Using machine learning to identify patterns of lifetime health problems in decedents with autism spectrum disorder
Using machine learning to identify patterns of lifetime health problems in decedents with autism spectrum disorder
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DOI：
10.1002/aur.1960
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发表时间：
2018-08-01
期刊：
影响因子：
4.7
通讯作者：
Mailick, Marsha R.
中科院分区：
文献类型：
--
作者：
Bishop-Fitzpatrick, Lauren;Movaghar, Arezoo;Mailick, Marsha R.
对自闭症谱系障碍(ASD)患者一生中经历的健康问题知之甚少。我们使用机器学习算法，回顾分析了与未识别的电子健康记录相关的诊断代码，以表征ASD患者和匹配的已死亡社区对照患者的诊断模式。参与者是91名自闭症患者和6186名性别和出生年份匹配的自1979年以来死亡的已故社区对照，他们中的大多数在死亡时是中年人或老年人。我们分析了电子健康记录中提供的所有ICD-9代码、V代码和E代码，以及与这些代码相关的Elixhauser共病类别。诊断模式仅根据患者的ICD-9代码、V代码和E代码将ASD患者与已死亡的社区对照区分开来，敏感度为75%，特异度为94%。患有自闭症的死者大多数情况的发生率都较高，包括心血管疾病、运动问题、耳朵问题、泌尿问题、消化问题、长期用药的副作用以及非特异性的实验室测试和遭遇。相比之下，患有ASD的死者患癌症的几率较低。研究结果表明，ASD患者的死亡患者具有独特的终生诊断模式，并强调了随着ASD患者群体的年龄增长，需要对其一生中的健康结果进行更多研究。随着20世纪90年代确诊的一大批自闭症患者进入成年和中年，有关终身健康问题的知识对护理和预防工作将变得越来越重要。自闭症报告2018，11：1120-1128。(C)2018年国际自闭症研究协会，Wiley期刊，Inc.摘要这项研究考察了终生健康问题的模式，以找出自闭症患者死亡和社区对照死亡之间的差异。在他们的电子健康记录中，自闭症患者的大多数健康问题的发生率都更高，包括心血管、泌尿、呼吸、消化和运动问题。他们的癌症发病率也较低。随着大量自闭症患者进入成年期和中年，需要更多的研究来了解这些潜在的健康风险。
Very little is known about the health problems experienced by individuals with autism spectrum disorder (ASD) throughout their life course. We retrospectively analyzed diagnostic codes associated with de-identified electronic health records using a machine learning algorithm to characterize diagnostic patterns in decedents with ASD and matched decedent community controls. Participants were 91 decedents with ASD and 6,186 sex and birth year matched decedent community controls who had died since 1979, the majority of whom were middle aged or older adults at the time of their death. We analyzed all ICD-9 codes, V-codes, and E-codes available in the electronic health record and Elixhauser comorbidity categories associated with those codes. Diagnostic patterns distinguished decedents with ASD from decedent community controls with 75% sensitivity and 94% specificity solely based on their lifetime ICD-9 codes, V-codes, and E-codes. Decedents with ASD had higher rates of most conditions, including cardiovascular disease, motor problems, ear problems, urinary problems, digestive problems, side effects from long-term medication use, and nonspecific lab tests and encounters. In contrast, decedents with ASD had lower rates of cancer. Findings suggest distinctive lifetime diagnostic patterns among decedents with ASD and highlight the need for more research on health outcomes across the lifespan as the population of individuals with ASD ages. As a large wave of individuals with ASD diagnosed in the 1990s enters adulthood and middle age, knowledge about lifetime health problems will become increasingly important for care and prevention efforts. Autism Res2018, 11: 1120-1128. (c) 2018 International Society for Autism Research, Wiley Periodicals, Inc.Lay SummaryThis study looked at patterns of lifetime health problems to find differences between people with autism who had died and community controls who had died. People with autism had higher rates of most health problems, including cardiovascular, urinary, respiratory, digestive, and motor problems, in their electronic health records. They also had lower rates of cancer. More research is needed to understand these potential health risks as a large number of individuals with autism enter adulthood and middle age.