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A dynamic model for predicting graft function in kidney recipients' upcoming follow up visits: A clinical application of artificial neural network.

Abstract：

BACKGROUND:Predicting the function of transplanted kidneys would help clinicians in individualized medical interventions. We aimed to develop and validate a predictive tool for a future value of estimated glomerular filtration rate (eGFR) at upcoming visits. METHODS:We used static and time-dependent covariates as inputs of artificial neural network based prediction models for predicting an eGFR value for an upcoming visit. We included 675 kidney recipients, who received transplant in the Urmia kidney transplant center in 2001-2013 and were longitudinally cared for in 2001-2017. The first 75% of records of longitudinal data of each patient were used to develop the prediction models and the remaining last 25% for evaluating its performance. Models' performances were evaluated by Mean Square Error (MSE) and Mean Absolute Error (MAE). RESULTS:The development and validation datasets included 18,773 and 7038 records of historical data, respectively. The most accurate model included 3 static covariates of recipients' gender and donors' age and gender as well as 11 dynamic covariates of recipients including current age, time since transplant, serum creatinine, fasting blood sugar, weight and blood pressures available at each visit time. The performance of prediction models in the validation cohort was improved when history window of time dependent variables' recent values was increased from 1 to 10 (an MSE decline from 161 to 99). CONCLUSIONS:Our best performed model is able to dynamically predict a future eGFR value for kidney recipients' upcoming visits. Integrating such a clinical tool into daily workflow of outpatient clinics can potentially support clinicians in optimal and individualized decision makings.

journal_name

Int J Med Inform

journal_title

International journal of medical informatics

authors

Rashidi Khazaee P,Bagherzadeh J,Niazkhani Z,Pirnejad H

doi

10.1016/j.ijmedinf.2018.09.012

subject

Has Abstract

pub_date

2018-11-01 00:00:00

pages

125-133

eissn

1386-5056

issn

1872-8243

pii

S1386-5056(18)30111-4

journal_volume

119

pub_type

杂志文章

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