Two-year death prediction models among patients with Chagas Disease using machine learning-based methods

Chagas disease (CD) is recognized by the World Health Organization as one of the thirteen most neglected tropical diseases. More than 80% of people affected by CD will not have access to diagnosis and continued treatment, which partly supports the high morbidity and mortality rate. Machine Learning (ML) can identify patterns in data that can be used to increase our understanding of a specific problem or make predictions about the future. Thus, the aim of this study was to evaluate different models of ML to predict death in two years of patients with CD. ML models were developed using different techniques and configurations. The techniques used were: Random Forests, Adaptive Boosting, Decision Tree, Support Vector Machine, and Artificial Neural Networks. The adopted settings considered only interview variables, only complementary exam variables, and finally, both mixed. Data from a cohort study with CD patients called SaMi-Trop were analyzed. The predictor variables came from the baseline; and the outcome, which was death, came from the first follow-up. All models were evaluated in terms of Sensitivity, Specificity and G-mean. Among the 1694 individuals with CD considered, 134 (7.9%) died within two years of follow-up. Using only the predictor variables from the interview, the different techniques achieved a maximum G-mean of 0.64 in predicting death. Using only the variables from complementary exams, the G-mean was up to 0.77. In this configuration, the protagonism of NT-proBNP was evident, where it was possible to observe that an ML model using only this single variable reached G-mean of 0.76. The configuration that mixed interview variables and complementary exams achieved G-mean of 0.75. ML can be used as a useful tool with the potential to contribute to the management of patients with CD, by identifying patients with the highest probability of death.Trial Registration: This trial is registered with ClinicalTrials.gov, Trial ID: NCT02646943.Author summary: Chagas disease (CD) is a public health problem despite the partial control of its transmission. Up to 30% of infected people may have cardiac alterations, which are associated with a worse prognosis, with high mortality rates. One of the strategies that can be used to define interventions in order to reduce the impact of CD would be Machine Learning (ML). Thus, the aim of this study was to evaluate different models of ML to predict death in two years of patients with CD. We included 1,694 patients with CD, considering 21 municipalities in endemic regions in Brazil over a two-year period. Of these, 7.9% died. Our study revealed that it is possible to develop ML models which allows the development of tools to predict death within two years, among patients with CD. The different techniques ranged G-mean from 0.59 to 0.77. Thus, we observed that ML can be used as a useful tool with the potential to contribute to the management of patients with CD worldwide, by identifying patients with a higher probability of death.