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Development and External Validation of a Deep Learning Algorithm for Prognostication of Cardiovascular Outcomes
- Title
- Development and External Validation of a Deep Learning Algorithm for Prognostication of Cardiovascular Outcomes
- Authors
- Cho, In-Jeong; Sung, Ji Min; Kim, Hyeon Chang; Lee, Sang-Eun; Chae, Myeong-Hun; Kavousi, Maryam; Rueda-Ochoa, Oscar L.; Ikram, M. Arfan; Franco, Oscar H.; Min, James K.; Chang, Hyuk-Jae
- Ewha Authors
- 조인정
- SCOPUS Author ID
- 조인정
- Issue Date
- 2020
- Journal Title
- KOREAN CIRCULATION JOURNAL
- ISSN
- 1738-5520
1738-5555
- Citation
- KOREAN CIRCULATION JOURNAL vol. 50, no. 1, pp. 72 - 84
- Keywords
- Cardiovascular diseases; Artificial intelligence
- Publisher
- KOREAN SOC CARDIOLOGY
- Indexed
- SCIE; SCOPUS; KCI
- Document Type
- Article
- Abstract
- Background and Objectives: We aim to explore the additional discriminative accuracy of a deep learning (DL) algorithm using repeated-measures data for identifying people at high risk for cardiovascular disease (CVD), compared to Cox hazard regression. Methods: Two CVD prediction models were developed from National Health Insurance Service-Health Screening Cohort (NHIS-HEALS): a Cox regression model and a DL model. Performance of each model was assessed in the internal and 2 external validation cohorts in Koreans (National Health Insurance Service-National Sample Cohort; NHIS-NSC) and in Europeans (Rotterdam Study). A total of 412,030 adults in the NHIS-HEALS; 178,875 adults in the NHIS-NSC; and the 4,296 adults in Rotterdam Study were included. Results: Mean ages was 52 years (46% women) and there were 25,777 events (6.3%) in NHIS-HEALS during the follow-up. In internal validation, the DL approach demonstrated a C-statistic of 0.896 (95% confidence interval, 0.886-0.907) in men and 0.921 (0.908-0.934) in women and improved reclassification compared with Cox regression (net reclassification index [NM], 24.8% in men, 29.0% in women). In external validation with NHIS-NSC, DL demonstrated a C-statistic of 0.868 (0.860-0.876) in men and 0.889 (0.876-0.898) in women, and improved reclassification compared with Cox regression (NRI, 24.9% in men, 26.2% in women). In external validation applied to the Rotterdam Study, DL demonstrated a C-statistic of 0.860 (0.824-0.897) in men and 0.867 (0.830-0.903) in women, and improved reclassification compared with Cox regression (NRI, 36.9% in men, 31.8% in women). Conclusions: A DL algorithm exhibited greater discriminative accuracy than Cox model approaches.
- DOI
- 10.4070/kcj.2019.0105
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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