Network analysis of autistic disease comorbidities in Chinese children based on ICD-10 codes
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RESEARCH ARTICLE
Network analysis of autistic disease comorbidities in Chinese children based on ICD‑10 codes Xiaojun Li1, Guangjian Liu1, Wenxiong Chen2, Zhisheng Bi3* and Huiying Liang1*
Abstract Background: Autism is a lifelong disability associated with several comorbidities that confound diagnosis and treatment. A better understanding of these comorbidities would facilitate diagnosis and improve treatments. Our aim was to improve the detection of comorbid diseases associated with autism. Methods: We used an FP-growth algorithm to retrospectively infer disease associations using 1488 patients with autism treated at the Guangzhou Women and Children’s Medical Center. The disease network was established using Cytoscape 3.7. The rules were internally validated by 10-fold cross-validation. All rules were further verified using the Columbia Open Health Data (COHD) and by literature search. Results: We found 148 comorbid diseases including intellectual disability, developmental speech disorder, and epilepsy. The network comprised of 76 nodes and 178 directed links. 158 links were confirmed by literature search and 105 links were validated by COHD. Furthermore, we identified 14 links not previously reported. Conclusion: We demonstrate that the FP-growth algorithm can detect comorbid disease patterns, including novel ones, in patients with autism. Keywords: Autism, Comorbidity, Disease network Background Autism appearing in infancy and early childhood is a developmental disorder characterized by difficulties with social interaction and communication, and by restricted and repetitive behavior [1]. Autism has become a pressing social concern as the rapid increase in its prevalence has provoked public anxiety [2]. The prevalence of childhood autism is 26.6 per 10,000 people in China [2, 3]. Additionally, it is a lifelong developmental disability and thus autistic patients have a heavy demand for educational, social, and medical services [2]. Consequently, *Correspondence: [email protected]; [email protected] 1 Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510623, China 3 School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou 511436, China Full list of author information is available at the end of the article
early detection and prevention of autism are urgently needed to reduce the disease burden. Generally, if the concurrent diseases in patients have a common genesis, they are known as comorbidities [4]. Comorbidities are associated with worse health outcomes, more complex clinical management, and increased health care costs [4]. As a result, comprehensive and individualized treatment needs to be adopted for patients with comorbidities. Therefore, a way to effectively and objectively evaluate comorbidities is imperative for doctors, especially doctors treating patients with autism, as 70% of these patients are reported to have concurrent conditions [5]. Understanding the relationships between comorbid diseases
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