Comprehensive Evaluation of Machine Learning for Type 2 Diabetes Risk Prediction: Large-Scale External Validation and Fairness Analysis
Mirrored from arXiv — Machine Learning for archival readability. Support the source by reading on the original site.
Computer Science > Machine Learning
arXiv:2607.16253 (cs)
[Submitted on 27 Jun 2026]
Title:Comprehensive Evaluation of Machine Learning for Type 2 Diabetes Risk Prediction: Large-Scale External Validation and Fairness Analysis
Authors:Rajveer Singh Pall, Sameer Yadav, Siddharth Bhalerao, Sourabh Sahu, Ritu Ahluwalia, Bhaskar Awadhiya
View a PDF of the paper titled Comprehensive Evaluation of Machine Learning for Type 2 Diabetes Risk Prediction: Large-Scale External Validation and Fairness Analysis, by Rajveer Singh Pall and 5 other authors
View PDF
Abstract:Machine learning-based Type 2 diabetes risk prediction models obtain good internal validation results but lose effectiveness in real-world applications due to deficient external testing and fairness assessment. We developed a multi-dimensional framework evaluating discrimination, calibration, interpretability, and algorithmic fairness on nationally representative populations. An XGBoost model was trained on NHANES 2015-2020 (n=15,685) using eight non-laboratory predictors: age, sex, race/ethnicity, BMI, smoking status, physical activity, history of heart attack, and history of stroke. External validation was performed on BRFSS 2020-2022 (n=1,285,783) under realistic distribution shift. Internal validation showed good discrimination (AUC=0.794, 95% CI 0.788-0.800), with performance loss on external validation (AUC=0.717, relative decrease: -9.7%, p<0.001). Fairness analysis revealed severe bias: elderly adults (>=60) showed AUC=0.607 vs 0.742 for young adults (difference=0.135, p<0.001); obese individuals showed AUC=0.698 vs 0.735 for normal weight (difference=0.037, p<0.001). Gender showed comparable performance (male=0.723 vs female=0.712, p=0.142). Calibration revealed risk overestimation (Brier score=0.123). SHAP analysis identified age, BMI, and physical activity as primary risk drivers. Populations with highest diabetes risk receive the worst algorithmic performance, underscoring the need for fairness-aware, age-stratified deployment strategies before clinical use.
| Comments: | Accepted and published at the IEEE EDS Technically Sponsored International Conference on Intelligent Processing, Hardware, Electronics, and Radio Systems (CIPHER-2026), 13-15 Feb 2026, NIT Jalandhar, India (IEEE Conference Record #70417, Paper ID: 155). 8 pages, 4 figures, 3 tables |
| Subjects: | Machine Learning (cs.LG); Artificial Intelligence (cs.AI) |
| Cite as: | arXiv:2607.16253 [cs.LG] |
| (or arXiv:2607.16253v1 [cs.LG] for this version) | |
| https://doi.org/10.48550/arXiv.2607.16253
arXiv-issued DOI via DataCite (pending registration)
|
|
| Journal reference: | Proc. 2026 Int. Conf. on Intelligent Processing, Hardware, Electronics and Radio Systems (CIPHER), Jalandhar, India, Feb. 2026 |
| Related DOI: | https://doi.org/10.1109/CIPHER70417.2026.11523789
DOI(s) linking to related resources
|
Submission history
From: Rajveer Singh Pall [view email][v1] Sat, 27 Jun 2026 07:02:40 UTC (464 KB)
Full-text links:
Access Paper:
- View PDF
View a PDF of the paper titled Comprehensive Evaluation of Machine Learning for Type 2 Diabetes Risk Prediction: Large-Scale External Validation and Fairness Analysis, by Rajveer Singh Pall and 5 other authors
References & Citations
Loading...
Bookmark
Bibliographic Tools
Code, Data, Media
Demos
Related Papers
About arXivLabs
Bibliographic and Citation Tools
Bibliographic Explorer Toggle
Bibliographic Explorer (What is the Explorer?)
Connected Papers Toggle
Connected Papers (What is Connected Papers?)
Litmaps Toggle
Litmaps (What is Litmaps?)
scite.ai Toggle
scite Smart Citations (What are Smart Citations?)
Code, Data and Media Associated with this Article
alphaXiv Toggle
alphaXiv (What is alphaXiv?)
Links to Code Toggle
CatalyzeX Code Finder for Papers (What is CatalyzeX?)
DagsHub Toggle
DagsHub (What is DagsHub?)
GotitPub Toggle
Gotit.pub (What is GotitPub?)
Huggingface Toggle
Hugging Face (What is Huggingface?)
ScienceCast Toggle
ScienceCast (What is ScienceCast?)
Demos
Replicate Toggle
Replicate (What is Replicate?)
Spaces Toggle
Hugging Face Spaces (What is Spaces?)
Spaces Toggle
TXYZ.AI (What is TXYZ.AI?)
Recommenders and Search Tools
Link to Influence Flower
Influence Flower (What are Influence Flowers?)
Core recommender toggle
CORE Recommender (What is CORE?)
IArxiv recommender toggle
IArxiv Recommender
(What is IArxiv?)
arXivLabs: experimental projects with community collaborators
arXivLabs is a framework that allows collaborators to develop and share new arXiv features directly on our website.
Both individuals and organizations that work with arXivLabs have embraced and accepted our values of openness, community, excellence, and user data privacy. arXiv is committed to these values and only works with partners that adhere to them.
Have an idea for a project that will add value for arXiv's community? Learn more about arXivLabs.
More from arXiv — Machine Learning
-
LoKiFormer: Locality-aware Attention with Decoupled Knowledge Memory for Efficient Large Language Model Pretraining
Aug 14
-
Which Site, and When: A Free-Satellite-Data Test of Himalayan Glacial Lake Bursts, Landslides, and Ice Floods
Aug 14
-
MARCH: Scaling Recurrent Memory with Content-Routed State Anchors
Aug 14
-
Multi-AUV Ad-hoc network-based Target Tracking: A Value Gradient Guidance Multi-Agent Diffusion Reinforcement Learning Approach
Aug 14
Discussion (0)
Sign in to join the discussion. Free account, 30 seconds — email code or GitHub.
Sign in →No comments yet. Sign in and be the first to say something.