Hannun Pedro Guilherme Coelho, Andrade Luis Gustavo Modelli de
Universidade Estadual Paulista, Departamento de Medicina Interna, São Paulo, SP, Brasil.
J Bras Nefrol. 2019 Apr-Jun;41(2):284-287. doi: 10.1590/2175-8239-jbn-2018-0047. Epub 2018 Oct 18.
The prediction of post transplantation outcomes is clinically important and involves several problems. The current prediction models based on standard statistics are very complex, difficult to validate and do not provide accurate prediction. Machine learning, a statistical technique that allows the computer to make future predictions using previous experiences, is beginning to be used in order to solve these issues. In the field of kidney transplantation, computational forecasting use has been reported in prediction of chronic allograft rejection, delayed graft function, and graft survival. This paper describes machine learning principles and steps to make a prediction and performs a brief analysis of the most recent applications of its application in literature.
There is compelling evidence that machine learning approaches based on donor and recipient data are better in providing improved prognosis of graft outcomes than traditional analysis. The immediate expectations that emerge from this new prediction modelling technique are that it will generate better clinical decisions based on dynamic and local practice data and optimize organ allocation as well as post transplantation care management. Despite the promising results, there is no substantial number of studies yet to determine feasibility of its application in a clinical setting.
The way we deal with storage data in electronic health records will radically change in the coming years and machine learning will be part of clinical daily routine, whether to predict clinical outcomes or suggest diagnosis based on institutional experience.
移植后结果的预测在临床上具有重要意义,且涉及若干问题。当前基于标准统计学的预测模型非常复杂,难以验证,且无法提供准确的预测。机器学习是一种允许计算机利用以往经验进行未来预测的统计技术,正开始被用于解决这些问题。在肾移植领域,已有报道称计算预测在慢性移植物排斥反应、移植肾功能延迟恢复及移植物存活的预测中得到应用。本文介绍了机器学习进行预测的原理和步骤,并对其在文献中的最新应用进行了简要分析。
有令人信服的证据表明,基于供体和受体数据的机器学习方法在提供比传统分析更好的移植物结果预后方面表现更佳。这种新的预测建模技术带来的直接期望是,它将基于动态和本地实践数据做出更好的临床决策,并优化器官分配以及移植后护理管理。尽管取得了令人鼓舞的结果,但尚未有大量研究来确定其在临床环境中应用的可行性。
在未来几年,我们处理电子健康记录中存储数据的方式将发生根本性变化,机器学习将成为临床日常工作的一部分,无论是用于预测临床结果还是根据机构经验建议诊断。