Evidence map›Paper›PMID 31104700›Full record

ArticleComputer methods and programs in biomedicine2019

Predicting daily outcomes in acetaminophen-induced acute liver failure patients with machine learning techniques.

Jaime Lynn Speiser, Constantine J Karvellas, Bethany J Wolf, Dongjun Chung, David G Koch, Valerie L Durkalski

Abstract read
In one paragraph

Article in Computer methods and programs in biomedicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

6 authors.

Jaime Lynn SpeiserDepartment of Biostatistics and Data Science, Wake Forest School of Medicine, Winston Salem, NC, United States. Electronic address: jspeiser@wakehealth.edu.
Constantine J KarvellasDivisions of Hepatology and Critical Care Medicine, University of Alberta, Edmonton, Canada.
Bethany J WolfDepartment of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States.
Dongjun ChungDepartment of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States.
David G KochDivision of Gastroenterology and Hepatology, Department of Medicine, Medical University of South Carolina, Charleston, SC, United States.
Valerie L DurkalskiDepartment of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States.

Funding

A Multi-Center Study of Acute Liver Failure in AdultsU01DK058369 · NIDDK · UT SOUTHWESTERN MEDICAL CENTER · PI DURKALSKI, VALERIE L, FONTANA, ROBERT J · 2005 to 2019
$27.4M
Wake Forest Clinical and Translational Science AwardKL2TR001421 · NCATS · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI MILLER, DAVID P · 2015 to 2023
$5.8M
South Carolina Clinical & Translational Research Institute (SCTR)TL1TR001451 · NCATS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI FEGHALI-BOSTWICK, CAROL A. · 2015 to 2024
$4.6M
A MULTI-CENTER THERAPY TRIAL FOR ACUTE LIVER FAILURER01DK058369 · NIDDK · UNIVERSITY OF TEXAS SW MED CTR/DALLAS · PI LEE, WILLIAM M · 2000 to 2004
$4.2M
NCATS NIH HHS KL2 TR001421NCATS NIH HHS TL1 TR001451NIDDK NIH HHS R01 DK058369NIDDK NIH HHS U01 DK058369
6 · The paper itself

Abstract

BACKGROUND/

objectiveAssessing prognosis for acetaminophen-induced acute liver failure (APAP-ALF) patients during the first week of hospitalization often presents significant challenges. Current models such as the King's College Criteria (KCC) and the Acute Liver Failure Study Group (ALFSG) Prognostic Index are developed to predict outcome using only a single time point on hospital admission. Models using longitudinal data are not currently available for APAP-ALF patients. We aim to develop and compare performance of prediction models for outcomes during the first week of hospitalization for APAP-ALF patients.

methodsModels are developed for the ALFSG registry data to predict longitudinal outcomes for 1042 APAP-ALF patients enrolled 01/1998-02/2016. The primary outcome is defined as daily low versus high coma grade. Accuracy in prediction of outcome (AC), sensitivity (SN), specificity (SP) and area under the receiver operating curve (AUC) are compared between the following models: classification and regression tree, random forest, frequentist generalized linear mixed model (GLMM), Bayesian GLMM, BiMM tree, and BiMM forest using original and imputed datasets.

resultsBiMM tree offers predictive (test set) 63% AC, 72% SP and 53% SN for the original dataset, whereas BiMM forest offers predictive (test set) 69% AC, 63% SP and 74% SN for the imputed dataset. BiMM tree has the highest AUC for the original testing dataset (0.697), whereas BiMM forest and standard random forest have the highest AUC for the imputed testing dataset (0.749). The three most important predictors of daily outcome for the BiMM tree are pressor use, bilirubin and creatinine. The BiMM forest model identifies lactate, ammonia and ALT as the three most important predictors of outcome.

conclusionsBiMM tree offers a prognostic tool for APAP-ALF patients, which has good accuracy and simple interpretation of predictors which are consistent with clinical observations. BiMM tree and forest models are developed using the first week of in-patient data and are appropriate for predicting outcome over time. While the BiMM forest has slightly higher predictive AC, the BiMM tree model is simpler to use at the bedside.

Indexed as

Machine LearningAcetaminophenAdultArea Under CurveBayes TheoremDatabases, FactualFemaleHumansLinear ModelsLiver Failure, AcuteMaleMiddle AgedPredictive Value of TestsPrognosisRegistriesRetrospective StudiesAcetaminophenAcetaminophen hepatotoxicityAcute liver failureDecision treeFulminant hepatic failureRandom forest

Identifiers

PMID31104700
PMCPMC6530588

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.