JMIR Publications

ABSTRACT

Background:

Predicting the risk of glycated hemoglobin (HbA1c) elevation can help identify patients with the potential for developing serious chronic health problems such as diabetes and cardiovascular diseases. Early preventive interventions based upon advanced predictive models using electronic health records (EHR) data for such patients can ultimately help provide better health outcomes.

Objective:

Our study investigates the performance of predictive models to forecast HbA1c elevation levels by employing machine learning approaches using data from current and previous visits in the EHR systems for patients who had not been previously diagnosed with any type of diabetes.

Methods:

This study employed one statistical model and three commonly used conventional machine learning models, as well as a deep learning model, to predict patients’ current levels of HbA1c. For the deep learning model, we also integrated current visit data with historical (longitudinal) data from previous visits. Explainable machine learning methods were used to interrogate the models and have an understanding of the reasons behind the models' decisions. All models were trained and tested using a large and naturally balanced dataset from Saudi Arabia with 18,844 unique patient records.

Results:

The machine learning models achieved the best results for predicting current HbA1c elevation risk. The deep learning model outperformed the statistical and conventional machine learning models with respect to all reported measures when employing time-series data. The best performing model was the multi-layer perceptron (MLP) which achieved an accuracy of 74.52% when used with historical data.

Conclusions:

This study shows that machine learning models can provide promising results for the task of predicting current HbA1c levels. For deep learning in particular, utilizing the patient's longitudinal time-series data improved the performance and affected the relative importance for the predictors used. The models showed robust results that were consistent with comparable studies.