Machine Learning Prediction Models for Chronic Kidney Disease using National Health Insurance Claim Data in Taiwan

Background and Objective: Chronic kidney disease (CKD) represent a heavy burden on the healthcare system because of the increasing number of patients, high risk of progression to end-stage renal disease, and poor prognosis of morbidity and mortality. The aim of this study is to develop a machine-learning model that uses the comorbidity and medication data, obtained from Taiwan9s National Health Insurance Research Database, to forecast whether an individual will develop CKD within the next 6 or 12 months, and thus forecast the prevalence in the population. Methods: A total of 18,000 people with CKD and 72,000 people without CKD diagnosis along with the past two years of medication and comorbidity data matched by propensity score were used to build a predicting model. A series of approaches were tested, including Convoluted Neural Networks (CNN). 5-fold cross-validation was used to assess the performance metrics of the algorithms. Results: Both for the 6 month and 12-month models, the CNN approach performed best, with the AUROC of 0.957 and 0.954, respectively. The most prominent features in the tree-based models were identified, including diabetes mellitus, age, gout, and medications such as sulfonamides, angiotensins which had an impact on the progression of CKD. Conclusions: The model proposed in this study can be a useful tool for the policy-makers helping them in predicting the trends of CKD in the population in the next 6 to 12 months. Information provided by this model can allow closely monitoring the people with risk, early detection of CKD, better allocation of resources, and patient-centric management.