Evidence map›Paper›PMID 37652176›Full record

ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2023

Predicting post-liver transplant outcomes in patients with acute-on-chronic liver failure using Expert-Augmented Machine Learning.

Jin Ge, Jean C Digitale, Cynthia Fenton, Charles E McCulloch, Jennifer C Lai, Mark J Pletcher, Efstathios D Gennatas

Abstract read
In one paragraph

Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. Review
  5. Article
  6. Generalizability of kidney transplant data in electronic health records - The Epic Cosmos database vs the Scientific Registry of Transplant Recipients.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2025
    Article
  7. Review
  8. Article
  9. Article
  10. From prognostication to therapeutics: Four key questions to accelerate the development of therapeutics for patients with acute-on-chronic liver failure.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2024
    Article
  11. Common definitions and variables are needed for the United States to join the conversation on acute-on-chronic liver failure.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Jin GeDivision of Gastroenterology and Hepatology, Department of Medicine, University of California-San Francisco, San Francisco, California, USA. Electronic address: jin.ge@ucsf.edu.
Jean C DigitaleDepartment of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California, USA.
Cynthia FentonDivision of Hospital Medicine, Department of Medicine, University of California-San Francisco, San Francisco, California, USA.
Charles E McCullochDepartment of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California, USA.
Jennifer C LaiDivision of Gastroenterology and Hepatology, Department of Medicine, University of California-San Francisco, San Francisco, California, USA.
Mark J PletcherDepartment of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California, USA.
Efstathios D GennatasDepartment of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California, USA.

Funding

Clinical and Translational Science InstituteUL1TR001872 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI COLLARD, HAROLD R, JACOBY, VANESSA · 2016 to 2025
$112.1M
UCSF Liver Core CenterP30DK026743 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Holger Willenbring · 1986 to 2026
$30.7M
Institutional Career Development Core SupplementKL2TR001870 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KANAYA, ALKA M., SARKAR, URMIMALA · 2016 to 2025
$19.7M
The spectrum of cognitive impairment including Alzheimer’s Disease and Related Dementias after liver transplantationR01AG059183 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Jennifer C. Lai · 2018 to 2026
$9.9M
The Impact of Frailty on Liver Transplant Outcomes in Older Adults with Hepatocellular CarcinomaK24AG080021 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Jennifer C. Lai · 2023 to 2026
$755k
Predicting earliest safe extubation time in pediatric patientsF31HL156498 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI DIGITALE, JEAN · 2021 to 2023
$118k
NCATS NIH HHS KL2 TR001870NCATS NIH HHS UL1 TR001872NHLBI NIH HHS F31 HL156498NIA NIH HHS K24 AG080021NIA NIH HHS R01 AG059183NIDDK NIH HHS P30 DK026743
6 · The paper itself

Abstract

Liver transplantation (LT) is a treatment for acute-on-chronic liver failure (ACLF), but high post-LT mortality has been reported. Existing post-LT models in ACLF have been limited. We developed an Expert-Augmented Machine Learning (EAML) model to predict post-LT outcomes. We identified ACLF patients who underwent LT in the University of California Health Data Warehouse. We applied the RuleFit machine learning (ML) algorithm to extract rules from decision trees and create intermediate models. We asked human experts to rate the rules generated by RuleFit and incorporated these ratings to generate final EAML models. We identified 1384 ACLF patients. For death at 1 year, areas under the receiver-operating characteristic curve were 0.707 (confidence interval [CI] 0.625-0.793) for EAML and 0.719 (CI 0.640-0.800) for RuleFit. For death at 90 days, areas under the receiver-operating characteristic curve were 0.678 (CI 0.581-0.776) for EAML and 0.707 (CI 0.615-0.800) for RuleFit. In pairwise comparisons, both EAML and RuleFit models outperformed cross-sectional models. Significant discrepancies between experts and ML occurred in rankings of biomarkers used in clinical practice. EAML may serve as a method for ML-guided hypothesis generation in further ACLF research.

Indexed as

Acute-On-Chronic Liver FailureLiver TransplantationBiomarkersCross-Sectional StudiesHumansPrognosisRetrospective StudiesROC CurveBiomarkersACLFbig datamachine learningposttransplant outcomesUCHDW

Identifiers

PMID37652176
PMCPMC11018271

What OpenQuestion holds

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Read underepoch 390

Registered trials

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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.