Application of machine learning algorithms to construct and validate a prediction model for coronary heart disease risk in patients with periodontitis: a population-based study

Abstract

BackgroundThe association between periodontitis and cardiovascular disease is increasingly recognized. In this research, a prediction model utilizing machine learning (ML) was created and verified to evaluate the likelihood of coronary heart disease in individuals affected by periodontitis.MethodsWe conducted a comprehensive analysis of data obtained from the National Health and Nutrition Examination Survey (NHANES) database, encompassing the period between 2009 and 2014.This dataset comprised detailed information on a total of 3,245 individuals who had received a confirmed diagnosis of periodontitis. Subsequently, the dataset was randomly partitioned into a training set and a validation set at a ratio of 6:4. As part of this study, we conducted weighted logistic regression analyses, both univariate and multivariate, to identify risk factors that are independent predictors for coronary heart disease in individuals who have periodontitis. Five different machine learning algorithms, namely Logistic Regression (LR), Gradient Boosting Machine (GBM), Support Vector Machine (SVM), K-Nearest Neighbor (KNN), and Classification and Regression Tree (CART), were utilized to develop the model on the training set. The evaluation of the prediction models’ performance was conducted on both the training set and validation set, utilizing metrics including AUC (Area under the receiver operating characteristic curve), Brier score, calibration plot, and decision curve analysis (DCA). Additionally, a graphical representation called a nomogram was created using logistic regression to visually depict the predictive model.ResultsThe factors that were found to independently contribute to the risk, as determined by both univariate and multivariate logistic regression analyses, encompassed age, race, presence of myocardial infarction, chest pain status, utilization of lipid-lowering medications, levels of serum uric acid and serum creatinine. Among the five evaluated machine learning models, the KNN model exhibited exceptional accuracy, achieving an AUC value of 0.977. The calibration plot and brier score illustrated the model's ability to accurately estimate probabilities. Furthermore, the model's clinical applicability was confirmed by DCA.ConclusionOur research showcases the effectiveness of machine learning algorithms in forecasting the likelihood of coronary heart disease in individuals with periodontitis, thereby aiding healthcare professionals in tailoring treatment plans and making well-informed clinical decisions.