Effect of Clinical History on Predictive Model Performance for Renal Complications of Diabetes
This work addresses the early identification of diabetic nephropathy risk for patients with diabetes, but it is incremental as it applies existing methods to new data with a focus on clinical history impact.
The study developed logistic regression models to predict renal complications in diabetes patients using real-world data, achieving high performance (AUROC up to 0.98) and showing that incorporating past clinical history improves model performance by up to 4%.
Diabetes is a chronic disease characterised by a high risk of developing diabetic nephropathy, which, in turn, is the leading cause of end-stage chronic kidney disease. The early identification of individuals at heightened risk of such complications or their exacerbation can be of paramount importance to set a correct course of treatment. In the present work, from the data collected in the DARWIN-Renal (DApagliflozin Real-World evIdeNce-Renal) study, a nationwide multicentre retrospective real-world study, we develop an array of logistic regression models to predict, over different prediction horizons, the crossing of clinically relevant glomerular filtration rate (eGFR) thresholds for patients with diabetes by means of variables associated with demographic, anthropometric, laboratory, pathology, and therapeutic data. In doing so, we investigate the impact of information coming from patient's past visits on the model's predictive performance, coupled with an analysis of feature importance through the Boruta algorithm. Our models yield very good performance (AUROC as high as 0.98). We also show that the introduction of information from patient's past visits leads to improved model performance of up to 4%. The usefulness of past information is further corroborated by a feature importance analysis.