PMID- 36216232
OWN - NLM
STAT- MEDLINE
DCOM- 20221115
LR  - 20230519
IS  - 1532-0480 (Electronic)
IS  - 1532-0464 (Linking)
VI  - 135
DP  - 2022 Nov
TI  - Longitudinal deep learning clustering of Type 2 Diabetes Mellitus trajectories 
      using routinely collected health records.
PG  - 104218
LID - S1532-0464(22)00223-4 [pii]
LID - 10.1016/j.jbi.2022.104218 [doi]
AB  - Type 2 diabetes mellitus (T2DM) is a highly heterogeneous chronic disease with 
      different pathophysiological and genetic characteristics affecting its 
      progression, associated complications and response to therapies. The advances in 
      deep learning (DL) techniques and the availability of a large amount of 
      healthcare data allow us to investigate T2DM characteristics and evolution with a 
      completely new approach, studying common disease trajectories rather than cross 
      sectional values. We used an Kernelized-AutoEncoder algorithm to map 5 years of 
      data of 11,028 subjects diagnosed with T2DM in a latent space that embedded 
      similarities and differences between patients in terms of the evolution of the 
      disease. Once we obtained the latent space, we used classical clustering 
      algorithms to create longitudinal clusters representing different evolutions of 
      the diabetic disease. Our unsupervised DL clustering algorithm suggested seven 
      different longitudinal clusters. Different mean ages were observed among the 
      clusters (ranging from 65.3+/-11.6 to 72.8+/-9.4). Subjects in clusters B 
      (Hypercholesteraemic) and E (Hypertensive) had shorter diabetes duration (9.2+/-3.9 
      and 9.5+/-3.9 years respectively). Subjects in Cluster G (Metabolic) had the 
      poorest glycaemic control (mean glycated hemoglobin 7.99+/-1.42%), while cluster E 
      had the best one (mean glycated hemoglobin 7.04+/-1.11%). Obesity was observed 
      mainly in clusters A (Neuropathic), C (Multiple Complications), F (Retinopathy) 
      and G. A dashboard is available at dm2.b2slab.upc.edu to visualize the different 
      trajectories corresponding to the 7 clusters.
CI  - Copyright (c) 2022 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Manzini, Enrico
AU  - Manzini E
AD  - Universitat Politecnica de Catalunya, Barcelona, Spain; Networking Biomedical 
      Research Centre in the subject area of Bioengineering, Biomaterials and 
      Nanomedicine, Madrid, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, 
      Spain. Electronic address: enrico.manzini@upc.edu.
FAU - Vlacho, Bogdan
AU  - Vlacho B
AD  - DAP-Cat Group, Unitat de Suport a la Recerca, Fundacio Institut Universitari per 
      a la recerca a l'Atencio Primaria de Salut Jordi Gol i Gurina (IDIAPJGol), 
      Barelona, Spain.
FAU - Franch-Nadal, Josep
AU  - Franch-Nadal J
AD  - DAP-Cat Group, Unitat de Suport a la Recerca, Fundacio Institut Universitari per 
      a la recerca a l'Atencio Primaria de Salut Jordi Gol i Gurina (IDIAPJGol), 
      Barelona, Spain; Center for Biomedical Research on Diabetes and Associated 
      Metabolic Diseases (CIBERDEM CB15/00071), Instituto de Salud Carlos III, 28029, 
      Madrid, Spain; Primary Health Care Center Raval Sud, Institut Catala de la Salut, 
      Barcelona, Spain.
FAU - Escudero, Joan
AU  - Escudero J
AD  - Grupo Pulso, Spain.
FAU - Genova, Ana
AU  - Genova A
AD  - Grupo Pulso, Spain.
FAU - Reixach, Elisenda
AU  - Reixach E
AD  - Fundacio TIC Salut Social, Departament de Salut, Generalitat de Catalunya, 
      Barcelona, Spain.
FAU - Andres, Erik
AU  - Andres E
AD  - Fundacio TIC Salut Social, Departament de Salut, Generalitat de Catalunya, 
      Barcelona, Spain.
FAU - Pizarro, Israel
AU  - Pizarro I
AD  - Novo Nordisk, Spain.
FAU - Portero, Jose-Luis
AU  - Portero JL
AD  - Novo Nordisk, Spain.
FAU - Mauricio, Didac
AU  - Mauricio D
AD  - DAP-Cat Group, Unitat de Suport a la Recerca, Fundacio Institut Universitari per 
      a la recerca a l'Atencio Primaria de Salut Jordi Gol i Gurina (IDIAPJGol), 
      Barelona, Spain; Center for Biomedical Research on Diabetes and Associated 
      Metabolic Diseases (CIBERDEM CB15/00071), Instituto de Salud Carlos III, 28029, 
      Madrid, Spain; Department of Medicine, University of Vic - Central University of 
      Catalonia, Vic, Spain. Electronic address: didacmauricio@gmail.com.
FAU - Perera-Lluna, Alexandre
AU  - Perera-Lluna A
AD  - Universitat Politecnica de Catalunya, Barcelona, Spain; Networking Biomedical 
      Research Centre in the subject area of Bioengineering, Biomaterials and 
      Nanomedicine, Madrid, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, 
      Spain.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20221008
PL  - United States
TA  - J Biomed Inform
JT  - Journal of biomedical informatics
JID - 100970413
RN  - 0 (Glycated Hemoglobin A)
SB  - IM
MH  - Humans
MH  - *Diabetes Mellitus, Type 2/epidemiology/diagnosis
MH  - Glycated Hemoglobin/analysis
MH  - Cross-Sectional Studies
MH  - *Deep Learning
MH  - Cluster Analysis
OTO - NOTNLM
OT  - AutoEncoder
OT  - Deep learning
OT  - Diabetic complications
OT  - Electronic health records
OT  - Longitudinal cluster
OT  - Type 2 diabetes
COIS- Declaration of Competing Interest The authors declare the following financial 
      interests/personal relationships which may be considered as potential competing 
      interests: Enrico Manzini reports was provided by Pulso. Enrico Manzini, 
      Alexandre Perera-Lluna reports a relationship with Spanish Ministry of Economy 
      and Competitiveness that includes: funding grants. Enrico Manzini, Alexandre 
      Perera-Lluna reports a relationship with Networking Biomedical Research Centre in 
      the subject area of Bioengineering, Biomaterials and Nanomedicine that includes: 
      funding grants. Enrico Manzini, Alexandre-Perera-Lluna reports a relationship 
      with Instituto de Investigacion Carlos III that includes: funding grants. Enrico 
      Manzini, Alexandre Perera-Lluna reports a relationship with Share4Rare project 
      that includes: funding grants. Josep Franch-Nadal, Didac Mauricio reports a 
      relationship with AstraZeneca Pharmaceuticals LP that includes: funding grants 
      and speaking and lecture fees. Josep Franch-Nadal, Didac Mauricio reports a 
      relationship with Ascensia Diabetes Care pain L that includes: speaking and 
      lecture fees. Josep Franch-Nadal, Didac Mauricio reports a relationship with 
      Boehringer Ingelheim GmbH that includes: funding grants and speaking and lecture 
      fees. Josep Franch-Nadal, Didac Mauricio reports a relationship with G K that 
      includes: funding grants and speaking and lecture fees. Josep Franch-Nadal, Didac 
      Mauricio reports a relationship with Lilly pain that includes: funding grants and 
      speaking and lecture fees. Josep Franch-Nadal, Didac Mauricio reports a 
      relationship with M D that includes: funding grants and speaking and lecture 
      fees. Josep Franch-Nadal, Didac Mauricio reports a relationship with Novartis 
      Pharmaceuticals Corporation that includes: funding grants and speaking and 
      lecture fees. Josep Franch-Nadal, Didac Mauricio reports a relationship with Novo 
      Nordisk Inc that includes: funding grants and speaking and lecture fees. Josep 
      Franch-Nadal, Didac Mauricio reports a relationship with Sanofi that includes: 
      funding grants and speaking and lecture fees.
EDAT- 2022/10/11 06:00
MHDA- 2022/11/16 06:00
CRDT- 2022/10/10 19:26
PHST- 2022/06/20 00:00 [received]
PHST- 2022/09/08 00:00 [revised]
PHST- 2022/10/03 00:00 [accepted]
PHST- 2022/10/11 06:00 [pubmed]
PHST- 2022/11/16 06:00 [medline]
PHST- 2022/10/10 19:26 [entrez]
AID - S1532-0464(22)00223-4 [pii]
AID - 10.1016/j.jbi.2022.104218 [doi]
PST - ppublish
SO  - J Biomed Inform. 2022 Nov;135:104218. doi: 10.1016/j.jbi.2022.104218. Epub 2022 
      Oct 8.