Predicting atrial fibrillation and flutter using BEHRT and identifying multimorbidity patterns using BERTopic

Atrial fibrillation and flutter are heart rhythm disorders frequently associated with multiple other chronic conditions, complicating their management and requiring optimized care. Analyzing pre-atrial fibrillation and flutter comorbidity patterns could enable proactive, preventive, and personalized healthcare.

This population-based nested case-control study analyzed data from the Korean National Health Insurance Corporation (2002-2019). Adults aged ≥19 years with at least three years of recorded claims were included. Cases were individuals newly diagnosed with atrial fibrillation and flutter between 2007 and 2019 following a washout period (2002-2006). Controls were matched 1:4 using stratified random sampling. Using 5-year disease histories, BEHRT, a transformer-based model, predicted atrial fibrillation and flutter, while BERTopic identified sex-specific multimorbidity patterns. Predictive performance was evaluated using the area under the receiver operating characteristic curve (AUC).

BEHRT achieved an AUC of 0.80 for predicting atrial fibrillation and flutter among 600,030 participants (8,661 cases and 591,369 controls). BERTopic analysis revealed sex-specific multimorbidity patterns: aortic aneurysm, hypertensive heart disease, and chronic obstructive pulmonary disease were common in males, while Alzheimer's disease, Parkinson's disease, and rheumatic heart disease were prominent in females.

The combination of BEHRT and BERTopic demonstrated the ability to predict atrial fibrillation and flutter based on multimorbid histories while identifying distinct sex-specific disease patterns. These findings underscore the potential for artificial intelligence to enhance personalized healthcare and optimize prevention and management strategies for chronic conditions.