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Zhang R, Yin M, Jiang A, Zhang S, Xu X, Liu L. Automated machine learning for early prediction of acute kidney injury in acute pancreatitis. BMC Med Inform Decis Mak 2024; 24:16. [PMID: 38212745 PMCID: PMC10785491 DOI: 10.1186/s12911-024-02414-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 01/01/2024] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Acute kidney injury (AKI) represents a frequent and grave complication associated with acute pancreatitis (AP), substantially elevating both mortality rates and the financial burden of hospitalization. The aim of our study is to construct a predictive model utilizing automated machine learning (AutoML) algorithms for the early prediction of AKI in patients with AP. METHODS We retrospectively analyzed patients who were diagnosed with AP in our hospital from January 2017 to December 2021. These patients were randomly allocated into a training set and a validation set at a ratio of 7:3. To develop predictive models for each set, we employed the least absolute shrinkage and selection operator (LASSO) algorithm along with AutoML. A nomogram was developed based on multivariate logistic regression analysis outcomes. The model's efficacy was assessed using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). Additionally, the performance of the model constructed via AutoML was evaluated using decision curve analysis (DCA), feature importance, SHapley Additive exPlanations (SHAP) plots, and locally interpretable model-agnostic explanations (LIME). RESULTS This study incorporated a total of 437 patients who met the inclusion criteria. Out of these, 313 were assigned to the training cohort and 124 to the validation cohort. In the training and validation cohorts, AKI occurred in 68 (21.7%) and 29(23.4%) patients, respectively. Comparative analysis revealed that the AutoML models exhibited enhanced performance over traditional logistic regression (LR). Furthermore, the deep learning (DL) model demonstrated superior predictive accuracy, evidenced by an area under the ROC curve of 0.963 in the training set and 0.830 in the validation set, surpassing other comparative models. The key variables identified as significant in the DL model within the training dataset included creatinine (Cr), urea (Urea), international normalized ratio (INR), etiology, smoking, alanine aminotransferase (ALT), hypertension, prothrombin time (PT), lactate dehydrogenase (LDH), and diabetes. CONCLUSION The AutoML model, utilizing DL algorithm, offers considerable clinical significance in the early detection of AKI among patients with AP.
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Affiliation(s)
- Rufa Zhang
- Department of Gastroenterology, Changshu Hospital Affiliated to Soochow University, Changshu NO.1 People's Hospital, No. 1 Shuyuan Street, 215500, Suzhou, Jiangsu, China
| | - Minyue Yin
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Anqi Jiang
- Department of Gastroenterology, Changshu Hospital Affiliated to Soochow University, Changshu NO.1 People's Hospital, No. 1 Shuyuan Street, 215500, Suzhou, Jiangsu, China
| | - Shihou Zhang
- Department of Gastroenterology, Changshu Hospital Affiliated to Soochow University, Changshu NO.1 People's Hospital, No. 1 Shuyuan Street, 215500, Suzhou, Jiangsu, China
| | - Xiaodan Xu
- Department of Gastroenterology, Changshu Hospital Affiliated to Soochow University, Changshu NO.1 People's Hospital, No. 1 Shuyuan Street, 215500, Suzhou, Jiangsu, China.
| | - Luojie Liu
- Department of Gastroenterology, Changshu Hospital Affiliated to Soochow University, Changshu NO.1 People's Hospital, No. 1 Shuyuan Street, 215500, Suzhou, Jiangsu, China.
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Wei T, Peng S, Li X, Li J, Gu M, Li X. Critical evaluation of established risk prediction models for acute respiratory distress syndrome in adult patients: A systematic review and meta-analysis. J Evid Based Med 2023; 16:465-476. [PMID: 38058055 DOI: 10.1111/jebm.12565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 11/22/2023] [Indexed: 12/08/2023]
Abstract
AIM To assess the performance of validated prediction models for acute respiratory distress syndrome (ARDS) by systematic review and meta-analysis. METHODS Eight databases (Medline, CINAHL, Embase, The Cochrane Library, CNKI, WanFang Data, Sinomed, and VIP) were searched up to March 26, 2023. Studies developed and validated a prediction model for ARDS in adult patients were included. Items on study design, incidence, derivation methods, predictors, discrimination, and calibration were collected. The risk of bias was assessed by the Prediction model Risk of Bias Assessment Tool. Models with a reported area under the curve of the receiver operating characteristic (AUC) metric were analyzed. RESULTS A total of 25 studies were retrieved, including 48 unique prediction models. Discrimination was reported in all studies, with AUC ranging from 0.701 to 0.95. Emerged AUC value of the logistic regression model was 0.837 (95% CI: 0.814 to 0.859). Besides, the value in the ICU group was 0.856 (95% CI: 0.812 to 0.899), the acute pancreatitis group was 0.863 (95% CI: 0.844 to 0.882), and the postoperation group was 0.835 (95% CI: 0.808 to 0.861). In total, 24 of the included studies had a high risk of bias, which was mostly due to the improper methods in predictor screening (13/24), model calibration assessment (9/24), and dichotomization of continuous predictors (6/24). CONCLUSIONS This study shows that most prediction models for ARDS are at high risk of bias, and the discrimination ability of the model is excellent. Adherence to standardized guidelines for model development is necessary to derive a prediction model of value to clinicians.
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Affiliation(s)
- Tao Wei
- Anesthesiology Department, Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
| | - Siyi Peng
- The Early Clinical Trial Center in The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
| | - Xuying Li
- Department of Nursing, Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
| | - Jinhua Li
- Department of Nursing, Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
| | - Mengdan Gu
- Anesthesiology Department, Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
| | - Xiaoling Li
- Anesthesiology Department, Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
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Zou K, Ren W, Huang S, Jiang J, Xu H, Zeng X, Zhang H, Peng Y, Lü M, Tang X. The role of artificial neural networks in prediction of severe acute pancreatitis associated acute respiratory distress syndrome: A retrospective study. Medicine (Baltimore) 2023; 102:e34399. [PMID: 37478242 PMCID: PMC10662815 DOI: 10.1097/md.0000000000034399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/28/2023] [Indexed: 07/23/2023] Open
Abstract
Early identification and intervention of acute respiratory distress syndrome (ARDS) are particularly important. This study aimed to construct predictive models for ARDS following severe acute pancreatitis (SAP) by artificial neural networks and logistic regression. The artificial neural networks model was constructed using clinical data from 214 SAP patients. The patient cohort was randomly divided into a training set and a test set, with 149 patients allocated to the training set and 65 patients assigned to the test set. The artificial neural networks and logistic regression models were trained by the training set, and then the performance of both models was evaluated using the test set. The sensitivity, specificity, PPV, NPV, accuracy, and AUC value of artificial neural networks model were 68.0%, 87.5%, 77.3%, 81.4%, 80.0%, 0.853 ± 0.054 (95% CI: 0.749-0.958). The sensitivity, specificity, PPV, NPV, accuracy and AUC value of logistic regression model were 48.7%, 85.3%, 65.5%, 74.4%, 72.0%, 0.799 ± 0.045 (95% CI: 0.710-0.888). There were no significant differences between the artificial neural networks and logistic regression models in predictive performance. Bedside Index of Severity in Acute Pancreatitis score, procalcitonin, prothrombin time, and serum calcium were the most important predictive variables in the artificial neural networks model. The discrimination abilities of logistic regression and artificial neural networks models in predicting SAP-related ARDS were similar. It is advisable to choose the model according to the specific research purpose.
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Affiliation(s)
- Kang Zou
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Wensen Ren
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Shu Huang
- Department of Gastroenterology, the People’s Hospital of Lianshui, Huaian, China
| | - Jiao Jiang
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Huan Xu
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Xinyi Zeng
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Han Zhang
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Yan Peng
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Muhan Lü
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Xiaowei Tang
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
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Song LJ, Xiao B. Acute pancreatitis: Structured report template of magnetic resonance imaging. World J Radiol 2023; 15:157-169. [PMID: 37424735 PMCID: PMC10324496 DOI: 10.4329/wjr.v15.i6.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/25/2023] [Accepted: 06/16/2023] [Indexed: 06/28/2023] Open
Abstract
Acute pancreatitis (AP) is a common acute abdomen disease of the digestive system. It has a potentially fatal risk because of its variable severity and various complications. With the widespread application of the Revised Atlanta Classification, new requirements for AP imaging reports are introduced. Experts in abdominal radiology and pancreatology in the United States published the first structured computed tomography reporting template for AP in 2020. However, there is no corresponding structured magnetic resonance imaging (MRI) reporting template globally. Therefore, this article focuses on the structured MRI report of AP images from our pancreatitis imaging center, which is intended to improve the systematic understanding of this disease and standardize the writing of MRI structured reports. In the meantime, we aim to promote the clinical diagnosis and assessment of MRI efficacy for AP and its multiple complications. It is further intended to facilitate academic exchanges and scientific research between different medical centers.
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Affiliation(s)
- Ling-Ji Song
- Department of Radiology, Sichuan Key Laboratory of Medical Imaging, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Bo Xiao
- Department of Radiology, Sichuan Key Laboratory of Medical Imaging, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
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Song LJ, Xiao B. Medical imaging for pancreatic diseases: Prediction of severe acute pancreatitis complicated with acute respiratory distress syndrome. World J Gastroenterol 2022; 28:6206-6212. [PMID: 36504558 PMCID: PMC9730435 DOI: 10.3748/wjg.v28.i44.6206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/15/2022] [Accepted: 11/17/2022] [Indexed: 02/06/2023] Open
Abstract
In this editorial we comment on the article published in the recent issue of the World Journal of Gastroenterology [2022; 28 (19): 2123-2136]. We pay attention to how to construct a simpler and more reliable new clinical predictive model to early identify patients at high risk of acute respiratory distress syndrome (ARDS) associated with severe acute pancreatitis (SAP), and to early predict the severity of organ failure from chest computed tomography (CT) findings in SAP patients. As we all know, SAP has a sudden onset, is a rapidly changing condition, and can be complicated with ARDS and even multiple organ dysfunction syndrome, and its mortality rate has remained high. At present, there are many clinical scoring systems for AP, including the bedside index for severity in AP, acute physiology and chronic health evaluation II, systemic inflammatory response syndrome, Japanese severe score, quick sepsis-related organ failure assessment, etc. However, some of these scoring systems are complex and require multiple and difficult clinical parameters for risk stratification. Although the aforementioned biomarkers are readily available, their ability to predict ARDS varies. Accor-dingly, it is extremely necessary to establish a simple and valuable novel model to predict the development of ARDS in AP. In addition, the extra-pancreatic manifestations of AP patients often involve the chest, among which pleural effusion and pulmonary consolidation are the more common complications. Therefore, by measuring the semi-quantitative indexes of chest CT in AP patients, such as the amount of pleural effusion and the number of lobes involved as pulmonary consolidation, it has important reference value for the early diagnosis of SAP complicated with ARDS and is expected to provide a basis for the early treatment of ARDS.
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Affiliation(s)
- Ling-Ji Song
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Bo Xiao
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
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