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  • Ivanics, TommyUppsala universitet,Gastrointestinalkirurgi,Univ Hlth Network Toronto, Multi Organ Transplant Program, Toronto, ON, Canada.;Henry Ford Hosp, Dept Surg, Detroit, MI USA. (author)

Machine learning-based mortality prediction models using national liver transplantation registries are feasible but have limited utility across countries

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • ELSEVIER SCIENCE INC,2023
  • printrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:uu-506986
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-506986URI
  • https://doi.org/10.1016/j.ajt.2022.12.002DOI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Many countries curate national registries of liver transplant (LT) data. These registries are often used to generate predictive models; however, potential performance and transferability of these models remain unclear. We data from 3 national registries and developed machine learning algorithm (MLA)-based models to predict 90 post-LT mortality within and across countries. Predictive performance and external validity of each model assessed. Prospectively collected data of adult patients (aged >= 18 years) who underwent primary LTs between January 2008 and December 2018 from the Canadian Organ Replacement Registry (Canada), National Service Blood and Transplantation (United Kingdom), and United Network for Organ Sharing (United were used to develop MLA models to predict 90-day post-LT mortality. Models were developed using each registry individually (based on variables inherent to the individual databases) and using all 3 registries combined iables in common between the registries [harmonized]). The model performance was evaluated using area the receiver operating characteristic (AUROC) curve. The number of patients included was as follows: Canada, = 1214; the United Kingdom, n = 5287; and the United States, n = 59,558. The best performing MLA-based model was ridge regression across both individual registries and harmonized data sets. Model performance diminished from individualized to the harmonized registries, especially in Canada (individualized ridge: AUROC, 0.74; range, 0.73-0.74; harmonized: AUROC, 0.68; range, 0.50-0.73) and US (individualized ridge: AUROC, range, 0.70-0.71; harmonized: AUROC, 0.66; range, 0.66-0.66) data sets. External model performance countries was poor overall. MLA-based models yield a fair discriminatory potential when used within individual databases. However, the external validity of these models is poor when applied across countries. Standardization of registry-based variables could facilitate the added value of MLA-based models in informing decision making future LTs.

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Added entries (persons, corporate bodies, meetings, titles ...)

  • So, DelvinHosp Sick Children, Ctr Computat Med, Toronto, ON, Canada. (author)
  • Claasen, Marco P. A. W.Univ Hlth Network Toronto, Multi Organ Transplant Program, Toronto, ON, Canada.;Univ Med Ctr Rotterdam, Erasmus MC Transplant Inst, Dept Surg, Div HPB & Transplant Surg, Rotterdam, Netherlands. (author)
  • Wallace, DavidKings Coll Hosp NHS Fdn Trust, London Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, London, England.;Kings Coll Hosp NHS Fdn Trust, Inst Liver Studies, London, England. (author)
  • Patel, Madhukar S.Univ Texas Southwestern Med Ctr, Div Surg Transplantat, Dept Surg, Dallas, TX USA. (author)
  • Gravely, AnnabelUniv Hlth Network Toronto, Multi Organ Transplant Program, Toronto, ON, Canada. (author)
  • Choi, Woo JinUniv Hlth Network Toronto, Multi Organ Transplant Program, Toronto, ON, Canada. (author)
  • Shwaartz, ChayaUniv Hlth Network Toronto, Multi Organ Transplant Program, Toronto, ON, Canada. (author)
  • Walker, KateGuys & St Thomas NHS Fdn Trust, Dept Nephrol & Transplantat, London, England. (author)
  • Erdman, LaurenHosp Sick Children, Ctr Computat Med, Toronto, ON, Canada. (author)
  • Sapisochin, GonzaloUniv Hlth Network Toronto, Multi Organ Transplant Program, Toronto, ON, Canada.;585 Univ Ave,11PMB184, Toronto, ON M5G 2N2, Canada. (author)
  • Uppsala universitetGastrointestinalkirurgi (creator_code:org_t)

Related titles

  • In:American Journal of Transplantation: ELSEVIER SCIENCE INC23:1, s. 64-711600-61351600-6143

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