A machine learning-based risk prediction model for diabetic oral ulceration

Abstract Background Diabetic oral ulceration (DOU) is a prevalent and debilitating complication among diabetic patients, significantly impairing their quality of life and imposing substantial economic burdens. Studies indicate that over 90% of diabetic patients experience oral complications, with 45...

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Main Authors: Wang Xiaoling, Wang BingQian, Zhu Zhenqi, Li Wen, Gu Shuyan, Chen Hanbei, Xin Feng, Chenglong Yang, Jutang li, Guoyao Tang, Jie Wei
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Oral Health
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Online Access:https://doi.org/10.1186/s12903-025-06096-x
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author Wang Xiaoling
Wang BingQian
Zhu Zhenqi
Li Wen
Gu Shuyan
Chen Hanbei
Xin Feng
Chenglong Yang
Jutang li
Guoyao Tang
Jie Wei
author_facet Wang Xiaoling
Wang BingQian
Zhu Zhenqi
Li Wen
Gu Shuyan
Chen Hanbei
Xin Feng
Chenglong Yang
Jutang li
Guoyao Tang
Jie Wei
author_sort Wang Xiaoling
collection DOAJ
description Abstract Background Diabetic oral ulceration (DOU) is a prevalent and debilitating complication among diabetic patients, significantly impairing their quality of life and imposing substantial economic burdens. Studies indicate that over 90% of diabetic patients experience oral complications, with 45% suffering from oral ulcers. Clear diagnosis is crucial for effective clinical management and prognosis improvement. However, current diagnostic methods often fall short in early detection and intervention. Machine learning (ML) has shown promise in predicting disease development, yet no relevant predictive models for DOU have been established. Methods This study aimed to develop an ML-based predictive model for DOU using oral examination, clinical, and socioeconomic data. The dataset included 324 diabetic patients, with 127 DOU features. One-hundred-fold cross-validation was employed for model optimization and feature selection. Data preprocessing involved handling missing values, scaling different range values, and feature selection using techniques such as Variance Threshold (VT), Mutual Information (MI), and Variance Inflation Factor (VIF). Four prediction models, Support Vector Machine Classifier (SVC), Multi-layer Perceptron (MLP), Logistic Regression Classifier (LogReg), and Perceptron, were established and evaluated. Results The SVC model outperformed the other models, achieving an accuracy (ACC) of 0.95 and an area under the ROC curve (AUC) of 0.91. The top five features contributing to the model’s predictions were the current number of oral ulcers, diminished oral functional capacity, number of decayed or missing teeth, possession of health insurance (commercial), and Low-Density Lipoprotein (LDL-C), accounting for 57.32% of the total importance. Oral examination indicators accounted for 46.46%, serum lipid markers for 6.93%, and sociodemographic factors, personal lifestyles, and cardiovascular diseases also played significant roles. Conclusion The SVC model demonstrated superior performance and stability, making it suitable for predicting DOU occurrence and development in diabetic patients. This study’s innovation lies in the comprehensive evaluation of multiple factors, including oral examinations, physiological indicators, self-management capabilities, and economic factors, to facilitate efficient DOU screening. The findings highlight the potential of ML in improving diagnostic accuracy and enabling timely interventions for DOU, ultimately contributing to better clinical management and patient outcomes. Future research should focus on validating the model across larger, multicenter cohorts and further exploring the long-term impact of ML-guided interventions on DOU management.
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spelling doaj-art-6967b3d8dd9c47d6a25d39ffb444aa752025-08-20T03:54:11ZengBMCBMC Oral Health1472-68312025-05-0125111610.1186/s12903-025-06096-xA machine learning-based risk prediction model for diabetic oral ulcerationWang Xiaoling0Wang BingQian1Zhu Zhenqi2Li Wen3Gu Shuyan4Chen Hanbei5Xin Feng6Chenglong Yang7Jutang li8Guoyao Tang9Jie Wei10Department of Endocrinology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong UniversityIntensive Care Unit, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese MedicineScience Teaching and Research Group, Konger Primary SchoolDepartment of Endocrinology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong UniversityCenter for Health Policy and Management Studies, School of Government, Nanjing UniversityDepartment of Endocrinology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Stomatology, Xinhua Hospital, Core Unit of National Clinical Research Center for Oral Diseases, Shanghai Jiao Tong University School of MedicineDepartment of Stomatology, Xinhua Hospital, Core Unit of National Clinical Research Center for Oral Diseases, Shanghai Jiao Tong University School of MedicineHongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Stomatology, Xinhua Hospital, Core Unit of National Clinical Research Center for Oral Diseases, Shanghai Jiao Tong University School of MedicineDepartment of Stomatology, Xinhua Hospital, Core Unit of National Clinical Research Center for Oral Diseases, Shanghai Jiao Tong University School of MedicineAbstract Background Diabetic oral ulceration (DOU) is a prevalent and debilitating complication among diabetic patients, significantly impairing their quality of life and imposing substantial economic burdens. Studies indicate that over 90% of diabetic patients experience oral complications, with 45% suffering from oral ulcers. Clear diagnosis is crucial for effective clinical management and prognosis improvement. However, current diagnostic methods often fall short in early detection and intervention. Machine learning (ML) has shown promise in predicting disease development, yet no relevant predictive models for DOU have been established. Methods This study aimed to develop an ML-based predictive model for DOU using oral examination, clinical, and socioeconomic data. The dataset included 324 diabetic patients, with 127 DOU features. One-hundred-fold cross-validation was employed for model optimization and feature selection. Data preprocessing involved handling missing values, scaling different range values, and feature selection using techniques such as Variance Threshold (VT), Mutual Information (MI), and Variance Inflation Factor (VIF). Four prediction models, Support Vector Machine Classifier (SVC), Multi-layer Perceptron (MLP), Logistic Regression Classifier (LogReg), and Perceptron, were established and evaluated. Results The SVC model outperformed the other models, achieving an accuracy (ACC) of 0.95 and an area under the ROC curve (AUC) of 0.91. The top five features contributing to the model’s predictions were the current number of oral ulcers, diminished oral functional capacity, number of decayed or missing teeth, possession of health insurance (commercial), and Low-Density Lipoprotein (LDL-C), accounting for 57.32% of the total importance. Oral examination indicators accounted for 46.46%, serum lipid markers for 6.93%, and sociodemographic factors, personal lifestyles, and cardiovascular diseases also played significant roles. Conclusion The SVC model demonstrated superior performance and stability, making it suitable for predicting DOU occurrence and development in diabetic patients. This study’s innovation lies in the comprehensive evaluation of multiple factors, including oral examinations, physiological indicators, self-management capabilities, and economic factors, to facilitate efficient DOU screening. The findings highlight the potential of ML in improving diagnostic accuracy and enabling timely interventions for DOU, ultimately contributing to better clinical management and patient outcomes. Future research should focus on validating the model across larger, multicenter cohorts and further exploring the long-term impact of ML-guided interventions on DOU management.https://doi.org/10.1186/s12903-025-06096-xDiabetesOral ulcerMachine learningPredictive model
spellingShingle Wang Xiaoling
Wang BingQian
Zhu Zhenqi
Li Wen
Gu Shuyan
Chen Hanbei
Xin Feng
Chenglong Yang
Jutang li
Guoyao Tang
Jie Wei
A machine learning-based risk prediction model for diabetic oral ulceration
BMC Oral Health
Diabetes
Oral ulcer
Machine learning
Predictive model
title A machine learning-based risk prediction model for diabetic oral ulceration
title_full A machine learning-based risk prediction model for diabetic oral ulceration
title_fullStr A machine learning-based risk prediction model for diabetic oral ulceration
title_full_unstemmed A machine learning-based risk prediction model for diabetic oral ulceration
title_short A machine learning-based risk prediction model for diabetic oral ulceration
title_sort machine learning based risk prediction model for diabetic oral ulceration
topic Diabetes
Oral ulcer
Machine learning
Predictive model
url https://doi.org/10.1186/s12903-025-06096-x
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