Application of deep neural survival networks to the development of risk prediction models for diabetes mellitus, hypertension, and dyslipidemia

Abstract

Objectives : Although numerous risk prediction models have been proposed, few such models have been developed using neural network-based survival analysis. We developed risk prediction models for three cardiovascular disease risk factors (diabetes mellitus, hypertension, and dyslipidemia) among a working-age population in Japan using DeepSurv, a deep feed-forward neural network. Methods : Data were obtained from the Japan Epidemiology Collaboration on Occupational Health Study. A total of 51 258, 44 197, and 31 452 individuals were included in the development of risk models for diabetes mellitus, hypertension, and dyslipidemia, respectively; two-thirds of whom were used to develop prediction models, and the rest were used to validate the models. We compared the performances of DeepSurv-based models with those of prediction models based on the Cox proportional hazards model. Results : The area under the receiver-operating characteristic curve was 0.878 [95% confidence interval (CI) = 0.864–0.892] for diabetes mellitus, 0.835 (95% CI = 0.826–0.845) for hypertension, and 0.826 (95% CI = 0.817–0.835) for dyslipidemia. Compared with the Cox proportional hazards-based models, the DeepSurv-based models had better reclassification performance [diabetes mellitus: net reclassification improvement (NRI) = 0.474, P ≤ 0.001; hypertension: NRI = 0.194, P ≤ 0.001; dyslipidemia: NRI = 0.397, P ≤ 0.001] and discrimination performance [diabetes mellitus: integrated discrimination improvement (IDI) = 0.013, P ≤ 0.001; hypertension: IDI = 0.007, P ≤ 0.001; and dyslipidemia: IDI = 0.043, P ≤ 0.001]. Conclusion : This study suggests that DeepSurv has the potential to improve the performance of risk prediction models for cardiovascular disease risk factors.