MACHINE LEARNING ALGORITHMS FOR

PREDICTIVE ANALYTICS

Report
Submitted by

JEENA GEORGE

M23MEAI10

MASTER OF TECHNOLOGY

IN
Artificial Intelligence

December 2023
Contents

1 Introduction 1

2 Literature Survey 3

3 Results and Discussion 7

4 Conclusion and Future Scope 11

References 13
Chapter 1

Introduction

In today’s rapidly evolving technological landscape, the utilization of machine learning

algorithms for predictive analysis has become paramount. These sophisticated algorithms
enable organizations to sift through vast datasets, uncover patterns, and make informed
predictions about future trends. The advantages of employing machine learning in predictive
analysis are multifaceted, ranging from enhanced accuracy and efficiency to the ability
to adapt and learn from evolving data patterns. This transformative approach not only
streamlines decision-making processes but also empowers businesses to stay ahead in dynamic
and competitive environments.
In the present scenario, the application of machine learning algorithms has significantly
advanced various fields of medical research and healthcare. One noteworthy application
involves the analysis of a single-channel electrocardiogram (ECG) to detect systolic
and diastolic dysfunction of the left ventricle. Through the utilization of machine
learning methods, a novel screening method has been developed, leveraging single-channel
ECG and pulse wave recordings to enhance the identification of a decrease in left
ventricular function.Another area where machine learning proves invaluable is in the realm
of neuroendocrine neoplasms (NENs). This involves the development and validation
of a predictive model for assessing the risk of lymph node metastasis among gastric NEN
patients. By harnessing machine learning platforms, this predictive model adds a valuable
dimension to understanding and managing the complexities of NENs.Furthermore, in the
context of diabetes-related complications: , machine learning algorithms, when applied

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to administrative data, offer a proactive approach. The objective here is to predict the risk
of developing various complications associated with diabetes in the years following diagnosis,
providing a valuable tool for personalized healthcare and early intervention.Amid the ongoing
challenges posed by the COVID-19 pandemic , machine learning plays a pivotal role in
understanding and mitigating risks. A study examining biological, social, and clinical factors
in hospitalized COVID-19 patients seeks to identify common traits and comorbidities. This
knowledge is essential for reducing the consequences of the virus within the susceptible
population.Lastly, the prevalence of Major Adverse Cardiovascular Events (MACE)
in individuals with type 2 diabetes mellitus (T2DM): is a significant concern.
Through the application of machine learning, the current study aims to predict MACE
among T2DM patients, providing a valuable tool for early identification and prevention
in this at-risk population. The widespread adoption of machine learning in these diverse
medical scenarios underscores its pivotal role in advancing predictive analysis for improved
patient outcomes.
The widespread application of machine learning in medical research is evident across
various domains, from predicting cardiovascular events in diabetes to screening for cardiac
dysfunction and understanding the complexities of neuro-endocrine neoplasms. These
advancements underscore the transformative impact of machine learning in enhancing
predictive analysis for better healthcare outcomes. As we transition to the introduction, it
becomes clear that the integration of machine learning into these medical contexts not only
refines risk assessment but also heralds a new era of proactive and personalized approaches
to patient care.

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Chapter 2

Literature Survey

A lot of activity has already been accomplished in the area of medical field using different
machine learning techniques. A screening method for predicting left ventricular
dysfunction based on spectral analysis of a single-channel electrocardiogram
using machine learning algorithms: The prevalence of heart failure (HF) is very high
in the world. The number of patients with HF in the world is around 23 million with more
than 50percentage of them suffering from severe HF with a decrease in quality of life and
work capacity [1]. In the outpatient setting, reports that 16percentage have heart failure
with preserved ejection fraction (HFpEF) [2]. At the same time, the specificity of complaints
(dyspnea, edema, heart murmurs, etc.) is rather low - only 48–55percentage. HFpEF is
characterized by high morbidity and mortality and more than 50percentage of patients suffer
from it [3], with a 5- year survival rate of about 35percentage. Although, early treatment
initiation prevents rapid progression and allows better control of the disease, screening for
asymptomatic heart failure requires expensive laboratory and ultrasound diagnostics. The
use of telemedicine technologies allows better control over the course of HF. Telemedicine
monitoring of hemodynamic indicators, weight, tolerance to physical activity in HF patients
(n = 1060) at least once a month, as well as with any change in well-being as well as
training programs for patients has reduced the risk of mortality by 11percentage, all cardiac
end points by 33percentage and hospitalization by 20percentage per year. According to
researches and our data, it is possible to control left ventricular (LV) systolic function
(SF) and diastolic function (DF) using electrocardiogram (ECG) and there are studies that

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demonstrate the association of certain changes in the ECG with LV systolic dysfunction
[4]. Also, there were some published studies that examined the possibility of detecting LV
systolic dysfunction with the analysis of a 12-channel ECG.Over the past few years, Some
research studies detected LV diastolic dysfunction (DD) by means of ECG spectral analysis
based on machine learning (ML) algorithms. However, the use of ECG as a diagnostic tool for
determination of LV SF and DF is not widely accepted hence, the purpose of our work was to
create a prototype of machine learning model in order to detect LV EF below 52percentage
for male and 54percentage for female and any LV DD using ECG. ECG registration was
performed using a portable single-channel ECG monitor.A prospective, non-randomized,
observational, single-center study consequentially included 614 patients between September
2019 and November 2020.Out of 614 subjects, 39 were excluded as it was impossible to
evaluate diastolic or systolic function on echocardiography due to poor visualization (12
patients- 1.95percentage), poor quality of ECG (14 patients – 2.3percentage) recording,
rhythm disorders making ECG record irrelevant (13 patients – 2.1percentage).
Application of machine learning algorithms to predict lymph node metasta-
sis in gastric neuroendocrine neoplasms: The paragraph discusses neuroendocrine
neoplasms (NENs), their origins, and the prevalence of gastric NENs, citing an annual
incidence rate of 3.6 cases per 100,000 individuals [5]. Approximately two-thirds of NENs
occur in the gastroenteropancreatic system, with gastric NENs representing 6.9–23percent-
age. The detection rate of gastric NENs has increased due to improved methods. Gastric
NENs, divided into types 1, 2, and 3, exhibit distinct characteristics, including associations
with hypergastrinaemia. Endoscopic dissection opinions vary, with some advocating for
endoscopic resection for certain criteria, while others link larger tumor sizes to higher lymph
node metastasis risk. Gastric NEN3 with lesions ¡2 cm and no lymphovascular invasion can
now be treated with endoscopic methods [6]. To enhance therapeutic decision-making, the
study aims to construct a model predicting lymph node metastasis (LNM) risk in gastric
NENs based on clinicopathological information. The use of machine learning, inspired by
applications in oncology [7], involves six algorithms to predict LNM in gastric NEN patients.
Predicting the onset of diabetes-related complications after a diabetes
diagnosis with machine learning algorithms: The burden of diabetes ranks

4
eighth globally in disability-adjusted life years (DALYs), constituting 2.8percentage of total
DALYs, and saw a 148percentage increase from 1990 to 2019 [8]. Diabetes significantly
elevates mortality, morbidity, and disability risks, necessitating innovative approaches to
control healthcare expenditure. Individuals with diabetes face higher risks of cardiovascular
diseases, kidney failure, foot ulcers, and functional impairment. Quality of life in diabetes
is impacted by complications rather than diabetes itself, with varying quantitative effects
among complications[9]. Given the negative impact on quality of life, mortality, and economic
burden, identifying those at higher risk of diabetes progression can aid targeted prevention
programs[8]. Artificial intelligence (AI) plays a crucial role in diabetes care, offering improved
glucose monitoring, automated insulin delivery, and predictive analytics to identify high-risk
patients and provide early intervention[9]. AI also aids in early detection of complications
through medical image analysis and assists in creating personalized treatment plans based
on health data [9]. The paper aims to predict nine diabetes-related complications using four
machine learning algorithms (logistic regression, decision tree, random forest, and extreme
gradient boosting) over one, two, and three years since diabetes onset, evaluating prediction
performance and accuracy over varying time spans.
Analysis of COVID-19 cases and comorbidities using machine learning
algorithms: A case study of the Limpopo Province, South Africa: The primary
method to combat the COVID-19 pandemic is vaccination [10]. Despite extensive studies
on sociodemographic and clinical characteristics related to COVID-19, there’s limited
information on the impact of various variables on outcomes[10]. Discovered in Wuhan in
December 2019, COVID-19 quickly became a global threat, with over 7 million confirmed
cases and 404,000 fatalities by June 8, 2020 [11]. South Korea reported its first case
on January 20, 2020, with 273 fatalities and 11,814 cases by June 8, 2020. The virus
ranges from mild symptoms to severe consequences, leading to a global health crisis.
Machine learning has been utilized to predict COVID-19 outcomes. Previous studies
highlighted age, gender, comorbidities, and laboratory values as significant predictors of
severity. D-dimer levels and specific comorbidities like hypertension and diabetes also impact
outcomes. Predictive modelling assists in identifying high-risk patients and optimizing
care[12]. Machine learning classifiers, part of the broader field of artificial intelligence

5
(AI), aid in decision-making, extracting prediction models from vast datasets. This study
focuses on predicting COVID-19 mortality risk using four classification algorithms: logistic
regression, support vector machine, decision tree, and random forest. Logistic regression
describes relationships between output and predictor variables. Support vector machine
classifies data into two classes based on a hyperplane. Decision trees predict output by
recursively partitioning predictors. Gradient boosting combines decision trees, dynamically
learning from predecessors. The study aims to enhance prediction accuracy for COVID-19
mortality risk, providing valuable insights for healthcare decision-making [13].
Machine learning algorithms to predict major adverse cardiovascular events
in patients with diabetes: Major adverse cardiovascular events (MACE), including
stroke, myocardial infarction (MI), and heart failure, are a leading cause of mortality,
especially in individuals with type 2 diabetes mellitus (T2DM) [14]. Various strategies,
including non-pharmacologic interventions and statin therapy, have been employed to reduce
MACE incidence [15]. Sodium glucose cotransporter inhibitors (SGLT2 inhibitors) show
promise in improving the prognosis of DM patients with MACE [16]. Machine learning (ML)
algorithms have gained popularity in predicting MACE risk, demonstrating accuracy ranging
from 79percentage to 88percentage. However, prior studies often lacked comprehensive
coverage of MACE components and crucial features, such as phosphate and blood urea
nitrogen, particularly in patients receiving SGLT2 inhibitors. The present study aims to
address these gaps by incorporating diverse patient attributes from the All of Us (AoU)
research program to predict MACE in T2DM patients using state-of-the-art ML techniques.
Continuous monitoring of SGLT2 inhibitors’ effectiveness necessitates the identification of
patient attributes influencing MACE, making ML algorithms a valuable tool [17].
The subsequent sections will delve into additional findings and draw conclusions based
on the literatures examined above.

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Chapter 3

Results and Discussion

This section reports the analysis of the results obtained.

In the first paper , A screening method for predicting left ventricular dys-
function based on spectral analysis of a single-channel electrocardiogram using
machine learning algorithms: a comprehensive dataset was taken where out of 614
subjects, 39 were excluded as it was impossible to evaluate diastolic or systolic function
on echocardiography due to poor visualization (12 patients- 1.95percentage), poor quality
of ECG (14 patients – 2.3percentage) recording, rhythm disorders making ECG record
irrelevant (13 patients – 2.1percentage). It is very important to control hemodynamics
in heart diseases because it has been proven that this significantly reduces the risk of Heart
Failure. Machine learning greatly facilitates the diagnosis of many human disease. There
are some publications that demonstrate the possibility of using data from the analysis of
a 12-channel ECG to detect LV. Here mathematical models for LV EF below 52percentage
for male and 54percentage for female and LVDD detection with a comprehensive analysis of
the frequency and amplitude ECG parameters, recorded with single-channel ECG monitor.
Sensitivity and specificity of Lasso logistic regression and Random forest were quite high.
The results potentially will allow us to apply these mathematical methods for screening in the
outpatient setting or in non-medical institutions as well as for long-term remote monitoring
of disease.
In the second paper, Application of machine learning algorithms to predict
lymph node metastasis in gastric neuroendocrine neoplasms: Patient data

7
were obtained between 2000 and 2019 from the SEER database, which contains patient
information and cancer characteristics (http://www.seer.cancer.gov) The study focuses on
gastric neuroendocrine neoplasms (NENs) and their prognosis, particularly the role of lymph
node metastasis (LNM) in patient outcomes. LNM is critical in determining treatment
choices for intermediate tumors, emphasizing the significance of accurate risk evaluation.
While endoscopic therapies are recommended for smaller tumors, the guidelines lack detailed
risk assessment for LNM. To address this gap, the study employs six machine learning
algorithms to identify risk factors and create accurate predictive models.
Notably, the predictive model highlights size, T stage, degree of differentiation, age, and
M stage as key predictors of LNM. Tumor size emerges as a crucial factor, integrated into
the Eighth American Joint Committee on Cancer (AJCC) staging, enhancing prognostic
performance. Larger tumors correlate with increased invasion depth and a higher risk of
LNM. The T stage, representing tumor invasion depth, is independently associated with
LNM, aligning with the general pattern of increased risk with higher T stages.
The study emphasizes that endoscopic therapy may be an alternative for mucosal and
submucosal tumors but surgical intervention is preferred for deeper tumors, regardless of
size.The research identifies additional predictors of LNM, including gender and age. Male
patients and younger individuals are associated with a higher risk of LNM, which aligns
with existing studies. The age factor is explained by age-related changes in lymph node
morphology, contributing to a higher risk of metastasis in younger patients.
The study utilizes the Surveillance, Epidemiology, and End Results (SEER) registry, a
comprehensive source for cancer statistics, combined with machine learning to create effective
predictive tools for LNM in gastric NENs. Machine learning’s flexibility in analyzing various
data types and discerning patterns from large datasets proves advantageous, providing
insights beyond traditional statistical analyses. Random forest emerges as the most effective
algorithm in predicting LNM, demonstrating high accuracy.
In the third paper, Predicting the onset of diabetes-related complications after
a diabetes diagnosis with machine learning algorithms: The study delves into
gastric neuroendocrine neoplasms (NENs), placing a focal point on the pivotal role of lymph
node metastasis (LNM) in shaping patient prognosis and treatment decisions. Accurate

8
risk assessment for LNM is particularly crucial for intermediate tumors, guiding the choice
between endoscopic and surgical interventions. While guidelines recommend endoscopic
therapies for smaller tumors, there is a noted lack of detailed risk evaluation for LNM. To
fill this void, the study leverages six machine learning algorithms to pinpoint risk factors
and construct precise predictive models. The resulting model underscores the significance
of tumor size, T stage, degree of differentiation, age, and M stage as key predictors of
LNM.Tumor size emerges as a critical factor integrated into the Eighth American Joint
Committee on Cancer (AJCC) staging, bolstering prognostic performance. Larger tumors
show a correlation with increased invasion depth and a heightened risk of LNM. The T stage,
indicative of tumor invasion depth, independently associates with LNM, aligning with the
broader trend of elevated risk with higher T stages. The study underscores the potential
of endoscopic therapy as an alternative for mucosal and submucosal tumors, with surgical
intervention preferred for deeper tumors, irrespective of size.
Additionally, the research identifies gender and age as additional predictors of LNM,
with male patients and younger individuals displaying a higher risk, corroborating findings
from existing studies. Age-related changes in lymph node morphology contribute to the
elevated risk of metastasis in younger patients.The study capitalizes on the Surveillance,
Epidemiology, and End Results (SEER) registry, a comprehensive cancer statistics source,
coupled with machine learning to craft effective predictive tools for LNM in gastric NENs.
The flexibility of machine learning in analyzing diverse data types and extracting patterns
from extensive datasets proves advantageous, offering insights beyond traditional statistical
analyses. Among the machine learning algorithms employed, random forest emerges as the
most effective, showcasing high accuracy in predicting.
Analysis of COVID-19 cases and comorbidities using machine learning
algorithms: A case study of the Limpopo Province, South Africa: The study
on the analysis of COVID-19 cases and comorbidities using machine learning algorithms in
Limpopo Province, South Africa provides valuable insights into the factors that influence
mortality in hospitalized COVID-19 patients. The finding that age, ever ventilated, ever
oxygenated, intensive ward upon admission, Waterberg district, and private facility type
were among the risk factors that could be selected for the logistic regression model to

9
predict mortality is consistent with previous research on COVID-19 risk factors. However,
the study also highlights the potential of machine learning algorithms to identify complex
relationships and patterns that may not be immediately apparent through traditional
statistical methods. The use of machine learning algorithms in analyzing COVID-19 data is
a promising approach to improve our understanding of the disease and inform more effective
public health interventions and treatment strategies. Comparing the accuracy of the four
classification algorithms, random forest gave the highest accuracy measure on the model
(79percentage). While with respect in the aspect of safety of life, the decision tree was shown
to be the best method because of its highest FP value and the lowest FN value. Random
forest provided the highest AUC value of 0.87, suggesting that it has the power to distinguish
between positive and negative classes. Based on the findings of the study, we conclude that
age, ever been ventilated, ever been oxygenated, intensive ward upon admission, and private
facility and a few other variables, would affect the possibility of dying from COVID-19. The
dataset was imbalanced as patients who died from COVID-19 were far fewer than patients
who were discharged alive. For that reason, Random Over-Sampling Examples (ROSE) were
used to balance the dataset. The dataset was partitioned into two sets with 70percentage
used for the training set and 30percentage for the testing set. After fitting the model using
the training set, the testing set was used to make predictions and the results.
Machine learning algorithms to predict major adverse cardiovascular events
in patients with diabetes: It has been noted that SGLT2 inhibitors can provide
protection against MACE including stroke, HF and MI [26]. There was a paucity of
prognostic models that predict MACE in patients who receive SGLT2 inhibitors. The
present study evaluated different ML models in predicting MACE in T2DM patients and
described features that might influence MACE. The implemented models showed reasonable
performance in predicting MACE including, the RF, XGBoost and the ensemble models with
accuracy range of 0.75 and 0.86.

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Chapter 4

Conclusion and Future Scope

The study in the Journal utilized mathematical models for left ventricular ejection fraction
(LV EF) and left ventricular diastolic dysfunction (LVDD) detection, employing single-
channel ECG monitoring. High sensitivity and specificity of Lasso logistic regression and
Random Forest were achieved, suggesting potential application in outpatient screening for
individuals with LV EF below 52percentage for males and 54percentage for females.
For gastric neuroendocrine neoplasms (NENs), six machine learning algorithms were
applied to demographic characteristics, establishing predictive models for lymph node
metastasis (LNM). Independent risk factors such as T stage, tumor size, degree of
differentiation, and gender were identified. Random Forest demonstrated superior predictive
ability, indicating clinical potential for application in predicting LNM in gastric NEN
patients.
In the context of COVID-19, machine learning algorithms provided valuable insights into
the complex interactions between the virus and comorbidities. The study emphasized the
potential for informing effective public health interventions and treatment strategies. The
findings suggested that individuals aged 40 and above had a higher likelihood of COVID-
19 mortality, highlighting the importance of considering age as a critical factor in reducing
mortality rates.
In predicting major adverse cardiovascular events (MACE) in type 2 diabetes mellitus
(T2DM) patients receiving SGLT2 inhibitors, machine learning models demonstrated
acceptable performance. The inclusion of electrolytes, particularly phosphate, blood urea

11
nitrogen (BUN), calcium, and chloride, proved crucial for efficient MACE prediction. These
attributes can also be calibrated for prognostic and routine monitoring parameters, extending
their application to predict individual components of MACE.
Future research could focus on addressing the limitations of individual studies and
validating findings across diverse populations. Additionally, comparing model sensitivities
across various techniques for dealing with imbalanced datasets in COVID-19 research
would enhance methodological robustness. Furthermore, incorporating real-time monitoring
and continuous data updates into machine learning models could improve their adaptive
capabilities in predicting and managing conditions like diabetes and its complications.
Integration of advanced technologies and multi-modal data sources may further enhance the
efficiency of these predictive models, providing more personalized and effective healthcare
interventions.

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