traditional statistical methods of predictive modeling, such as SCORE, PROCAM, and Framingham, according to the European guidelines for the prevention of cardiovascular disease, not adapted for all patients and require significant human involvement in the selection of predictive variables, transformation and imputation of variables. In ROC-analysis for prediction of significant cardiovascular disease (CVD), the areas under the curve for Framingham: 0.62–0.72, for SCORE: 0.66–0.73 and for PROCAM: 0.60–0.69. To improve it, we apply for approaches to predict a CVD event rely on conventional risk factors by machine learning and deep learning models to 10-year CVD event prediction by using longitudinal electronic health record (EHR).

Methods: For machine learning, we applied logistic regression (LR) and recurrent neural networks with long short-term memory (LSTM) units as a deep learning algorithm. We extract from longitudinal EHR the following features: demographic, vital signs, diagnoses (ICD-10-cm: I21-I22.9: I61-I63.9) and medication. The problem in this step, that near 80 percent of clinical information in EHR is “unstructured” and contains errors and typos. Missing data are important for the correct training process using by deep learning & machine learning algorithm. The study cohort included patients between the ages of 21 to 75 with a dynamic observation window. In total, we got 31517 individuals in the dataset, but only 3652 individuals have all features or missing features values can be easy to impute. Among these 3652 individuals, 29.4% has a CVD, mean age 49.4 years, 68,2% female.

Evaluation: We randomly divided the dataset into a training and a test set with an 80/20 split. The LR was implemented with Python Scikit-Learn and the LSTM model was implemented with Keras using Tensorflow as the backend.

Results: We applied machine learning and deep learning models using the same features as traditional risk scale and longitudinal EHR features for CVD prediction, respectively. Machine learning model (LR) achieved an AUROC of 0.74–0.76 and deep learning (LSTM) 0.75–0.76. By using features from EHR logistic regression and deep learning models improved the AUROC to 0.78–0.79.

Conclusion: The machine learning models outperformed a traditional clinically-used predictive model for CVD risk prediction (i.e. SCORE, PROCAM, and Framingham equations). This approach was used to create a clinical decision support system (CDSS). It uses both traditional risk scales and models based on neural networks. Especially important is the fact that the system can calculate the risks of cardiovascular disease automatically and recalculate immediately after adding new information to the EHR. The results are delivered to the user's personal account.

Member Benefit

This content is only available year-round to ESC Professional Members, Fellows of the ESC, and Young Combined Members

Get your access to resources

Join now
  • 1ESC Professional Members – access all ESC Congress resources 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now
logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are