Tailoring Adverse Event Prediction in Type 1 Diabetes with Patient-Specific Deep Learning Models

Effective management of Type 1 Diabetes requires continuous glucose monitoring and precise insulin adjustments to prevent hyperglycemia and hypoglycemia. With the growing adoption of wearable glucose monitors and mobile health applications, accurate blood glucose prediction is essential for enhancing automated insulin delivery and decision-support systems. This paper presents a deep learning-based approach for personalized blood glucose prediction, leveraging patient-specific data to improve prediction accuracy and responsiveness in real-world scenarios. Unlike traditional generalized models, our method accounts for individual variability, enabling more effective subject-specific predictions. We compare Leave-One-Subject-Out Cross-Validation with a fine-tuning strategy to evaluate their ability to model patient-specific dynamics. Results show that personalized models significantly improve the prediction of adverse events, enabling more precise and timely interventions in real-world scenarios. To assess the impact of patient-specific data, we conduct experiments comparing a multimodal, patient-specific approach against traditional CGM-only methods. Additionally, we perform an ablation study to investigate model performance with progressively smaller training sets, identifying the minimum data required for effective personalization-an essential consideration for real-world applications where extensive data collection is often challenging. Our findings underscore the potential of adaptive, personalized glucose prediction models for advancing next-generation diabetes management, particularly in wearable and mobile health platforms, enhancing consumer-oriented diabetes care solutions.

What Drives Length of Stay After Elective Spine Surgery? Insights from a Decade of Predictive Modeling

Objective: Predicting length of stay after elective spine surgery is essential for optimizing patient outcomes and hospital resource use. This systematic review synthesizes computational methods used to predict length of stay in this patient population, highlighting model performance and key predictors. Methods: Following PRISMA guidelines, we systematically searched PubMed, Google Scholar, and ACM Digital Library for studies published between December 1st, 2015, and December 1st, 2024. Eligible studies applied statistical or machine learning models to predict length of stay for elective spine surgery patients. Three reviewers independently screened studies and extracted data. Results: Out of 1,263 screened studies, 29 studies met inclusion criteria. Length of stay was predicted as a continuous, binary, or percentile-based outcome. Models included logistic regression, random forest, boosting algorithms, and neural networks. Machine learning models consistently outperformed traditional statistical models, with AUCs ranging from 0.94 to 0.99. K-Nearest Neighbors and Naive Bayes achieved top performance in some studies. Common predictors included age, comorbidities (notably hypertension and diabetes), BMI, type and duration of surgery, and number of spinal levels. However, external validation and reporting practices varied widely across studies. Discussion: There is growing interest in artificial intelligence and machine learning in length of stay prediction, but lack of standardization and external validation limits clinical utility. Future studies should prioritize standardized outcome definitions and transparent reporting needed to advance real-world deployment. Conclusion: Machine learning models offer strong potential for length of stay prediction after elective spine surgery, highlighting their potential for improving discharge planning and hospital resource management.

Structured Insight from Unstructured Data: Large Language Models for SDOH-Driven Diabetes Risk Prediction

Social determinants of health (SDOH) play a critical role in Type 2 Diabetes (T2D) management but are often absent from electronic health records and risk prediction models. Most individual-level SDOH data is collected through structured screening tools, which lack the flexibility to capture the complexity of patient experiences and unique needs of a clinic's population. This study explores the use of large language models (LLMs) to extract structured SDOH information from unstructured patient life stories and evaluate the predictive value of both the extracted features and the narratives themselves for assessing diabetes control. We collected unstructured interviews from 65 T2D patients aged 65 and older, focused on their lived experiences, social context, and diabetes management. These narratives were analyzed using LLMs with retrieval-augmented generation to produce concise, actionable qualitative summaries for clinical interpretation and structured quantitative SDOH ratings for risk prediction modeling. The structured SDOH ratings were used independently and in combination with traditional laboratory biomarkers as inputs to linear and tree-based machine learning models (Ridge, Lasso, Random Forest, and XGBoost) to demonstrate how unstructured narrative data can be applied in conventional risk prediction workflows. Finally, we evaluated several LLMs on their ability to predict a patient's level of diabetes control (low, medium, high) directly from interview text with A1C values redacted. LLMs achieved 60% accuracy in predicting diabetes control levels from interview text. This work demonstrates how LLMs can translate unstructured SDOH-related data into structured insights, offering a scalable approach to augment clinical risk models and decision-making.

Early Prediction of Type 2 Diabetes Using Multimodal data and Tabular Transformers

This study introduces a novel approach for early Type 2 Diabetes Mellitus (T2DM) risk prediction using a tabular transformer (TabTrans) architecture to analyze longitudinal patient data. By processing patients` longitudinal health records and bone-related tabular data, our model captures complex, long-range dependencies in disease progression that conventional methods often overlook. We validated our TabTrans model on a retrospective Qatar BioBank (QBB) cohort of 1,382 subjects, comprising 725 men (146 diabetic, 579 healthy) and 657 women (133 diabetic, 524 healthy). The study integrated electronic health records (EHR) with dual-energy X-ray absorptiometry (DXA) data. To address class imbalance, we employed SMOTE and SMOTE-ENN resampling techniques. The proposed model`s performance is evaluated against conventional machine learning (ML) and generative AI models, including Claude 3.5 Sonnet (Anthropic`s constitutional AI), GPT-4 (OpenAI`s generative pre-trained transformer), and Gemini Pro (Google`s multimodal language model). Our TabTrans model demonstrated superior predictive performance, achieving ROC AUC $\geq$ 79.7 % for T2DM prediction compared to both generative AI models and conventional ML approaches. Feature interpretation analysis identified key risk indicators, with visceral adipose tissue (VAT) mass and volume, ward bone mineral density (BMD) and bone mineral content (BMC), T and Z-scores, and L1-L4 scores emerging as the most important predictors associated with diabetes development in Qatari adults. These findings demonstrate the significant potential of TabTrans for analyzing complex tabular healthcare data, providing a powerful tool for proactive T2DM management and personalized clinical interventions in the Qatari population. Index Terms: tabular transformers, multimodal data, DXA data, diabetes, T2DM, feature interpretation, tabular data

Predictive Analytics for Dementia: Machine Learning on Healthcare Data

Dementia is a complex syndrome impacting cognitive and emotional functions, with Alzheimer's disease being the most common form. This study focuses on enhancing dementia prediction using machine learning (ML) techniques on patient health data. Supervised learning algorithms are applied in this study, including K-Nearest Neighbors (KNN), Quadratic Discriminant Analysis (QDA), Linear Discriminant Analysis (LDA), and Gaussian Process Classifiers. To address class imbalance and improve model performance, techniques such as Synthetic Minority Over-sampling Technique (SMOTE) and Term Frequency-Inverse Document Frequency (TF-IDF) vectorization were employed. Among the models, LDA achieved the highest testing accuracy of 98%. This study highlights the importance of model interpretability and the correlation of dementia with features such as the presence of the APOE-epsilon4 allele and chronic conditions like diabetes. This research advocates for future ML innovations, particularly in integrating explainable AI approaches, to further improve predictive capabilities in dementia care.

AnyECG: Evolved ECG Foundation Model for Holistic Health Profiling

Background: Artificial intelligence enabled electrocardiography (AI-ECG) has demonstrated the ability to detect diverse pathologies, but most existing models focus on single disease identification, neglecting comorbidities and future risk prediction. Although ECGFounder expanded cardiac disease coverage, a holistic health profiling model remains needed. Methods: We constructed a large multicenter dataset comprising 13.3 million ECGs from 2.98 million patients. Using transfer learning, ECGFounder was fine-tuned to develop AnyECG, a foundation model for holistic health profiling. Performance was evaluated using external validation cohorts and a 10-year longitudinal cohort for current diagnosis, future risk prediction, and comorbidity identification. Results: AnyECG demonstrated systemic predictive capability across 1172 conditions, achieving an AUROC greater than 0.7 for 306 diseases. The model revealed novel disease associations, robust comorbidity patterns, and future disease risks. Representative examples included high diagnostic performance for hyperparathyroidism (AUROC 0.941), type 2 diabetes (0.803), Crohn disease (0.817), lymphoid leukemia (0.856), and chronic obstructive pulmonary disease (0.773). Conclusion: The AnyECG foundation model provides substantial evidence that AI-ECG can serve as a systemic tool for concurrent disease detection and long-term risk prediction.

A Proposed Paradigm for Imputing Missing Multi-Sensor Data in the Healthcare Domain

Chronic diseases such as diabetes pose significant management challenges, particularly due to the risk of complications like hypoglycemia, which require timely detection and intervention. Continuous health monitoring through wearable sensors offers a promising solution for early prediction of glycemic events. However, effective use of multisensor data is hindered by issues such as signal noise and frequent missing values. This study examines the limitations of existing datasets and emphasizes the temporal characteristics of key features relevant to hypoglycemia prediction. A comprehensive analysis of imputation techniques is conducted, focusing on those employed in state-of-the-art studies. Furthermore, imputation methods derived from machine learning and deep learning applications in other healthcare contexts are evaluated for their potential to address longer gaps in time-series data. Based on this analysis, a systematic paradigm is proposed, wherein imputation strategies are tailored to the nature of specific features and the duration of missing intervals. The review concludes by emphasizing the importance of investigating the temporal dynamics of individual features and the implementation of multiple, feature-specific imputation techniques to effectively address heterogeneous temporal patterns inherent in the data.

XAI-MeD: Explainable Knowledge Guided Neuro-Symbolic Framework for Domain Generalization and Rare Class Detection in Medical Imaging

Explainability domain generalization and rare class reliability are critical challenges in medical AI where deep models often fail under real world distribution shifts and exhibit bias against infrequent clinical conditions This paper introduces XAIMeD an explainable medical AI framework that integrates clinically accurate expert knowledge into deep learning through a unified neuro symbolic architecture XAIMeD is designed to improve robustness under distribution shift enhance rare class sensitivity and deliver transparent clinically aligned interpretations The framework encodes clinical expertise as logical connectives over atomic medical propositions transforming them into machine checkable class specific rules Their diagnostic utility is quantified through weighted feature satisfaction scores enabling a symbolic reasoning branch that complements neural predictions A confidence weighted fusion integrates symbolic and deep outputs while a Hunt inspired adaptive routing mechanism guided by Entropy Imbalance Gain EIG and Rare Class Gini mitigates class imbalance high intra class variability and uncertainty We evaluate XAIMeD across diverse modalities on four challenging tasks i Seizure Onset Zone SOZ localization from rs fMRI ii Diabetic Retinopathy grading across 6 multicenter datasets demonstrate substantial performance improvements including 6 percent gains in cross domain generalization and a 10 percent improved rare class F1 score far outperforming state of the art deep learning baselines Ablation studies confirm that the clinically grounded symbolic components act as effective regularizers ensuring robustness to distribution shifts XAIMeD thus provides a principled clinically faithful and interpretable approach to multimodal medical AI.

Scalable Back-End for an AI-Based Diabetes Prediction Application

The rising global prevalence of diabetes necessitates early detection to prevent severe complications. While AI-powered prediction applications offer a promising solution, they require a responsive and scalable back-end architecture to serve a large user base effectively. This paper details the development and evaluation of a scalable back-end system designed for a mobile diabetes prediction application. The primary objective was to maintain a failure rate below 5% and an average latency of under 1000 ms. The architecture leverages horizontal scaling, database sharding, and asynchronous communication via a message queue. Performance evaluation showed that 83% of the system's features (20 out of 24) met the specified performance targets. Key functionalities such as user profile management, activity tracking, and read-intensive prediction operations successfully achieved the desired performance. The system demonstrated the ability to handle up to 10,000 concurrent users without issues, validating its scalability. The implementation of asynchronous communication using RabbitMQ proved crucial in minimizing the error rate for computationally intensive prediction requests, ensuring system reliability by queuing requests and preventing data loss under heavy load.

APC-GNN++: An Adaptive Patient-Centric GNN with Context-Aware Attention and Mini-Graph Explainability for Diabetes Classification

We propose APC-GNN++, an adaptive patient-centric Graph Neural Network for diabetes classification. Our model integrates context-aware edge attention, confidence-guided blending of node features and graph representations, and neighborhood consistency regularization to better capture clinically meaningful relationships between patients. To handle unseen patients, we introduce a mini-graph approach that leverages the nearest neighbors of the new patient, enabling real-time explainable predictions without retraining the global model. We evaluate APC-GNN++ on a real-world diabetes dataset collected from a regional hospital in Algeria and show that it outperforms traditional machine learning models (MLP, Random Forest, XGBoost) and a vanilla GCN, achieving higher test accuracy and macro F1- score. The analysis of node-level confidence scores further reveals how the model balances self-information and graph-based evidence across different patient groups, providing interpretable patient-centric insights. The system is also embedded in a Tkinter-based graphical user interface (GUI) for interactive use by healthcare professionals .