Toward a multivariate prediction model of pharmacological treatment for women with gestational diabetes mellitus: algorithm development and validation

<p><strong>Background: </p></strong> Successful management of gestational diabetes mellitus (GDM) reduces the risk of morbidity in women and newborns. A woman’s BG readings and risk factors are used by clinical staff to make decisions regarding the initiation of pharmacologic...

Full description

Bibliographic Details
Main Authors: Velardo, C, Clifton, D, Hamblin, S, Tarassenko, L, Khan, R, Mackillop, L
Format: Internet publication
Language:English
Published: JMIR Publications 2020
_version_ 1811141204287422464
author Velardo, C
Clifton, D
Hamblin, S
Tarassenko, L
Khan, R
Mackillop, L
author_facet Velardo, C
Clifton, D
Hamblin, S
Tarassenko, L
Khan, R
Mackillop, L
author_sort Velardo, C
collection OXFORD
description <p><strong>Background: </p></strong> Successful management of gestational diabetes mellitus (GDM) reduces the risk of morbidity in women and newborns. A woman’s BG readings and risk factors are used by clinical staff to make decisions regarding the initiation of pharmacological treatment in women with GDM. Mobile-Health (mHealth) solutions allow the real-time follow-up of women with GDM and allow timely treatment and management. Machine learning offers the opportunity to quickly analyse large quantities of data to automatically flag women at risk of requiring pharmacological treatment. <p><strong> Objective: </p></strong> We sought to assess whether data collected through a mHealth system can be analysed to automatically evaluate the switch to pharmacological treatment from diet-based management of GDM. <p><strong> Methods: </p></strong> We collected data from 3,029 patients to design a machine-learning model that can identify when a woman with GDM needs to switch to medications (Insulin or Metformin) by analysing the data related to blood glucose and other risk factors. <p><strong> Results: </p></strong> Through the analysis of 411,785 blood glucose (BG) readings we have designed a machine learning model that can predict the timing of initiation of pharmacological treatment. After one hundred experimental repetitions we have obtained an average performance of 0.80 AUC and an algorithm that allows the flexibility of setting the operating point rather than relying on a static heuristic method, currently used in clinical practice. <p><strong> Conclusions: </p></strong> Using real-time data collected via a mHealth system may further improve the timeliness of intervention and potentially improve patient care. Further real-time clinical testing will enable validating our algorithm using real-world data.
first_indexed 2024-09-25T04:34:09Z
format Internet publication
id oxford-uuid:db8348cc-eaba-4cb1-9aa6-ea6bfe63dc73
institution University of Oxford
language English
last_indexed 2024-09-25T04:34:09Z
publishDate 2020
publisher JMIR Publications
record_format dspace
spelling oxford-uuid:db8348cc-eaba-4cb1-9aa6-ea6bfe63dc732024-09-11T15:30:31ZToward a multivariate prediction model of pharmacological treatment for women with gestational diabetes mellitus: algorithm development and validation Internet publicationhttp://purl.org/coar/resource_type/c_7ad9uuid:db8348cc-eaba-4cb1-9aa6-ea6bfe63dc73EnglishSymplectic ElementsJMIR Publications2020Velardo, CClifton, DHamblin, STarassenko, LKhan, RMackillop, L<p><strong>Background: </p></strong> Successful management of gestational diabetes mellitus (GDM) reduces the risk of morbidity in women and newborns. A woman’s BG readings and risk factors are used by clinical staff to make decisions regarding the initiation of pharmacological treatment in women with GDM. Mobile-Health (mHealth) solutions allow the real-time follow-up of women with GDM and allow timely treatment and management. Machine learning offers the opportunity to quickly analyse large quantities of data to automatically flag women at risk of requiring pharmacological treatment. <p><strong> Objective: </p></strong> We sought to assess whether data collected through a mHealth system can be analysed to automatically evaluate the switch to pharmacological treatment from diet-based management of GDM. <p><strong> Methods: </p></strong> We collected data from 3,029 patients to design a machine-learning model that can identify when a woman with GDM needs to switch to medications (Insulin or Metformin) by analysing the data related to blood glucose and other risk factors. <p><strong> Results: </p></strong> Through the analysis of 411,785 blood glucose (BG) readings we have designed a machine learning model that can predict the timing of initiation of pharmacological treatment. After one hundred experimental repetitions we have obtained an average performance of 0.80 AUC and an algorithm that allows the flexibility of setting the operating point rather than relying on a static heuristic method, currently used in clinical practice. <p><strong> Conclusions: </p></strong> Using real-time data collected via a mHealth system may further improve the timeliness of intervention and potentially improve patient care. Further real-time clinical testing will enable validating our algorithm using real-world data.
spellingShingle Velardo, C
Clifton, D
Hamblin, S
Tarassenko, L
Khan, R
Mackillop, L
Toward a multivariate prediction model of pharmacological treatment for women with gestational diabetes mellitus: algorithm development and validation
title Toward a multivariate prediction model of pharmacological treatment for women with gestational diabetes mellitus: algorithm development and validation
title_full Toward a multivariate prediction model of pharmacological treatment for women with gestational diabetes mellitus: algorithm development and validation
title_fullStr Toward a multivariate prediction model of pharmacological treatment for women with gestational diabetes mellitus: algorithm development and validation
title_full_unstemmed Toward a multivariate prediction model of pharmacological treatment for women with gestational diabetes mellitus: algorithm development and validation
title_short Toward a multivariate prediction model of pharmacological treatment for women with gestational diabetes mellitus: algorithm development and validation
title_sort toward a multivariate prediction model of pharmacological treatment for women with gestational diabetes mellitus algorithm development and validation
work_keys_str_mv AT velardoc towardamultivariatepredictionmodelofpharmacologicaltreatmentforwomenwithgestationaldiabetesmellitusalgorithmdevelopmentandvalidation
AT cliftond towardamultivariatepredictionmodelofpharmacologicaltreatmentforwomenwithgestationaldiabetesmellitusalgorithmdevelopmentandvalidation
AT hamblins towardamultivariatepredictionmodelofpharmacologicaltreatmentforwomenwithgestationaldiabetesmellitusalgorithmdevelopmentandvalidation
AT tarassenkol towardamultivariatepredictionmodelofpharmacologicaltreatmentforwomenwithgestationaldiabetesmellitusalgorithmdevelopmentandvalidation
AT khanr towardamultivariatepredictionmodelofpharmacologicaltreatmentforwomenwithgestationaldiabetesmellitusalgorithmdevelopmentandvalidation
AT mackillopl towardamultivariatepredictionmodelofpharmacologicaltreatmentforwomenwithgestationaldiabetesmellitusalgorithmdevelopmentandvalidation