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Chorev M, Haderlein J, Chandra S, Menon G, Burton BJL, Pearce I, McKibbin M, Thottarath S, Karatsai E, Chandak S, Kotagiri A, Talks J, Grabowska A, Ghanchi F, Gale R, Hamilton R, Antony B, Garnavi R, Mareels I, Giani A, Chong V, Sivaprasad S. A Multi-Modal AI-Driven Cohort Selection Tool to Predict Suboptimal Non-Responders to Aflibercept Loading-Phase for Neovascular Age-Related Macular Degeneration: PRECISE Study Report 1. J Clin Med 2023; 12:jcm12083013. [PMID: 37109349 PMCID: PMC10142969 DOI: 10.3390/jcm12083013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/08/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
Patients diagnosed with exudative neovascular age-related macular degeneration are commonly treated with anti-vascular endothelial growth factor (anti-VEGF) agents. However, response to treatment is heterogeneous, without a clinical explanation. Predicting suboptimal response at baseline will enable more efficient clinical trial designs for novel, future interventions and facilitate individualised therapies. In this multicentre study, we trained a multi-modal artificial intelligence (AI) system to identify suboptimal responders to the loading-phase of the anti-VEGF agent aflibercept from baseline characteristics. We collected clinical features and optical coherence tomography scans from 1720 eyes of 1612 patients between 2019 and 2021. We evaluated our AI system as a patient selection method by emulating hypothetical clinical trials of different sizes based on our test set. Our method detected up to 57.6% more suboptimal responders than random selection, and up to 24.2% more than any alternative selection criteria tested. Applying this method to the entry process of candidates into randomised controlled trials may contribute to the success of such trials and further inform personalised care.
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Affiliation(s)
- Michal Chorev
- Centre for Applied Research, IBM Australia, Southbank, VIC 3006, Australia
| | - Jonas Haderlein
- Centre for Applied Research, IBM Australia, Southbank, VIC 3006, Australia
| | - Shruti Chandra
- National Institute of Health Research, Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London EC1V 2PD, UK
| | - Geeta Menon
- Frimley Health NHS Foundation Trust, Surrey GU16 7UJ, UK
| | - Benjamin J L Burton
- Department of Ophthalmology, James Paget University Hospitals NHS Foundation Trust, Norfolk NR31 6LA, UK
| | - Ian Pearce
- Clinical Eye Research Centre, St. Paul's Eye Unit, The Royal Liverpool and Broadgreen University Hospitals NHS Foundation Trust, Liverpool L7 8YE, UK
| | | | - Sridevi Thottarath
- National Institute of Health Research, Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London EC1V 2PD, UK
| | - Eleni Karatsai
- National Institute of Health Research, Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London EC1V 2PD, UK
| | - Swati Chandak
- National Institute of Health Research, Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London EC1V 2PD, UK
| | - Ajay Kotagiri
- South Tyneside and Sunderland NHS Foundation Trust, Sunderland SR4 7TP, UK
| | - James Talks
- Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK
| | - Anna Grabowska
- King's College Hospital NHS Foundation Trust, London SE5 9RS, UK
| | - Faruque Ghanchi
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford BD9 6RJ, UK
| | - Richard Gale
- York Teaching Hospital NHS Foundation Trust, York YO31 8HE, UK
| | - Robin Hamilton
- National Institute of Health Research, Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London EC1V 2PD, UK
| | - Bhavna Antony
- Centre for Applied Research, IBM Australia, Southbank, VIC 3006, Australia
| | - Rahil Garnavi
- Centre for Applied Research, IBM Australia, Southbank, VIC 3006, Australia
| | - Iven Mareels
- Centre for Applied Research, IBM Australia, Southbank, VIC 3006, Australia
| | - Andrea Giani
- Boehringer Ingelheim, 55218 Ingelheim am Rhein, Germany
| | - Victor Chong
- Institute of Ophthalmology, University College London, London NW3 2PF, UK
| | - Sobha Sivaprasad
- National Institute of Health Research, Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London EC1V 2PD, UK
- Institute of Ophthalmology, University College London, London NW3 2PF, UK
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