Abstract

Carotid atherosclerosis (CAS) is a risk factor for cardiovascular and cerebrovascular events, but duplex ultrasonography isn’t recommended in routine screening for asymptomatic populations according to medical guidelines. We aim to develop machine learning models to screen CAS in asymptomatic adults. A total of 2732 asymptomatic subjects for routine physical examination in our hospital were included in the study. We developed machine learning models to classify subjects with or without CAS using decision tree, random forest (RF), extreme gradient boosting (XGBoost), support vector machine (SVM) and multilayer perceptron (MLP) with 17 candidate features. The performance of models was assessed on the testing dataset. The model using MLP achieved the highest accuracy (0.748), positive predictive value (0.743), F1 score (0.742), area under receiver operating characteristic curve (AUC) (0.766) and Kappa score (0.445) among all classifiers. It’s followed by models using XGBoost and SVM. In conclusion, the model using MLP is the best one to screen CAS in asymptomatic adults based on the results from routine physical examination, followed by using XGBoost and SVM. Those models may provide an effective and applicable method for physician and primary care doctors to screen asymptomatic CAS without risk factors in general population, and improve risk predictions and preventions of cardiovascular and cerebrovascular events in asymptomatic adults.

Highlights

  • Carotid atherosclerosis (CAS) is a risk factor for cardiovascular and cerebrovascular events, but duplex ultrasonography isn’t recommended in routine screening for asymptomatic populations according to medical guidelines

  • Compared with Non-CAS group, CAS group was in older age (CAS group vs Non-CAS group: 56.3 ± 7.4 vs 49.4 ± 6.8 yrs), and had higher blood pressure (systolic blood pressure (SP): 132 ± 20 vs 123 ± 18 mmHg; diastolic blood pressure (DP): 80 ± 12 vs 76 ± 12 mmHg), higher blood uric acid (UA) level (376.5 ± 96.9 vs 352.7 ± 93.8), higher homocysteine (HCY) level (13.22 ± 5.86 vs 11.70 ± 5.31 μmol/L), and worse renal function (blood urea nitrogen (BUN): 5.1 ± 1.5 vs 4.7 ± 1.2 mmol/L; serum creatinine (Scr): 81.64 ± 21.80 vs 76.81 ± 16.10 μmol/L), (Table 1)

  • We developed models using decision tree, random forest (RF), XGBoot, support vector machine (SVM) and multilayer perceptron (MLP) to classify subjects with CAS from asymptomatic adults based on data of routine physical examination

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Summary

Introduction

Carotid atherosclerosis (CAS) is a risk factor for cardiovascular and cerebrovascular events, but duplex ultrasonography isn’t recommended in routine screening for asymptomatic populations according to medical guidelines. The model using MLP is the best one to screen CAS in asymptomatic adults based on the results from routine physical examination, followed by using XGBoost and SVM. Those models may provide an effective and applicable method for physician and primary care doctors to screen asymptomatic CAS without risk factors in general population, and improve risk predictions and preventions of cardiovascular and cerebrovascular events in asymptomatic adults. We will develop models using decision tree, random forest (RF), extreme gradient boosting (XGBoost), support vector machine (SVM) and multilayer perceptron (MLP) based on the data from general population without symptoms of CAS. Those models will help to screen CAS in asymptomatic adults

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