Predicting Current Glycated Hemoglobin Levels in Adults From Electronic Health Records: Validation of Multiple Logistic Regression Algorithm
Bibliographic record
Abstract
Background Electronic health record (EHR) systems generate large datasets that can significantly enrich the development of medical predictive models. Several attempts have been made to investigate the effect of glycated hemoglobin (HbA1c) elevation on the prediction of diabetes onset. However, there is still a need for validation of these models using EHR data collected from different populations. Objective The aim of this study is to perform a replication study to validate, evaluate, and identify the strengths and weaknesses of replicating a predictive model that employed multiple logistic regression with EHR data to forecast the levels of HbA1c. The original study used data from a population in the United States and this differentiated replication used a population in Saudi Arabia. Methods A total of 3 models were developed and compared with the model created in the original study. The models were trained and tested using a larger dataset from Saudi Arabia with 36,378 records. The 10-fold cross-validation approach was used for measuring the performance of the models. Results Applying the method employed in the original study achieved an accuracy of 74% to 75% when using the dataset collected from Saudi Arabia, compared with 77% obtained from using the population from the United States. The results also show a different ranking of importance for the predictors between the original study and the replication. The order of importance for the predictors with our population, from the most to the least importance, is age, random blood sugar, estimated glomerular filtration rate, total cholesterol, non–high-density lipoprotein, and body mass index. Conclusions This replication study shows that direct use of the models (calculators) created using multiple logistic regression to predict the level of HbA1c may not be appropriate for all populations. This study reveals that the weighting of the predictors needs to be calibrated to the population used. However, the study does confirm that replicating the original study using a different population can help with predicting the levels of HbA1c by using the predictors that are routinely collected and stored in hospital EHR systems.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".