Jingchuan Guo

Yu Huang, Jingchuan Guo, William T Donahoo et al.

Background: Racial and ethnic minority groups and individuals facing social disadvantages, which often stem from their social determinants of health (SDoH), bear a disproportionate burden of type 2 diabetes (T2D) and its complications. It is therefore crucial to implement effective social risk management strategies at the point of care. Objective: To develop an EHR-based machine learning (ML) analytical pipeline to identify the unmet social needs associated with hospitalization risk in patients with T2D. Methods: We identified 10,192 T2D patients from the EHR data (from 2012 to 2022) from the University of Florida Health Integrated Data Repository, including contextual SDoH (e.g., neighborhood deprivation) and individual-level SDoH (e.g., housing stability). We developed an electronic health records (EHR)-based machine learning (ML) analytic pipeline, namely individualized polysocial risk score (iPsRS), to identify high social risk associated with hospitalizations in T2D patients, along with explainable AI (XAI) techniques and fairness assessment and optimization. Results: Our iPsRS achieved a C statistic of 0.72 in predicting 1-year hospitalization after fairness optimization across racial-ethnic groups. The iPsRS showed excellent utility for capturing individuals at high hospitalization risk; the actual 1-year hospitalization rate in the top 5% of iPsRS was ~13 times as high as the bottom decile. Conclusion: Our ML pipeline iPsRS can fairly and accurately screen for patients who have increased social risk leading to hospitalization in T2D patients.

Tingsong Xiao, Yao An Lee, Zelin Xu et al.

Disease progression modeling aims to characterize and predict how a patient's disease complications worsen over time based on longitudinal electronic health records (EHRs). Accurate modeling of disease progression, such as type 2 diabetes, can enhance patient sub-phenotyping and inform effective and timely interventions. However, the problem is challenging due to the need to learn continuous-time dynamics of progression patterns based on irregular-time event samples and patient heterogeneity (\eg different progression rates and pathways). Existing mechanistic and data-driven methods either lack adaptability to learn from real-world data or fail to capture complex continuous-time dynamics on progression trajectories. To address these limitations, we propose Temporally Detailed Hypergraph Neural Ordinary Differential Equation (TD-HNODE), which represents disease progression on clinically recognized trajectories as a temporally detailed hypergraph and learns the continuous-time progression dynamics via a neural ODE framework. TD-HNODE contains a learnable TD-Hypergraph Laplacian that captures the interdependency of disease complication markers within both intra- and inter-progression trajectories. Experiments on two real-world clinical datasets demonstrate that TD-HNODE outperforms multiple baselines in modeling the progression of type 2 diabetes and related cardiovascular diseases.