Identifying the Leading Factors of Significant Weight Gains Using a New Rule Discovery Method

Overweight and obesity remain a major global public health concern and identifying the individualized patterns that increase the risk of future weight gains has a crucial role in preventing obesity and numerous subsequent diseases associated with obesity. In this work, we use a rule discovery method to study this problem, by presenting an approach that offers genuine interpretability and concurrently optimizes the accuracy (being correct often) and support (applying to many samples) of the identified patterns. Specifically, we extend an established subgroup-discovery method to generate the desired rules of type X → Y, and show how top features can be extracted from the X side, functioning as the best predictors of Y. In our obesity problem, X refers to the extracted features from a very large and multi-site EHR data, and Y indicates significant weight gains. Using our method, we also extensively compare the differences and inequities in patterns across 22 strata determined by the individuals’ gender, age, race, insurance type, neighborhood type, and income level. Through extensive series of experiments, we show new and complementary findings regarding the predictors of future dangerous weight gains.

[1]  Kyung-Hee Lee,et al.  Using association analysis to find diseases related to childhood obesity , 2017, 2017 Ninth International Conference on Ubiquitous and Future Networks (ICUFN).

[2]  J. Newman,et al.  Association of the metabolic syndrome with pulmonary venous hypertension. , 2009, Chest.

[3]  H. Salihu,et al.  Social Determinants of Overweight and Obesity Among Children in the United States , 2019, International journal of MCH and AIDS.

[4]  S. Raudenbush,et al.  Relationship between Urban Sprawl and Physical Activity, Obesity, and Morbidity , 2003, American journal of health promotion : AJHP.

[5]  H. Jang,et al.  Obesity Alters the Microbial Community Profile in Korean Adolescents , 2015, PloS one.

[6]  Nada Lavrac,et al.  Clinical data analysis based on iterative subgroup discovery: experiments in brain ischaemia data analysis , 2007, Applied Intelligence.

[7]  J. Shaw,et al.  Global estimates of the prevalence of diabetes for 2010 and 2030. , 2010, Diabetes research and clinical practice.

[8]  C. Dong,et al.  Relationship of obesity to depression: a family-based study , 2004, International Journal of Obesity.

[9]  T. Farley,et al.  The Association between Obesity and Urban Food Environments , 2010, Journal of Urban Health.

[10]  B. Klop,et al.  Dyslipidemia in Obesity: Mechanisms and Potential Targets , 2013, Nutrients.

[11]  Jana Schmidt,et al.  Interpreting PET scans by structured patient data: a data mining case study in dementia research , 2008, 2008 Eighth IEEE International Conference on Data Mining.

[12]  W. Strawbridge,et al.  Prospective association between obesity and depression: evidence from the Alameda County Study , 2003, International Journal of Obesity.

[13]  Theo Stijnen,et al.  Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. , 2010, Archives of general psychiatry.

[14]  Nada Lavrac,et al.  Generating Actionable Knowledge by Expert-Guided Subgroup Discovery , 2002, PKDD.

[15]  W. Dietz,et al.  Obesity and its Implications for COVID‐19 Mortality , 2020, Obesity.

[16]  Michael J. Pencina,et al.  Hyperlipidemia in Early Adulthood Increases Long-Term Risk of Coronary Heart Disease , 2015, Circulation.

[17]  G. De Pergola,et al.  Obesity as a Major Risk Factor for Cancer , 2013, Journal of obesity.

[18]  Recent origin and evolution of obesity-income correlation across the United States , 2018, Palgrave Communications.

[19]  A. Aljada,et al.  Inflammation: the link between insulin resistance, obesity and diabetes. , 2004, Trends in immunology.

[20]  J Rodin,et al.  Medical, metabolic, and psychological effects of weight cycling. , 1994, Archives of internal medicine.

[21]  Peter Clark,et al.  The CN2 Induction Algorithm , 1989, Machine Learning.

[22]  Christopher B. Forrest,et al.  Multi-Institutional Sharing of Electronic Health Record Data to Assess Childhood Obesity , 2013, PloS one.

[23]  L. Brennan,et al.  A systematic review of variables associated with the relationship between obesity and depression , 2013, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[24]  Hong Qiao,et al.  Comparing data mining methods with logistic regression in childhood obesity prediction , 2009, Inf. Syst. Frontiers.

[25]  David W. Bates,et al.  Using electronic health records to address overweight and obesity: a systematic review. , 2013, American journal of preventive medicine.

[26]  Tina Hernandez-Boussard,et al.  Advances in Electronic Phenotyping: From Rule-Based Definitions to Machine Learning Models. , 2018, Annual review of biomedical data science.

[27]  L. Thorpe,et al.  Racial and Ethnic Subgroup Disparities in Hypertension Prevalence, New York City Health and Nutrition Examination Survey, 2013–2014 , 2017, Preventing chronic disease.

[28]  R. Wing,et al.  Cluster Analysis of the National Weight Control Registry to Identify Distinct Subgroups Maintaining Successful Weight Loss , 2012, Obesity.

[29]  B. Howard,et al.  Obesity and dyslipidemia. , 2003, Endocrinology and metabolism clinics of North America.

[30]  Hosney Jahan,et al.  PRMT: Predicting Risk Factor of Obesity among Middle-Aged People Using Data Mining Techniques , 2018 .

[31]  T M Dugan,et al.  Machine Learning Techniques for Prediction of Early Childhood Obesity. , 2015, Applied clinical informatics.

[32]  E. Rapaport,et al.  Management of primary hyperlipidemia. , 1995, The New England journal of medicine.

[33]  C. Meyerhoefer,et al.  The High and Rising Costs of Obesity to the US Health Care System , 2017, Journal of General Internal Medicine.

[34]  Nada Lavrac,et al.  Learning Relational Descriptions of Differentially Expressed Gene Groups , 2008, IEEE Transactions on Systems, Man, and Cybernetics, Part C (Applications and Reviews).

[35]  K. Ferdinand,et al.  Hyperlipidemia in racial/ethnic minorities: differences in lipid profiles and the impact of statin therapy , 2009 .

[36]  Sidney H Kennedy,et al.  Real-World Data on SSRI Antidepressant Side Effects. , 2009, Psychiatry (Edgmont (Pa. : Township)).

[37]  Anita Deswal,et al.  Contributory Risk and Management of Comorbidities of Hypertension, Obesity, Diabetes Mellitus, Hyperlipidemia, and Metabolic Syndrome in Chronic Heart Failure: A Scientific Statement From the American Heart Association. , 2016, Circulation.

[38]  J. Connell,et al.  The link between abdominal obesity, metabolic syndrome and cardiovascular disease. , 2007, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[39]  Scott B. Patten,et al.  Major Depression, Antidepressant Medication and the Risk of Obesity , 2009, Psychotherapy and Psychosomatics.

[40]  Hongfang Liu,et al.  Developing a FHIR-based EHR phenotyping framework: A case study for identification of patients with obesity and multiple comorbidities from discharge summaries , 2019, J. Biomed. Informatics.

[41]  T. Kawada,et al.  Body mass index is a good predictor of hypertension and hyperlipidemia in a rural Japanese population , 2002, International Journal of Obesity.

[42]  V. Lambadiari,et al.  Obesity and COVID-19: immune and metabolic derangement as a possible link to adverse clinical outcomes , 2020, American journal of physiology. Endocrinology and metabolism.

[43]  A. Schuit,et al.  Clustering of lifestyle risk factors in a general adult population. , 2002, Preventive medicine.

[44]  W. Willett,et al.  Global obesity: trends, risk factors and policy implications , 2013, Nature Reviews Endocrinology.

[45]  P. Dannon,et al.  A Naturalistic Long-Term Comparison Study of Selective Serotonin Reuptake Inhibitors in the Treatment of Panic Disorder , 2007, Clinical neuropharmacology.

[46]  Ting Luo,et al.  Prevalence and determinants of hyperlipidemia in moderate altitude areas of the Yunnan-Kweichow plateau in Southwestern China. , 2012, High altitude medicine & biology.

[47]  P. Cuijpers,et al.  Depression and obesity: A meta-analysis of community-based studies , 2010, Psychiatry Research.

[48]  P. Sullivan,et al.  The impact of obesity on diabetes, hyperlipidemia and hypertension in the United States , 2008, Quality of Life Research.

[49]  María José del Jesús,et al.  Evolutionary fuzzy rule extraction for subgroup discovery in a psychiatric emergency department , 2011, Soft Comput..

[50]  G. Frühbeck,et al.  Beyond BMI - Phenotyping the Obesities , 2014, Obesity Facts.

[51]  A. Mokdad,et al.  Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. , 2003, JAMA.

[52]  Michael J Pencina,et al.  Application of new cholesterol guidelines to a population-based sample. , 2014, The New England journal of medicine.

[53]  Rahmatollah Beheshti,et al.  Obesity Prediction with EHR Data: A Deep Learning Approach with Interpretable Elements , 2019, ACM Trans. Comput. Heal..

[54]  C. Mantzoros,et al.  Adiponectin: a link between obesity and cancer , 2006, Expert opinion on investigational drugs.

[55]  Craig M. Hales,et al.  Prevalence of Obesity Among Adults, by Household Income and Education — United States, 2011–2014 , 2017, MMWR. Morbidity and mortality weekly report.

[56]  K. Donato,et al.  Body mass index and the prevalence of hypertension and dyslipidemia. , 2000, Obesity research.

[57]  María José del Jesús,et al.  An overview on subgroup discovery: foundations and applications , 2011, Knowledge and Information Systems.

[58]  M. Faith,et al.  Obesity-depression associations in the population. , 2002, Journal of psychosomatic research.

[59]  Ivana Vucenik,et al.  Annals of the New York Academy of Sciences Obesity and Cancer Risk: Evidence, Mechanisms, and Recommendations , 2022 .

[60]  Philip R. O. Payne,et al.  Community-level determinants of obesity: harnessing the power of electronic health records for retrospective data analysis , 2014, BMC Medical Informatics and Decision Making.

[61]  P. Cuijpers,et al.  Psychotherapy for Depression Across Different Age Groups: A Systematic Review and Meta-analysis. , 2020, JAMA psychiatry.

[62]  J. Linde,et al.  Association between obesity and depression in middle-aged women. , 2008, General hospital psychiatry.

[63]  P. Bryant,et al.  Social Determinants of Health Related to Obesity , 2015 .

[64]  R. Shelton,et al.  Gender-Specific Relationship between Obesity and Major Depression , 2017, Front. Endocrinol..

[65]  Kazuto Nakamura,et al.  Adipokines: a link between obesity and cardiovascular disease. , 2014, Journal of cardiology.

[66]  J. Ferguson SSRI Antidepressant Medications: Adverse Effects and Tolerability. , 2001, Primary care companion to the Journal of clinical psychiatry.

[67]  S V Subramanian,et al.  Who are the obese? A cluster analysis exploring subgroups of the obese. , 2016, Journal of public health.