Assisting the implementation of screening for type 1 diabetes by using artificial intelligence on publicly available data

Abstract

The type 1 diabetes community is coalescing around the benefits and advantages of early screening for disease risk. To be accepted by healthcare providers, regulatory authorities and payers, screening programmes need to show that the testing variables allow accurate risk prediction and that individualised risk-informed monitoring plans are established, as well as operational feasibility, cost-effectiveness and acceptance at population level. Artificial intelligence (AI) has the potential to contribute to solving these issues, starting with the identification and stratification of at-risk individuals. ASSET (AI for Sustainable Prevention of Autoimmunity in the Society; www.asset.healthcare) is a public/private consortium that was established to contribute to research around screening for type 1 diabetes and particularly to how AI can drive the implementation of a precision medicine approach to disease prevention. ASSET will additionally focus on issues pertaining to operational implementation of screening. The authors of this article, researchers and clinicians active in the field of type 1 diabetes, met in an open forum to independently debate key issues around screening for type 1 diabetes and to advise ASSET. The potential use of AI in the analysis of longitudinal data from observational cohort studies to inform the design of improved, more individualised screening programmes was also discussed. A key issue was whether AI would allow the research community and industry to capitalise on large publicly available data repositories to design screening programmes that allow the early detection of individuals at high risk and enable clinical evaluation of preventive therapies. Overall, AI has the potential to revolutionise type 1 diabetes screening, in particular to help identify individuals who are at increased risk of disease and aid in the design of appropriate follow-up plans. We hope that this initiative will stimulate further research on this very timely topic. Graphical Abstract

Attitudes of Parents and Children to Screening for the Risk of Developing Type 1 Diabetes. The ABIS General Population Study

“…Recently, the question of screening has become a highly topical issue as it has been shown that Teplizumab can postpone the diagnosis of type 1 diabetes [22] and this treatment has been approved by Food and Drug Administration in USA. In several areas screening of the general population has started and new methods using big data and artifical intelligence to improve prediction has been proposed [23]. It is relevant to investigate the view of adults in the general population on screening, and also of the children themselves, not least in families without specific genetic risk of getting the disease and with no family history of type 1 diabetes and therefore most often low awareness of diabetes.…”