Application of irregular and unbalanced data to predict diabetic nephropathy using visualization and feature selection methods.

OBJECTIVE: Diabetic nephropathy is damage to the kidney caused by diabetes mellitus. It is a common complication and a leading cause of death in people with diabetes. However, the decline in kidney function varies considerably between patients and the determinants of diabetic nephropathy have not been clearly identified. Therefore, it is very difficult to predict the onset of diabetic nephropathy accurately with simple statistical approaches such as t-test or chi(2)-test. To accurately predict the onset of diabetic nephropathy, we applied various machine learning techniques to irregular and unbalanced diabetes dataset, such as support vector machine (SVM) classification and feature selection methods. Visualization of the risk factors was another important objective to give physicians intuitive information on each patient's clinical pattern.

METHODS AND MATERIALS: We collected medical data from 292 patients with diabetes and performed preprocessing to extract 184 features from the irregular data. To predict the onset of diabetic nephropathy, we compared several classification methods such as logistic regression, SVM, and SVM with a cost sensitive learning method. We also applied several feature selection methods to remove redundant features and improve the classification performance. For risk factor analysis with SVM classifiers, we have developed a new visualization system which uses a nomogram approach.

RESULTS: Linear SVM classifiers combined with wrapper or embedded feature selection methods showed the best results. Among the 184 features, the classifiers selected the same 39 features and gave 0.969 of the area under the curve by receiver operating characteristics analysis. The visualization tool was able to present the effect of each feature on the decision via graphical output.

CONCLUSIONS: Our proposed method can predict the onset of diabetic nephropathy about 2-3 months before the actual diagnosis with high prediction performance from an irregular and unbalanced dataset, which statistical methods such as t-test and logistic regression could not achieve. Additionally, the visualization system provides physicians with intuitive information for risk factor analysis. Therefore, physicians can benefit from the automatic early warning of each patient and visualize risk factors, which facilitate planning of effective and proper treatment strategies.