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Framingham risk score conventional risk factors are potent to predict all-cause mortality using machine learning
QianQian Huang1,2, TianShu Zeng1,2, JiaoYue Zhang1,2
1Union Hospital, Department of Endocrinology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Insights
Framingham risk score factors effectively predict all-cause mortality in adults over 40 using machine learning. These conventional risk factors show potent predictive performance, similar to models using extensive data.
Area of Science:
- Public Health
- Biostatistics
- Gerontology
Background:
- Predicting all-cause mortality is crucial for efficient public health interventions.
- The Framingham risk score (FRS) is a widely used tool for cardiovascular disease prediction.
- Machine learning (ML) offers potential for improving predictive model performance.
Purpose of the Study:
- To develop and evaluate all-cause mortality prediction models using five ML algorithms.
- To determine if conventional FRS risk factors are sufficient for predicting all-cause mortality in individuals over 40 years.
- To compare the predictive performance of models using FRS factors versus all available features.
Main Methods:
- A 10-year population-based prospective cohort study in China (2011-2021).
- Inclusion of 9143 individuals over 40 years in 2011, with 6879 followed up in 2021.
- Development of prediction models using decision trees, random forest, SVM, XGBoost, and logistic regression, with either FRS factors or 182 available features.
- Model performance evaluated using the area under the receiver operating characteristic curve (AUC).
Main Results:
- Models using FRS conventional risk factors achieved AUCs ranging from 0.75 to 0.78 across five ML algorithms.
- Models utilizing all available features (182 items) showed slightly higher AUCs, ranging from 0.78 to 0.85.
- The predictive performance of models based on FRS factors was comparable to those using a comprehensive feature set.
Conclusions:
- Conventional Framingham risk score factors are potent predictors of all-cause mortality in individuals over 40 years when analyzed with machine learning algorithms.
- The findings suggest that FRS conventional risk factors provide substantial predictive power for all-cause mortality, potentially simplifying risk assessment.
- Further research could explore the integration of additional factors to further enhance predictive accuracy.
Abstract:
Predicting all-cause mortality using available or conveniently modifiable risk factors is potentially crucial in reducing deaths precisely and efficiently. Framingham risk score (FRS) is widely used in predicting cardiovascular diseases, and its conventional risk factors are closely pertinent to deaths. Machine learning is increasingly considered to improve the predicting performances by developing predictive models. We aimed to develop the all-cause mortality predictive models using five machine learning (ML) algorithms (decision trees, random forest, support vector machine (SVM), XgBoost, and logistic regression) and determine whether FRS conventional risk factors are sufficient for predicting all-cause mortality in individuals over 40 years. Our data were obtained from a 10-year population-based prospective cohort study in China, including 9143 individuals over 40 years in 2011, and 6879 individuals followed-up in 2021. The all-cause mortality prediction models were developed using five ML algorithms by introducing all features available (182 items) or FRS conventional risk factors. The area under the receiver operating characteristic curve (AUC) was used to evaluate the performance of the predictive models. The AUC and 95% confidence interval of the all-cause mortality prediction models developed by FRS conventional risk factors using five ML algorithms were 0.75 (0.726-0.772), 0.78 (0.755-0.799), 0.75 (0.731-0.777), 0.77 (0.747-0.792), and 0.78 (0.754-0.798), respectively, which is close to the AUC values of models established by all features (0.79 (0.769-0.812), 0.83 (0.807-0.848), 0.78 (0.753-0.798), 0.82 (0.796-0.838), and 0.85 (0.826-0.866), respectively). Therefore, we tentatively put forward that FRS conventional risk factors were potent to predict all-cause mortality using machine learning algorithms in the population over 40 years.
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