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Application of machine learning approaches for osteoporosis risk prediction in postmenopausal women

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Abstract

Summary

Many predictive tools have been reported for assessing osteoporosis risk. The development and validation of osteoporosis risk prediction models were supported by machine learning.

Introduction

Osteoporosis is a silent disease until it results in fragility fractures. However, early diagnosis of osteoporosis provides an opportunity to detect and prevent fractures. We aimed to develop machine learning approaches to achieve high predictive ability for osteoporosis risk that could help primary care providers identify which women are at increased risk of osteoporosis and should therefore undergo further testing with bone densitometry.

Methods

We included all postmenopausal Korean women from the Korea National Health and Nutrition Examination Surveys (KNHANES V-1, V-2) conducted in 2010 and 2011. Machine learning models using methods such as the k-nearest neighbors (KNN), decision tree (DT), random forest (RF), gradient boosting machine (GBM), support vector machine (SVM), artificial neural networks (ANN), and logistic regression (LR) were developed to predict osteoporosis risk. We analyzed the effect of applying the machine learning algorithms to the raw data and featuring the selected data only where the statistically significant variables were included as model inputs. The accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) were used to evaluate performance among the seven models.

Results

A total of 1792 patients were included in this study, of which 613 had osteoporosis. The raw data consisted of 19 variables and achieved performances (in terms of AUROCs) of 0.712, 0.684, 0.727, 0.652, 0.724, 0.741, and 0.726 for KNN, DT, RF, GBM, SVM, ANN, and LR with fivefold cross-validation, respectively. The feature selected data consisted of nine variables and achieved performances (in terms of AUROCs) of 0.713, 0.685, 0.734, 0.728, 0.728, 0.743, and 0.727 for KNN, DT, RF, GBM, SVM, ANN, and LR with fivefold cross-validation, respectively.

Conclusion

In this study, we developed and compared seven machine learning models to accurately predict osteoporosis risk. The ANN model performed best when compared to the other models, having the highest AUROC value. Applying the ANN model in the clinical environment could help primary care providers stratify osteoporosis patients and improve the prevention, detection, and early treatment of osteoporosis.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29, Saemoonan-ro, Gonro-gu, Seoul, 03181, Republic of Korea

    Jae-Geum Shim, Dong Woo Kim, Kyoung-Ho Ryu, Eun-Ah Cho, Jin-Hee Ahn, Jeong-In Kim & Sung Hyun Lee

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  1. Jae-Geum Shim
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Correspondence to Sung Hyun Lee.

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This study was approved by the Kangbuk Samsung Hospital Institutional Review Board. The KNHANES received ethical approval from the Institutional Review Board of the Korea Centers for Disease Control and Prevention. Informed consent was obtained from all participants for inclusion in the surveys.

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Shim, JG., Kim, D.W., Ryu, KH. et al. Application of machine learning approaches for osteoporosis risk prediction in postmenopausal women. Arch Osteoporos 15, 169 (2020). https://doi.org/10.1007/s11657-020-00802-8

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