Improvement in the Prediction of Coronary Heart Disease Risk by Using Artificial Neural Networks

BACKGROUND AND OBJECTIVES: Cardiovascular diseases, such as coronary heart disease (CHD), are the main cause of mortality and morbidity worldwide. Although CHD cannot be entirely predicted by classic risk factors, it is preventable. Therefore, predicting CHD risk is crucial to clinical cardiology research, and the development of innovative methods for predicting CHD risk is of great practical interest. The Framingham risk score (FRS) is one of the most frequently implemented risk models. However, recent advances in the field of analytics may enhance the prediction of CHD risk beyond the FRS. Here, we propose a model based on an artificial neural network (ANN) for predicting CHD risk with respect to the Framingham Heart Study (FHS) dataset. The performance of this model was compared to that of the FRS. METHODS: A sample of 3066 subjects from the FHS offspring cohort was subjected to an ANN. A multilayer perceptron ANN architecture was used and the lift, gains, receiver operating characteristic (ROC), and precision-recall predicted by the ANN were compared with those of the FRS. RESULTS: The lift and gain curves of the ANN model outperformed those of the FRS model in terms of top percentiles. The ROC curve showed that, for higher risk scores, the ANN model had higher sensitivity and higher specificity than those of the FRS model, although its area under the curve (AUC) was lower. For the precision-recall measures, the ANN generated significantly better results than the FRS with a higher AUC. CONCLUSIONS: The findings suggest that the ANN model is a promising approach for predicting CHD risk and a good screening procedure to identify high-risk subjects.