Absolute Risk Prediction for Cannabis Use Disorder in Adolescence and Early Adulthood Using Bayesian Machine Learning

Abstract

Introduction: Substance use disorders (SUD) have emerged as a pressing public health concern in the United States, with adolescent substance use often leading to SUDs in adulthood. Effective strategies are needed to stem this progression. To help fulfil this need, we developed a novel absolute risk prediction model for cannabis use disorder (CUD) for adolescents or young adults who use cannabis. Methods: We trained a Bayesian machine learning model that provides a personalised CUD absolute risk for adolescents or young adults who use cannabis with data from the National Longitudinal Study of Adolescent to Adult Health. Model performance was assessed using five-fold cross-validation (CV) with area under the curve (AUC) and ratio of the expected to observed number of cases (E/O). Independent validation of the final model was conducted using two datasets. Results: The proposed model has five risk factors: biological sex, delinquency, and scores on personality traits of conscientiousness, neuroticism and openness. For predicting CUD risk within 5 years of first cannabis use, AUC values for the training dataset and two validation datasets were 0.68, 0.64 and 0.75, respectively, and E/O values were 0.95, 0.98 and 1, respectively. This indicates good discrimination and calibration performance of the model. Discussion and Conclusion: The proposed model can aid clinicians in assessing the risk of developing CUD among adolescents and young adults who use cannabis, enabling clinically appropriate interventions.