Predicting misdiagnosed adult-onset type 1 diabetes using machine learning

It is now understood that almost half of newly diagnosed cases of type 1 diabetes are adult-onset. However, type 1 and type 2 diabetes are difficult to initially distinguish clinically in adults, potentially leading to ineffective care. In this study a machine learning model was developed to identif...

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Vydáno v:	Diabetes research and clinical practice Ročník 191; s. 110029
Hlavní autoři:	Cheheltani, Rabee, King, Nicholas, Lee, Suyin, North, Benjamin, Kovarik, Danny, Evans-Molina, Carmella, Leavitt, Nadejda, Dutta, Sanjoy
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Ireland Elsevier B.V 01.09.2022
Témata:	Adult Adult-onset type 1 diabetes Blood Glucose Clinical decision support tool Diabetes Mellitus, Type 1 - diagnosis Diabetes Mellitus, Type 1 - epidemiology Diabetes Mellitus, Type 2 - diagnosis Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - epidemiology Diagnostic Errors Glycated Hemoglobin Humans Machine Learning Misdiagnosis Predictive algorithm Retrospective Studies Misdiagnosis AI Clinical decision support tool Adult-onset type 1 diabetes Predictive algorithm Machine learning
ISSN:	0168-8227, 1872-8227, 1872-8227
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Abstract	It is now understood that almost half of newly diagnosed cases of type 1 diabetes are adult-onset. However, type 1 and type 2 diabetes are difficult to initially distinguish clinically in adults, potentially leading to ineffective care. In this study a machine learning model was developed to identify type 1 diabetes patients misdiagnosed as type 2 diabetes. In this retrospective study, a machine learning model was developed to identify misdiagnosed type 1 diabetes patients from a population of patients with a prior type 2 diabetes diagnosis. Using Ambulatory Electronic Medical Records (AEMR), features capturing relevant information on age, demographics, risk factors, symptoms, treatments, procedures, vitals, or lab results were extracted from patients' medical history. The model identified age, BMI/weight, therapy history, and HbA1c/blood glucose values among top predictors of misdiagnosis. Model precision at low levels of recall (10 %) was 17 %, compared to <1 % incidence rate of misdiagnosis at the time of the first type 2 diabetes encounter in AEMR. This algorithm shows potential for being translated into screening guidelines or a clinical decision support tool embedded directly in an EMR system to reduce misdiagnosis of adult-onset type 1 diabetes and implement effective care at the outset.
AbstractList	It is now understood that almost half of newly diagnosed cases of type 1 diabetes are adult-onset. However, type 1 and type 2 diabetes are difficult to initially distinguish clinically in adults, potentially leading to ineffective care. In this study a machine learning model was developed to identify type 1 diabetes patients misdiagnosed as type 2 diabetes. In this retrospective study, a machine learning model was developed to identify misdiagnosed type 1 diabetes patients from a population of patients with a prior type 2 diabetes diagnosis. Using Ambulatory Electronic Medical Records (AEMR), features capturing relevant information on age, demographics, risk factors, symptoms, treatments, procedures, vitals, or lab results were extracted from patients' medical history. The model identified age, BMI/weight, therapy history, and HbA1c/blood glucose values among top predictors of misdiagnosis. Model precision at low levels of recall (10 %) was 17 %, compared to <1 % incidence rate of misdiagnosis at the time of the first type 2 diabetes encounter in AEMR. This algorithm shows potential for being translated into screening guidelines or a clinical decision support tool embedded directly in an EMR system to reduce misdiagnosis of adult-onset type 1 diabetes and implement effective care at the outset. It is now understood that almost half of newly diagnosed cases of type 1 diabetes are adult-onset. However, type 1 and type 2 diabetes are difficult to initially distinguish clinically in adults, potentially leading to ineffective care. In this study a machine learning model was developed to identify type 1 diabetes patients misdiagnosed as type 2 diabetes.AIMSIt is now understood that almost half of newly diagnosed cases of type 1 diabetes are adult-onset. However, type 1 and type 2 diabetes are difficult to initially distinguish clinically in adults, potentially leading to ineffective care. In this study a machine learning model was developed to identify type 1 diabetes patients misdiagnosed as type 2 diabetes.In this retrospective study, a machine learning model was developed to identify misdiagnosed type 1 diabetes patients from a population of patients with a prior type 2 diabetes diagnosis. Using Ambulatory Electronic Medical Records (AEMR), features capturing relevant information on age, demographics, risk factors, symptoms, treatments, procedures, vitals, or lab results were extracted from patients' medical history.METHODSIn this retrospective study, a machine learning model was developed to identify misdiagnosed type 1 diabetes patients from a population of patients with a prior type 2 diabetes diagnosis. Using Ambulatory Electronic Medical Records (AEMR), features capturing relevant information on age, demographics, risk factors, symptoms, treatments, procedures, vitals, or lab results were extracted from patients' medical history.The model identified age, BMI/weight, therapy history, and HbA1c/blood glucose values among top predictors of misdiagnosis. Model precision at low levels of recall (10 %) was 17 %, compared to <1 % incidence rate of misdiagnosis at the time of the first type 2 diabetes encounter in AEMR.RESULTSThe model identified age, BMI/weight, therapy history, and HbA1c/blood glucose values among top predictors of misdiagnosis. Model precision at low levels of recall (10 %) was 17 %, compared to <1 % incidence rate of misdiagnosis at the time of the first type 2 diabetes encounter in AEMR.This algorithm shows potential for being translated into screening guidelines or a clinical decision support tool embedded directly in an EMR system to reduce misdiagnosis of adult-onset type 1 diabetes and implement effective care at the outset.CONCLUSIONSThis algorithm shows potential for being translated into screening guidelines or a clinical decision support tool embedded directly in an EMR system to reduce misdiagnosis of adult-onset type 1 diabetes and implement effective care at the outset.
ArticleNumber	110029
Author	Cheheltani, Rabee Kovarik, Danny Leavitt, Nadejda Dutta, Sanjoy Lee, Suyin North, Benjamin Evans-Molina, Carmella King, Nicholas
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Keywords	Misdiagnosis AI Clinical decision support tool Adult-onset type 1 diabetes Predictive algorithm Machine learning
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Snippet	It is now understood that almost half of newly diagnosed cases of type 1 diabetes are adult-onset. However, type 1 and type 2 diabetes are difficult to...
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SubjectTerms	Adult Adult-onset type 1 diabetes Blood Glucose Clinical decision support tool Diabetes Mellitus, Type 1 - diagnosis Diabetes Mellitus, Type 1 - epidemiology Diabetes Mellitus, Type 2 - diagnosis Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - epidemiology Diagnostic Errors Glycated Hemoglobin Humans Machine Learning Misdiagnosis Predictive algorithm Retrospective Studies
Title	Predicting misdiagnosed adult-onset type 1 diabetes using machine learning
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