Quantifying predictive capability of electronic health records for the most harmful breast cancer.


Conference Paper

Improved prediction of the "most harmful" breast cancers that cause the most substantive morbidity and mortality would enable physicians to target more intense screening and preventive measures at those women who have the highest risk; however, such prediction models for the "most harmful" breast cancers have rarely been developed. Electronic health records (EHRs) represent an underused data source that has great research and clinical potential. Our goal was to quantify the value of EHR variables in the "most harmful" breast cancer risk prediction. We identified 794 subjects who had breast cancer with primary non-benign tumors with their earliest diagnosis on or after 1/1/2004 from an existing personalized medicine data repository, including 395 "most harmful" breast cancer cases and 399 "least harmful" breast cancer cases. For these subjects, we collected EHR data comprised of 6 components: demographics, diagnoses, symptoms, procedures, medications, and laboratory results. We developed two regularized prediction models, Ridge Logistic Regression (Ridge-LR) and Lasso Logistic Regression (Lasso-LR), to predict the "most harmful" breast cancer one year in advance. The area under the ROC curve (AUC) was used to assess model performance. We observed that the AUCs of Ridge-LR and Lasso-LR models were 0.818 and 0.839 respectively. For both the Ridge-LR and Lasso-LR models, the predictive performance of the whole EHR variables was significantly higher than that of each individual component (p<0.001). In conclusion, EHR variables can be used to predict the "most harmful" breast cancer, providing the possibility to personalize care for those women at the highest risk in clinical practice.

Full Text

Duke Authors

Cited Authors

  • Wu, Y; Fan, J; Peissig, P; Berg, R; Tafti, AP; Yin, J; Yuan, M; Page, D; Cox, J; Burnside, ES

Published Date

  • February 2018

Published In

Volume / Issue

  • 10577 /

PubMed ID

  • 29706685

Pubmed Central ID

  • 29706685

International Standard Serial Number (ISSN)

  • 0277-786X

Digital Object Identifier (DOI)

  • 10.1117/12.2293954

Conference Location

  • United States