Use of artificial intelligence to estimate population health indicators in France

Abstract

Abstract Background The use of artificial intelligence is increasing to estimate and predict health outcomes from large data sets. The main objectives were to develop two algorithms using machine learning techniques to identify new cases of diabetes (case study I) and to classify type 1 and type 2 (case study II) in France. Methods We selected the training data set from a cohort study linked with French national Health database (i.e., SNDS). Two final datasets were used to achieve each objective. A supervised machine learning method including eight following steps was developed: the selection of the data set, case definition, coding and standardization of variables, split data into training and test data sets, variable selection, training, validation and selection of the model. We planned to apply the trained models on the SNDS to estimate the incidence of diabetes and the prevalence of type 1/2 diabetes. Results For the case study I, 23/3468 and for case study II, 14/3481 SNDS variables were selected based on an optimal balance between variance explained and using the ReliefExp algorithm. We trained four models using different classification algorithms on the training data set. The Linear Discriminant Analysis model performed best in both case studies. The models were assessed on the test datasets and achieved a specificity of 67% and a sensitivity of 62% in case study I, and a specificity of 97 % and sensitivity of 100% in case study II. The case study II model was applied to the SNDS and estimated the prevalence of type 1 diabetes in 2016 in France of 0.3% and for type 2, 4.4%. The case study model I was not applied to the SNDS. Conclusions The case study II model to estimate the prevalence of type 1/2 diabetes has good performance and will be used in routine surveillance. The case study I model to identify new cases of diabetes showed a poor performance due to missing necessary information on determinants of diabetes and will need to be improved for further research.