Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease (May 2023)

Survey and Evaluation of Hypertension Machine Learning Research

  • Clea du Toit,
  • Tran Quoc Bao Tran,
  • Neha Deo,
  • Sachin Aryal,
  • Stefanie Lip,
  • Robert Sykes,
  • Ishan Manandhar,
  • Aristeidis Sionakidis,
  • Leah Stevenson,
  • Harsha Pattnaik,
  • Safaa Alsanosi,
  • Maria Kassi,
  • Ngoc Le,
  • Maggie Rostron,
  • Sarah Nichol,
  • Alisha Aman,
  • Faisal Nawaz,
  • Dhruven Mehta,
  • Ramakumar Tummala,
  • Linsay McCallum,
  • Sandeep Reddy,
  • Shyam Visweswaran,
  • Rahul Kashyap,
  • Bina Joe,
  • Sandosh Padmanabhan

DOI
https://doi.org/10.1161/JAHA.122.027896
Journal volume & issue
Vol. 12, no. 9

Abstract

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Background Machine learning (ML) is pervasive in all fields of research, from automating tasks to complex decision‐making. However, applications in different specialities are variable and generally limited. Like other conditions, the number of studies employing ML in hypertension research is growing rapidly. In this study, we aimed to survey hypertension research using ML, evaluate the reporting quality, and identify barriers to ML's potential to transform hypertension care. Methods and Results The Harmonious Understanding of Machine Learning Analytics Network survey questionnaire was applied to 63 hypertension‐related ML research articles published between January 2019 and September 2021. The most common research topics were blood pressure prediction (38%), hypertension (22%), cardiovascular outcomes (6%), blood pressure variability (5%), treatment response (5%), and real‐time blood pressure estimation (5%). The reporting quality of the articles was variable. Only 46% of articles described the study population or derivation cohort. Most articles (81%) reported at least 1 performance measure, but only 40% presented any measures of calibration. Compliance with ethics, patient privacy, and data security regulations were mentioned in 30 (48%) of the articles. Only 14% used geographically or temporally distinct validation data sets. Algorithmic bias was not addressed in any of the articles, with only 6 of them acknowledging risk of bias. Conclusions Recent ML research on hypertension is limited to exploratory research and has significant shortcomings in reporting quality, model validation, and algorithmic bias. Our analysis identifies areas for improvement that will help pave the way for the realization of the potential of ML in hypertension and facilitate its adoption.

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