scholarly journals External validation of a proprietary delirium superimposed on dementia risk score using claims data and predictive analytics

2020 ◽  
Vol 16 (S10) ◽  
Author(s):  
Anitha Rao ◽  
Benjamin Miller ◽  
Tanzila Kulman ◽  
Paulo Pinho ◽  
Neelum T Aggarwal
2021 ◽  
Author(s):  
Rong Hua ◽  
Jianhao Xiong ◽  
Gail Li ◽  
Yidan Zhu ◽  
Zongyuan Ge ◽  
...  

AbstractImportanceThe Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) dementia risk score is a recognized tool for dementia risk stratification. However, its application is limited due to the requirements for multidimensional information and fasting blood draw. Consequently, effective, convenient and noninvasive tool for screening individuals with high dementia risk in large population-based settings is urgently needed.ObjectiveTo develop and validate a deep learning algorithm using retinal fundus photographs for estimating the CAIDE dementia risk score and identifying individuals with high dementia risk.DesignA deep learning algorithm trained via fundus photographs was developed, validated internally and externally with cross-sectional design.SettingPopulation-based.ParticipantsA health check-up population with 271,864 adults were randomized into a development dataset (95%) and an internal validation dataset (5%). The external validation used data from the Beijing Research on Ageing and Vessel (BRAVE) with 1,512 individuals.ExposuresThe estimated CAIDE dementia risk score generated from the algorithm.Main Outcome and MeasureThe algorithm’s performance for identifying individuals with high dementia risk was evaluated by area under the receiver operating curve (AUC) with 95% confidence interval (CI).ResultsThe study involved 258,305 participants (mean aged 42.1 ± 13.4 years, men: 52.7%) in development, 13,559 (mean aged 41.2 ± 13.3 years, men: 52.5%) in internal validation, and 1,512 (mean aged 59.8 ± 7.3 years, men: 37.1%) in external validation. The adjusted coefficient of determination (R2) between the estimated and actual CAIDE dementia risk score was 0.822 in the internal and 0.300 in the external validations, respectively. The algorithm achieved an AUC of 0.931 (95%CI, 0.922–0.939) in the internal validation group and 0.782 (95%CI, 0.749–0.815) in the external group. Besides, the estimated CAIDE dementia risk score was significantly associated with both comprehensive cognitive function and specific cognitive domains.Conclusions and RelevanceThe present study demonstrated that the deep learning algorithm trained via fundus photographs could well identify individuals with high dementia risk in a population-based setting. Our findings suggest that fundus photography may be utilized as a noninvasive and more expedient method for dementia risk stratification.Key PointsQuestionCan a deep learning algorithm based on fundus images estimate the CAIDE dementia risk score and identify individuals with high dementia risk?FindingsThe algorithm developed by fundus photographs from 258,305 check-up participants could well identify individuals with high dementia risk, with area under the receiver operating characteristic curve of 0.931 in internal validation and 0.782 in external validation dataset, respectively. Besides, the estimated CAIDE dementia risk score generated from the algorithm exhibited significant association with cognitive function.MeaningThe deep learning algorithm based on fundus photographs has potential to screen individuals with high dementia risk in population-based settings.


2016 ◽  
Vol 22 ◽  
pp. 12
Author(s):  
Laura Gray ◽  
Yogini Chudasama ◽  
Alison Dunkley ◽  
Freya Tyrer ◽  
Rebecca Spong ◽  
...  

2021 ◽  
Author(s):  
Nadim Mahmud ◽  
Zachary Fricker ◽  
Sarjukumar Panchal ◽  
James D. Lewis ◽  
David S. Goldberg ◽  
...  

2021 ◽  
pp. 036354652199382
Author(s):  
Mario Hevesi ◽  
Devin P. Leland ◽  
Philip J. Rosinsky ◽  
Ajay C. Lall ◽  
Benjamin G. Domb ◽  
...  

Background: Hip arthroscopy is rapidly advancing and increasingly commonly performed. The most common surgery after arthroscopy is total hip arthroplasty (THA), which unfortunately occurs within 2 years of arthroscopy in up to 10% of patients. Predictive models for conversion to THA, such as that proposed by Redmond et al, have potentially substantial value in perioperative counseling and decreasing early arthroscopy failures; however, these models need to be externally validated to demonstrate broad applicability. Purpose: To utilize an independent, prospectively collected database to externally validate a previously published risk calculator by determining its accuracy in predicting conversion of hip arthroscopy to THA at a minimum 2-year follow-up. Study Design: Cohort study (diagnosis); Level of evidence, 1. Methods: Hip arthroscopies performed at a single center between November 2015 and March 2017 were reviewed. Patients were assessed pre- and intraoperatively for components of the THA risk score studied—namely, age, modified Harris Hip Score, lateral center-edge angle, revision procedure, femoral version, and femoral and acetabular Outerbridge scores—and followed for a minimum of 2 years. Conversion to THA was determined along with the risk score’s receiver operating characteristic (ROC) curve and Brier score calibration characteristics. Results: A total of 187 patients (43 men, 144 women, mean age, 36.0 ± 12.4 years) underwent hip arthroscopy and were followed for a mean of 2.9 ± 0.85 years (range, 2.0-5.5 years), with 13 patients (7%) converting to THA at a mean of 1.6 ± 0.9 years. Patients who converted to THA had a mean predicted arthroplasty risk of 22.6% ± 12.0%, compared with patients who remained arthroplasty-free with a predicted risk of 4.6% ± 5.3% ( P < .01). The Brier score for the calculator was 0.04 ( P = .53), which was not statistically different from ideal calibration, and the calculator demonstrated a satisfactory area under the curve of 0.894 ( P < .001). Conclusion: This external validation study supported our hypothesis in that the THA risk score described by Redmond et al was found to accurately predict which patients undergoing hip arthroscopy were at risk for converting to subsequent arthroplasty, with satisfactory discriminatory, ROC curve, and Brier score calibration characteristics. These findings are important in that they provide surgeons with validated tools to identify the patients at greatest risk for failure after hip arthroscopy and assist in perioperative counseling and decision making.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 487-487
Author(s):  
Chenkai Wu ◽  
Xurui Jin

Abstract There are several shortcomings of the currently available risk prediction models for dementia. We developed a risk prediction model for dementia using machine-learning approach and compared its performance with traditional approaches. Data were from the Health, Aging, and Body Composition Study, comprising 3,075 older adults (at least 70 years). Dementia was defined as (1) use of a prescribed dementia medication, (2) adjudicated dementia diagnosis, or (3) a race-stratified cognitive decline&gt;1.5 SDs from the baseline mean. We selected 275 predictors collected from questionnaires, imaging data, performance testing, and biospecimen. We used random survival forest (RSF) to build the full model and rank the importance of predictors. Subsequently, we built parsimonious models with top-20 predictors using RSF and Cox regression. A dementia risk score was developed using top-ranked variables. We used the C-statistic for performance evaluation. Over a median of 11.4 years of follow-up, 659 dementias (21.4%) occurred. The RSF model (both including all and top-20 variables) showed a higher C-statistic than the regression model. Digit symbol score, physical performance battery, finger tapping score, weight change since age 50, serum adiponectin, and APOE genotype were the top-6 variables. We created a dementia risk score (0-10) using the top-6 variables. A 1-unit increase in the risk score was associated with an 8% higher risk of dementia. The risk score demonstrated good discrimination (C-statistic=0.75). Machine learning methods offered improvement over traditional approaches in predicting dementia. The risk prediction score derived from a parsimonious model had good prediction performance.


2014 ◽  
Vol 10 (5) ◽  
pp. 774-779 ◽  
Author(s):  
David Arterburn ◽  
Eric S. Johnson ◽  
Melissa G. Butler ◽  
David Fisher ◽  
Elizabeth A. Bayliss

2021 ◽  
Author(s):  
Alia Dani ◽  
Justin S. Heidel ◽  
Tingting Qiu ◽  
Yin Zhang ◽  
Yizhao Ni ◽  
...  

2021 ◽  
Author(s):  
Melis Anatürk ◽  
Raihaan Patel ◽  
Georgios Georgiopoulos ◽  
Danielle Newby ◽  
Anya Topiwala ◽  
...  

INTRODUCTION: Current prognostic models of dementia have had limited success in consistently identifying at-risk individuals. We aimed to develop and validate a novel dementia risk score (DRS) using the UK Biobank cohort.METHODS: After randomly dividing the sample into a training (n=166,487, 80%) and test set (n=41,621, 20%), logistic LASSO regression and standard logistic regression were used to develop the UKB-DRS.RESULTS: The score consisted of age, sex, education, apolipoprotein E4 genotype, a history of diabetes, stroke, and depression, and a family history of dementia. The UKB-DRS had good-to-strong discrimination accuracy in the UKB hold-out sample (AUC [95%CI]=0.79 [0.77, 0.82]) and in an external dataset (Whitehall II cohort, AUC [95%CI]=0.83 [0.79,0.87]). The UKB-DRS also significantly outperformed four published risk scores (i.e., Australian National University Alzheimer’s Disease Risk Index (ANU-ADRI), Cardiovascular Risk Factors, Aging, and Dementia score (CAIDE), Dementia Risk Score (DRS), and the Framingham Cardiovascular Risk Score (FRS) across both test sets.CONCLUSION: The UKB-DRS represents a novel easy-to-use tool that could be used for routine care or targeted selection of at-risk individuals into clinical trials.


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