Moving beyond regression techniques in cardiovascular risk prediction: Applying machine learning to address analytic challenges

Benjamin A. Goldstein, Ann Marie Navar, Rickey E. Carter

Research output: Contribution to journalReview article

74 Scopus citations


Risk prediction plays an important role in clinical cardiology research. Traditionally, most risk models have been based on regression models. While useful and robust, these statistical methods are limited to using a small number of predictors which operate in the sameway on everyone, and uniformly throughout their range. The purpose of this review is to illustrate the use of machine-learning methods for development of risk prediction models. Typically presented as black box approaches, most machine-learning methods are aimed at solving particular challenges that arise in data analysis that are not well addressed by typical regression approaches. To illustrate these challenges, as well as how different methods can address them, we consider trying to predicting mortality after diagnosis of acute myocardial infarction. We use data derived from our institution's electronic health record and abstract data on 13 regularly measured laboratory markers. We walk through different challenges that arise in modelling these data and then introduce different machine-learning approaches. Finally, we discuss general issues in the application of machine-learning methods including tuning parameters, loss functions, variable importance, and missing data. Overall, this review serves as an introduction for those working on risk modelling to approach the diffuse field of machine learning.

Original languageEnglish (US)
Pages (from-to)1805-1814
Number of pages10
JournalEuropean Heart Journal
Issue number23
StatePublished - Jun 14 2017



  • Electronic health records
  • Personalized medicine
  • Precision medicine
  • Risk prediction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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