Department of Evidence-based Medicine and clinical epidemiology, West China Medical School of Medicine/West China Hospital, Sichuan University, Chengdu, China.
Department of Career development, The fourth affiliated hospital of Anhui Medical University, Hefei, China.
Sci Rep. 2018 Jun 26;8(1):9712. doi: 10.1038/s41598-018-27772-9.
Warfarin is the most recommended anticoagulant drug for patients undergoing heart valve replacement. However, due to the narrow therapeutic window and individual dose, the use of warfarin needs more advanced technology. We used the data collected from a multi-central registered clinical system all over China about the patients who have undergone heart valve replacement, subsequently divided into three groups (training group: 10673 cases; internal validation group: 3558 cases; external validation group: 1463 cases) in order to construct a hybrid model with genetic algorithm and Back-Propagation neural network (BP-GA), For testing the model's prediction accuracy, we used Mean absolute error (MAE), Root mean squared error (RMSE) and the ideal predicted percentage of total and dose subgroups. In results, whether in internal or in external validation group, the total ideal predicted percentage was over 58% while the intermediate dose subgroup manifested the best. Moreover, it showed higher prediction accuracy, lower MAE value and lower RMSE value in the external validation group than that in the internal validation group (p < 0.05). In conclusion, BP-GA model is promising to predict warfarin maintenance dose.
华法林是心脏瓣膜置换术后患者最推荐的抗凝药物。然而，由于治疗窗较窄和个体剂量，华法林的使用需要更先进的技术。我们使用了来自中国多中心注册临床系统的数据，这些数据涉及已经接受心脏瓣膜置换术的患者，随后将其分为三组（训练组：10673 例；内部验证组：3558 例；外部验证组：1463 例），以构建一种基于遗传算法和反向传播神经网络（BP-GA）的混合模型，用于测试模型的预测准确性，我们使用了平均绝对误差（MAE）、均方根误差（RMSE）和总剂量亚组的理想预测百分比。结果显示，无论是内部验证组还是外部验证组，总理想预测百分比均超过 58%，而中剂量亚组表现最佳。此外，与内部验证组相比，外部验证组的预测准确性更高，MAE 值和 RMSE 值更低（p<0.05）。综上所述，BP-GA 模型有望预测华法林维持剂量。
