Comparison of Unsupervised Machine Learning Approaches for Cluster Analysis to Define Subgroups of Heart Failure with Preserved Ejection Fraction with Different Outcomes
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Bibliographic record
Abstract
Heart failure with preserved ejection (HFpEF) is a heterogenous condition affecting nearly half of all patients with heart failure (HF). Artificial intelligence methodologies can be useful to identify patient subclassifications with important clinical implications. We sought a comparison of different machine learning (ML) techniques and clustering capabilities in defining meaningful subsets of patients with HFpEF. Three unsupervised clustering strategies, hierarchical clustering, K-prototype, and partitioning around medoids (PAM), were used to identify distinct clusters in patients with HFpEF, based on a wide range of demographic, laboratory, and clinical parameters. The study population had a median age of 77 years, with a female majority, and moderate diastolic dysfunction. Hierarchical clustering produced six groups but two were too small (two and seven cases) to be clinically meaningful. The K-prototype methods produced clusters in which several clinical and biochemical features did not show statistically significant differences and there was significant overlap between the clusters. The PAM methodology provided the best group separations and identified six mutually exclusive groups (HFpEF1-6) with statistically significant differences in patient characteristics and outcomes. Comparison of three different unsupervised ML clustering strategies, hierarchical clustering, K-prototype, and partitioning around medoids (PAM), was performed on a mixed dataset of patients with HFpEF containing clinical and numerical data. The PAM method identified six distinct subsets of patients with HFpEF with different long-term outcomes or mortality. By comparison, the two other clustering algorithms, the hierarchical clustering and K-prototype, were less optimal.
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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 | 0.000 | 0.000 |
| 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 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 it