An Innovative Artificial Intelligence-Based App for the Diagnosis of Gestational Diabetes Mellitus (GDM-AI): Development Study.,Journal of Medical Internet Research

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An Innovative Artificial Intelligence-Based App for the Diagnosis of Gestational Diabetes Mellitus (GDM-AI): Development Study.
Journal of Medical Internet Research ( IF 5.8 ) Pub Date : 2020-09-15 , DOI: 10.2196/21573
Jiayi Shen _{1,

2} , Jiebin Chen ₃ , Zequan Zheng ₄ , Jiabin Zheng ₄ , Zherui Liu ₃ , Jian Song ₅ , Sum Yi Wong ₄ , Xiaoling Wang ₆ , Mengqi Huang ₆ , Po-Han Fang ₄ , Bangsheng Jiang ₄ , Winghei Tsang ₁ , Zonglin He ₄ , Taoran Liu ₇ , Babatunde Akinwunmi _{8,

9} , Chi Chiu Wang ₁₀ , Casper J P Zhang ₁₁ , Jian Huang ₁₂ , Wai-Kit Ming ₁

Affiliation

Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.
Sun Yat-sen University Cancer Center, Guangzhou, China.
College of Information Science and Technology, Jinan University, Guangzhou, China.
International School, Jinan University, Guangzhou, China.
School of International Studies, Sun Yat-sen University, Guangzhou, China.
School of Journalism and Communication, Jinan University, Guangzhou, China.
Faculty of Economics and Business, University of Groningen, Groningen, Netherlands.
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, United States.
Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Harvard University, Boston, MA, United States.
Department of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong.
Multidisciplinary, Collaborative Research Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, St Mary's Campus, Imperial College London, London, United Kingdom.

Background: Gestational diabetes mellitus (GDM) can cause adverse consequences to both mothers and their newborns. However, pregnant women living in low- and middle-income areas or countries often fail to receive early clinical interventions at local medical facilities due to restricted availability of GDM diagnosis. The outstanding performance of artificial intelligence (AI) in disease diagnosis in previous studies demonstrates its promising applications in GDM diagnosis. Objective: This study aims to investigate the implementation of a well-performing AI algorithm in GDM diagnosis in a setting, which requires fewer medical equipment and staff and to establish an app based on the AI algorithm. This study also explores possible progress if our app is widely used. Methods: An AI model that included 9 algorithms was trained on 12,304 pregnant outpatients with their consent who received a test for GDM in the obstetrics and gynecology department of the First Affiliated Hospital of Jinan University, a local hospital in South China, between November 2010 and October 2017. GDM was diagnosed according to American Diabetes Association (ADA) 2011 diagnostic criteria. Age and fasting blood glucose were chosen as critical parameters. For validation, we performed k-fold cross-validation (k=5) for the internal dataset and an external validation dataset that included 1655 cases from the Prince of Wales Hospital, the affiliated teaching hospital of the Chinese University of Hong Kong, a non-local hospital. Accuracy, sensitivity, and other criteria were calculated for each algorithm. Results: The areas under the receiver operating characteristic curve (AUROC) of external validation dataset for support vector machine (SVM), random forest, AdaBoost, k-nearest neighbors (kNN), naive Bayes (NB), decision tree, logistic regression (LR), eXtreme gradient boosting (XGBoost), and gradient boosting decision tree (GBDT) were 0.780, 0.657, 0.736, 0.669, 0.774, 0.614, 0.769, 0.742, and 0.757, respectively. SVM also retained high performance in other criteria. The specificity for SVM retained 100% in the external validation set with an accuracy of 88.7%. Conclusions: Our prospective and multicenter study is the first clinical study that supports the GDM diagnosis for pregnant women in resource-limited areas, using only fasting blood glucose value, patients’ age, and a smartphone connected to the internet. Our study proved that SVM can achieve accurate diagnosis with less operation cost and higher efficacy. Our study (referred to as GDM-AI study, ie, the study of AI-based diagnosis of GDM) also shows our app has a promising future in improving the quality of maternal health for pregnant women, precision medicine, and long-distance medical care. We recommend future work should expand the dataset scope and replicate the process to validate the performance of the AI algorithms.

This is the abstract only. Read the full article on the JMIR site. JMIR is the leading open access journal for eHealth and healthcare in the Internet age.

更新日期：2020-09-15

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