Learning from Longitudinal Data in Electronic Health Record and Genetic Data to Improve Cardiovascular Event Prediction

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作者
Juan Zhao
QiPing Feng
Patrick Wu
Roxana A. Lupu
Russell A. Wilke
Quinn S. Wells
Joshua C. Denny
Wei-Qi Wei
机构
[1] Vanderbilt University Medical Center,Department of Biomedical Informatics
[2] Vanderbilt University Medical Center,Division of Clinical Pharmacology
[3] Vanderbilt University School of Medicine,Medical Scientist Training Program
[4] University of South Dakota Sanford School of Medicine,Department of Medicine
[5] Vanderbilt University Medical Center,Department of Medicine
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Current approaches to predicting a cardiovascular disease (CVD) event rely on conventional risk factors and cross-sectional data. In this study, we applied machine learning and deep learning models to 10-year CVD event prediction by using longitudinal electronic health record (EHR) and genetic data. Our study cohort included 109, 490 individuals. In the first experiment, we extracted aggregated and longitudinal features from EHR. We applied logistic regression, random forests, gradient boosting trees, convolutional neural networks (CNN) and recurrent neural networks with long short-term memory (LSTM) units. In the second experiment, we applied a late-fusion approach to incorporate genetic features. We compared the performance with approaches currently utilized in routine clinical practice – American College of Cardiology and the American Heart Association (ACC/AHA) Pooled Cohort Risk Equation. Our results indicated that incorporating longitudinal feature lead to better event prediction. Combining genetic features through a late-fusion approach can further improve CVD prediction, underscoring the importance of integrating relevant genetic data whenever available.
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