2021 7th International Conference on Advanced Computing and Communication Systems (ICACCS)

Diabetes Prediction using Machine Learning

Algorithms with Feature Selection and
2021 7th International Conference on Advanced Computing and Communication Systems (ICACCS) | 978-1-6654-0521-8/20/$31.00 ©2021 IEEE | DOI: 10.1109/ICACCS51430.2021.9441935

Dimensionality Reduction
Sivaranjani S, Ananya S, Aravinth J, Karthika R
Department of Electronics and Communication Engineering
Amrita School o f Engineering, Coimbatore
Amrita Vishwa Vidyapeetham, India
siva01.11.1999@gmail.com, ananyasankar7@gmail.com,
j_aravinth@cb.amrita.edu, r_karthika@cb.amrita.edu

Abstract— In today’s world diabetes has become one o f the
most life threatening and at the same time most common diseases
not only in India but around the world. Diabetes is seen in all age
groups these days and they are attributed to lifestyle, genetic, stress
and age factor. Whatever be the reasons for diabetics, the outcome
could be severe if left unnoticed. Currently various methods are
being used to predict diabetes and diabetic inflicted diseases. In the
proposed work, we have used the Machine Learning algorithms
Support Vector Machine (SVM) & Random Forest (RF) that would
help to identify the potential chances o f getting affected by Diabetes
Related Diseases. After pre-processing the data, features which
influences the prediction are selected by implementing step forward
and backward feature selection. The Principle Component Analysis
(PCA) dimensionality reduction method is analyzed after the
selection o f specific features and the accuracy o f the prediction is
83% implementing Random Forest (RF) which is significant in
comparison with Support Vector Machine (SVM) with accuracy of
81.4%.
Keywords—PIMA dataset, pre-processing, classifier, Random
Forest (RF), Support Vector Machine (SVM), feature selection,
dimensionality reduction.
I. In t r o d u c t io n
Diabetes are classified into two types that is typel and type 2.
The primary difference between these two is that the people
who are affected by type 1 diabetes do not produce insulin.
While the people infected by type 2 diabetes do not respond
properly to insulin. They also do not make enough insulin at
the later stage. The major symptoms of those who are affected
by either typel or type2 diabetes are that they urinate
frequently, feeling hungry and thirsty frequently, feeling
fatigued and having blurry vision.
The global data of diabetic patients are on the rise year after
year. There are 382 million affected people worldwide [1].
More than 75% of the patients are Type 2 and the T2D
numbers is soaring every year which is a real cause of concern
to WHO. Lots of efforts are being put by various organizations
to stop the surge by creating awareness programs, healthcare
systems, Innovative Diagnosing methods, Improved
Medicines etc. The idea of this proposed work is to improve
the accuracy level of detecting the potential long-term damage
that a diabetic patient could encounter if the Blood Sugar not
kept under control.
There are several existing machine learning algorithms
proposed to predict the onset of diabetes. Decision tree is
basically following a tree like structure. In this, each node
denotes a test on a feature. Every single leaf node denotes a
class label and branches are conjunctions of features that lead
to class labels. It can be used for both numerical and
unambiguous data [2]. Naïve Bayes is another machine
learning algorithm which gives prediction on the basis of
probability of specific object. It assumes that a specific feature
is unrelated to any other previous features. The illness meter is
predicted correctly [3]. KNN is also known as lazy learning
algorithm. It classifies based on distance parameter. The
distance measures can be Manhattan, Euclidean and various
other calculations [4].
The collected data are processed to classify them into
categories. The objective of the classification problem is to
collect the structured and random data and classify them in to
a preferred order using Random forest and Support vector
machine algorithms. Random forest is a model that works on
multiple decision trees. It does not work on simple averaging
principles but works on two key concepts random sampling of
data and random subset of Features. This enhances the
accuracy level of the predictions. Support vector machine
(SVM) is a model for classification, regression and outlier’s
detection. SVM is unique than other classifications as it works
on margin maximation principles.
In our proposed work we discuss the two major classifiers, RF
and SVM. The classification model is implemented and the
results are examined. Feature selection and dimensionality
reduction are experimented and the results are analyzed and
the efficient methods are concluded.

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 2021 7th International Conference on Advanced Computing and Communication Systems (ICACCS)
This paper deals with four sections, which includes, section II
which deals with Related work which discusses about the
existing works, section III describes the System Design which
covers the proposed work flow and methodologies, section IV
briefs about Results and Discussion which compares different
techniques with their metric results and section V is about
Conclusion.
II. RELATED WORK
Some values in a dataset can be missing. Pre-processing of
missing values can be done by taking the mean values of the
existing values. This method is called “Imputation”.
Normalization and other pre-processors improve the efficiency
of the model. Principle Component Analysis (PCA) decreases
the dimensionalities of the features [5]. Various other pre-
processing techniques like normalization, scaling and other
combinations are analyzed. Data pre-processing is very
important in data mining and analyzing. Eliminating missing
values and transforming continuous data to finite values are
two methods of pre-processing the diabetes dataset [6]. It
increases the efficiency of timing.
More than 60% of Indians suffer from chronic diseases. The
prediction of human diseases like diabetes, cancer, asthma,
High blood pressure is done using various machine learning
techniques [7]. The data presented is the complete source of
information for the prediction of diseases. The contribution of
symptoms is of most significance. The prediction of diabetes
type I and type II are done using the symptoms like
weightless, blurred vision and fatigue.
Decision Tree (DT), SVM, RF, K-Nearest Neighbor (KNN)
and Naïve Bayes are the classification models used in [8].
Information about the diabetes status in and around and the
statistics were explained. The tree structure of the DT
algorithm explains the flow of the classification. The decision
node’s branches can be two or more. Ways to choose the best
attribute depends on the purity of the child nodes i.e. their
degree. Naïve Bayes is a probabilistic classification algorithm
which depends on the Bayes theory. SVM creates a hyper line
between data set and classifies accordingly.
RF is a both classification and regression model. It uses
bagging method to find random samples. KNN predicts the
category based on the similarity or degree of distance
measure. A modified approach is taken to select the most
appropriate feature and the performance is being evaluated
using the metrics [9] [10].
Various classifying algorithms are used and implemented in
predicting the diabetes mellitus. Classification is done in [11]
using three classifiers namely Naïve Bayes, SVM and
Decision Tree (DT) and evaluated on various measures. Naïve
Bayes was found efficient among the three with an accuracy
of 76.3 %. In this paper [12] classifies using K-nearest
neighbor (KNN), Logistic regression (LR) classifiers.
Gradient Boosting feature selection is carried out and results
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in increase of accuracy. The gradient boost scores are
analyzed across varying feature numbers.
Decision Tree, Random Forest, Neural Network classifying
algorithms are used in [13] for the model prediction and
performance metrics: sensitivity, specificity and accuracy
were analyzed. Feature selection (Principal Component
Analysis) was carried out and the results are verified using all
features, single feature like Glucose or skin thickness. In this
work [14] the comparison paper of various machine learning
classification algorithms as SVM, RF, LR, DT and KNN. The
data set was pre-processed and classified and the accuracy was
analyzed. With the results RF was proven to be more efficient
with an accuracy of 75%.
The data set used in [15] is obtained from CPCCSSN.
Gradient Boost Method (GBM), LR, RF and Rpart are the
algorithms used in the classification. Maximizing area under
the Receiver operating characteristic (ROC) curve using the
optimal hyperparameters. A 10-fold cress-validation is done to
analyze the trend in the prediction of unseen dataset. Random
Forest proves to be significant.
Support Vector Machine (SVM) classifier is used to check the
healthcare parameters like heart rate, blood pressure and
serves as a multi-parameter detector [16]. The classifier helps
in health monitoring. SVM classification algorithm is
modified and used in Software defined radio [17]. SVM
predicts the severity of Leukaemia Cancer by selecting the
most influencing features [18].
The concept of Random Forest Classifier algorithm and
feature selection for the model’s better performance is detailed
in this paper [19]. The improvement of the performance in
detection is implemented.
In the proposed work of classifying the inputs, Random Forest
(RF) classification algorithm and Support Vector Machine
(SVM) algorithm are used for the diabetes prediction and
classification [20]. Further Feature selection and
dimensionality reduction are processed and classification is
done at each different step to analyze the performance of the
model after each various modification. The performance of
each model is analyzed using metrics like accuracy, sensitivity
and specificity metrics.
III. SYSTEM DESIGN
In this section, we firstly introduce the diabetes data set and its
feature and use it as the input of the Machine Learning (ML)
model. Present the developed framework with model
architecture and implementation details. The below block
diagram of the proposed model is given in Fig.1.
The data set used in this experiment is PIMA Indian diabetes
dataset [21]. The data pre-processing is done such that the
missing values are replaced by non-zero mean values of each
parameter. Then the data set is classified using Random Forest
(RF) and Support Vector Machine (SVM) classifiers. Feature
selection is done to extract the most influencing parameters
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 2021 7th International Conference on Advanced Computing and Communication Systems (ICACCS)
and classification is done to check the improvement in
classification. Further dimensionality reduction is carried out
to minimize the dimensional space. Finally, the data is
classified using the above-mentioned classifiers.
Fig. 1. Block Diagram of the proposed model
A. Data Pre-processing
The dataset has some missing values in certain attributes,
which can cause inaccurate results in the prediction. Accuracy
of the model can also be reduced. In order to overcome that
the missing values of each attributes are treated with the
efficient mean value. Each ‘0’ value in a column is replaced
by the non-zero mean of that column except pregnancies as a
patient may not have a history.
B. Feature selection:
The main usage of feature selection in machine learning is that
the most important attributes or the best set of parameters are
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only extracted to maximize the performance of the model. The
one followed here is wrapper method. This method follows a
greedy search approach. This evaluates all the combinations of
features that are possible against the given evaluation
criterion. Here, forward feature selection and backward feature
elimination methods are used.
Forward feature selection is an iterative selection method. It
starts with the best performing variable with the target. Then
the next best performing variable is selected in combination
with the previously best selected one. This is repeated until
pre-set criterion is achieved. The pseudo code is as follows:
Step forward feature selection (n, p_values_of_n_features):
fix significance level (say SL=0.05)
for i from 1 to n
fit the model with feature i
check if it has the lowest p value
select that feature
while p_value < SL
add another feature with the same criteria with the
selected one(s)
end
Backward feature elimination is exactly opposite to the
previous method. In this method, all the variables are selected
and then the model is built. Next the variable which gives best
evaluation measured value is taken. This is repeated till the
criterion is achieved. The pseudo code is as follows:
Step backward feature elimination(n,p_values_of_n_features):
select significance level (say SL=0.05)
for i from 1 to n
fit the model with each feature i
select feature with highest p_value
while p_value > SL
remove that feature
fit the model with left out independent variables
end
C. Dimensionality reduction:
Dimensionality reduction is defined as the input parameters or
input variables of the given dataset. Generally, more input
parameters make predictive modelling task more difficult.
Hence, dimensionality reduction is nothing but reducing the
number of input variables to increase the efficiency. Principle
component analysis is the proposed method of dimensionality
reduction. It is used for the reduction of dimensionality by
decreasing the information loss and also maximizing the
interpretability. This creates uncorrelated variables that
maximize the variances effectively. The PCA method using
covariance method transforms a matrix of X dimension to a
matrix of another dimension Y where Y is a Karhunen-
Loeve transfonn (KLT) of X.
Y = KLT{X} (1)
The empirical mean value of the matrix is given by:
«/ = ^ZF=iJTy (2)
where Uj is the vector of empirical means, one mean for each
column j of the data matrix, Y;J is the data matrix, contains set
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of all data vectors, one vector from each row and n is the
number of row vectors in the data set.
The eigen vectors and eigen values of the covariance matrix is
given by the equation:
' V~1CV = D (3)
where D is the diagonal matrix of eigenvalues of C, V is
matrix containing the set of all eigenvectors of C, and C is the
covariance matrix.
D. Classification:
After processing the data using the feature selection and
dimensionality reduction methods, the model is classified and
the results are analyzed. It maps the input parameters to the
output and draws some conclusion based on the parameters
and its influence in predicting the output. As the output is
either a person is healthy or not, binary classification is
implemented. In this work, Random Forest (RF) and Support
Vector Machine (SVM) classifications are implemented in
predicting the onset of diabetes based on the input parameters.
IV. RESULTS AND DISCUSSION
The section discusses about the results obtained by
implementing the proposed model and analyzing the
efficiency. This section is divided into 4 parts: A. PIMA
dataset and pre-processing: The understanding of the dataset
and pre-processing it to increase the efficiency; B.
Performance of feature selection: Step forward and step
backward feature selection are implemented and analyzed; C.
Performance of dimensionality reduction: Principal
components analysis (PCA) method is implemented to reduce
the dimension and analyze the results; D. Overall
performance.
A. PIMA dataset and pre-processing
Pima Indian Diabetes Dataset with Class variable of
either ‘0’ or ‘1’ (binary class) is originally from the source of
Research Centre of National Institute of Diabetes and
Digestive and Kidney Diseases, RMI Group Leader Applied
Physics Laboratory The Johns Hopkins University. This
dataset is used for analysis of diabetes in various techniques
and algorithm. The dataset contains only female patients at
least 21 years old of Pima Indian heritage. As glucose level
may vary during pregnancies normally it is one of the
attributes. The total number of subjects(patients) in this data
set is 768 and we use it completely for the experiment. There
are totally 8 independent attributes or parameters and a single
class variable which says whether a patient is healthy or
diabetic. Each parameter is a numerical value with the units as
follows: no. of pregnancies in numbers, plasma glucose
concentration (2 hours in an oral glucose tolerance test) which
is dimensionless, diastolic blood pressure (mm Hg), triceps
skinfold thickness (mm), 2 hour serum insulin (mm U/ml),
Body Mass Index (BMI) in Kg/m2 and age in years. These
attributes are the independent parameters. And the outcome is
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the dependent parameter which predicts if a person is healthy
or not.
Data pre-processing as discussed place an important role in
dealing the missing values and after analyzing the results
using the metrics the efficiency of the model increases after
data pre-processing. The modified values of the missing
values are the mean value of the non-zero samples. The data
type of each parameter is been taken care of during
calculation. The mean values of glucose, blood pressure, skin
thickness, insulin, BMI, diabetes pedigree function and age are
122, 72, 29, 155, 32.46, 0.47 and 33 respectively.
The data set is classified after data pre-processing and the
results of each classifier is validated using a 5-fold cross
validation technique. Step forward feature selection and step
backward feature elimination are done to check the
performance of the both approaches. Exhaustive feature
selection is another approach but as it is suitable for large
amount if sample data it is not been evaluated in our work as
the data set has only 768 samples. Dimensionality reduction is
implemented after either one of the feature selection approach
and the significant changes are noted. The performance tables
of each method are given in Table 1 and Table 2.
The data pre-processing implementation is the first step and is
common to both step forward and step backward wrap
approaches. The data set is split into 7:3 ratio for the training
and test set respectively i.e. 70% of the data set are randomly
chosen as the training sample and the rest 30% is the testing
sample. This split is decided after various combinations which
proves to it be efficient. The test set is further divided
randomly and equally and validated for the untrained data.
The performance metrics are the accuracy of the training set,
the test accuracy and the validation accuracy. The validation
accuracy is after 5-fold cross validation of the 50% of test set.
The sensitivity of a model is called the true positive rate
(TPR) and is the proportion of samples that are actually
positive and predicted as positive. The specificity of a model
is referred to the true negative rate (TNR) i.e. the proportion of
samples that are predicted as negatives and also actually
negative.
The training accuracy and the testing accuracy of Random
Forest Classifier is more than the SVM classifier after data
pre-processing and validation accuracy for both the classifiers
are more or less equal. The sensitivity of the classifiers is 0.8
which showcases that the true positive rate is around 80% and
the specificity of the RF algorithm is 88% and of SVM is 78%
and shows that the true negative rate is significantly efficient
for RF classifier which conveys the degree of correctness.
TABLE I. PERFORMANCE OF FEATURE SELECTION
C la s s ifie r F e a tu r e T e s t A c c u ra c y in V a lid a tio n S e n s itiv ity S pecificity 7
S e le c tio n p e r c e n ta g e ( % ) A c c u ra c y ' in
p e r c e n ta g e ( % )
Step F orw ard 77.23 82.89 0.83 0 .82
R a n d o m F o re st S tep
B a ckw a rd
77.61 82.9 0.83 0 .82
S u p p o r t V e c to r
M a c h in e
Step F o rw ard 75.37 7 9.92 0.817 0.75
S tep
B a ckw a rd
7 4.62 81.41 0.8 2 0 .79
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 2021 7th International Conference on Advanced Computing and Communication Systems (ICACCS)
B. Performance o f feature selection
After data pre-processing the model selects the
features that increases the efficiency of the overall
performance with two methods, namely step forward and step
backward feature selection. Classification is carried out using
RF and SVM after each of these methods. The performances
of this implementation are discussed in this section. The
results are in Table 1. The best performing parameter of step
forward feature selection is obtained sequentially using the
efficiency score and as given a criterion, four best contributing
parameters are chosen. The four parameters are Number of
Pregnancies, Glucose, BMI and Age. In the RF classifier, the
train set and test set accuracy slightly decrease by 1% but the
feature selection method helps in reducing the complexity of
the model and the number of features or parameters
contributing are precisely reduced. The validation accuracy is
unchanged which shows that the prediction works as efficient
as before feature selection. The true positive rate increases by
a subtle amount of 0.02 and the true negative rate decreases by
0.06 but predicting positive for a negative may make the
patient more conscious, so it can be tolerable. In SVM
classifier, the train set, test set and validation accuracies
decrease by a small amount of 0.8% after the feature selection
but the sensitivity and specificity of the model proves to be of
the same rate as before the process of feature selection. It
infers that the true positives and negatives are predicted
appropriately given the reduction in the complexity of the
model by reducing the features. In step backward feature
elimination, the parameters are selected by comparing their
values measured by eliminating lowest performing feature
until the criteria of reaching four features is reached. The four
parameters selected by this approach are Glucose, BMI,
Diabetes Pedigree Function and Age. In RF classifier, the
overall performance is significantly efficient compared to the
step forward approach. The specificity in SVM remains same
compared to the others method. The changing trend in the
different set of accuracies of the model prevails same as the
step forward selection, but the efficiency proves to be more.
TABLE II. PERFORMANCE OF DIMENSIONALITY REDUCTION
C la s s ifie r D im e n sio n a lity ’ T e s t A c c u r a c y in V alidation
R e d u c tio n p e rc e n ta g e ( % ) A c c u ra c y in
R a n d o m F o re st A fte r Step 80.97%
p e rc e n ta g e (% )
F orw ard
A fte r Step 77.98% 7 9.92%
S u p p o r t V e c to r
B a c kw a rd
A fte r Step 7 6 .5 %
M a c h in e F orw ard
A fte r Step
76 .5 % 7 4.35%
B ackw ard
C. Performance o f dimensionality reduction
Dimensionality reduction by the PCA method is
implemented after the two feature selection methods
individually. Dimensionality reduction decreases the
dimensional space in computation and help in classifying
efficiently. Classification is done after reduction method using
the two classifiers. The results are in Table 2. In RF classifier,
the train set accuracy remains same and the test set accuracy
increases by 3%, but the validation accuracy reduces by 2%
percent as the sample size is a key factor in this approach. The
specificity decreases drastically by a value of 0.12 i.e. the true
negative rate but remains insignificant as mentioned above. In
SVM classifier, after dimensionality reduction, the accuracy
and the true prediction rates are declined further by 2-3% and
0.07 respectively. SVM proves to be insignificant over RF
with the step forward feature selection with the given analysis.
In step backward feature elimination, after dimensionality
reduction, the accuracies decrease and the sensitivity and
specificity show the same variations as the other approach.
Feature selection/elimination chooses the best attribute and
reduces the complexity. Dimensionality reductions is not
efficiently significant with the given data set as the sample
size is moderate.
TABLE III. COMPARISON WITH EXISTING METHODS
Algorithm Accuracy
in (°/o)
Support Vector Machine 77.73
(SVM)
Naive Bayes 76.30
Logistic Regression (RF) 77.64
Random Forest (RF) without 74.44
pre-processing
Random Forest (RF) with pre- S3
processing (Proposed Work)
D. Overall performance
Existing machine learning models and their comparison
with the proposed work in given in Table 3. Implementation of
SVM and other algorithms results in a best accuracy of
77.73% in this paper [8]. Similarly, Naïve Bayes has an
accuracy of 76.34% in [11], LR while comparing other
classifiers like KNN, DT, RF etc. is efficient with 77.64% in
[12] and among SVM, DT, RF, LR and KNN, RF was better
with 74.44% accuracy. In our proposed work, the model
selects four most contributing features and the accuracy after
step forward feature selection in RF is 83% and 80% in SVM
classifiers. The dimensionality reduction increases the test set
accuracy of the RF and SVM classifiers. The accuracy after
S e n s itiv ity S p e c ific ity
step backward feature selection for RF and SVM classifiers
7 7.69% 0.81 0.67
are 83% and 81.4%. The accuracy after dimensionality
0.85 0.69
reduction increases only in the test set of SVM model. The
7 3 .6 % 0 .817 0.75
feature selection proves to be significant and reduces the
complexity of the model. Dimensionality is not of high
0.784 0.6
significance as the dataset is not very large.
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