Felix Susanne E A, Bagheri Ayoub, Ramjankhan Faiz R, Spruit Marco R, Oberski Daniel, de Jonge Nicolaas, van Laake Linda W, Suyker Willem J L, Asselbergs Folkert W
Department of Cardiology, Division Heart & Lungs, University Medical Centre Utrecht, University of Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands.
Department of Methodology and Statistics, Faculty of Social Sciences, Utrecht University, Utrecht, the Netherlands.
Eur Heart J Digit Health. 2021 Oct 1;2(4):635-642. doi: 10.1093/ehjdh/ztab082. eCollection 2021 Dec.
Over a third of patients, treated with mechanical circulatory support (MCS) for end-stage heart failure, experience major bleeding. Currently, the prediction of a major bleeding in the near future is difficult because of many contributing factors. Predictive analytics using data mining could help calculating the risk of bleeding; however, its application is generally reserved for experienced researchers on this subject. We propose an easily applicable data mining tool to predict major bleeding in MCS patients.
All data of electronic health records of MCS patients in the University Medical Centre Utrecht were included. Based on the cross-industry standard process for data mining (CRISP-DM) methodology, an application named Auto-Crisp was developed. Auto-Crisp was used to evaluate the predictive models for a major bleeding in the next 3, 7, and 30 days after the first 30 days post-operatively following MCS implantation. The performance of the predictive models is investigated by the area under the curve (AUC) evaluation measure. In 25.6% of 273 patients, a total of 142 major bleedings occurred during a median follow-up period of 542 [interquartile range (IQR) 205-1044] days. The best predictive models assessed by Auto-Crisp had AUC values of 0.792, 0.788, and 0.776 for bleedings in the next 3, 7, and 30 days, respectively.
The Auto-Crisp-based predictive model created in this study had an acceptable performance to predict major bleeding in MCS patients in the near future. However, further validation of the application is needed to evaluate Auto-Crisp in other research projects.
超过三分之一接受机械循环支持(MCS)治疗终末期心力衰竭的患者发生严重出血。目前,由于多种促成因素,很难预测近期内的严重出血情况。使用数据挖掘的预测分析有助于计算出血风险;然而,其应用通常仅限于该领域的经验丰富的研究人员。我们提出一种易于应用的数据挖掘工具来预测MCS患者的严重出血情况。
纳入乌得勒支大学医学中心MCS患者电子健康记录的所有数据。基于数据挖掘的跨行业标准流程(CRISP-DM)方法,开发了一个名为Auto-Crisp的应用程序。Auto-Crisp用于评估MCS植入术后前30天之后接下来3天、7天和30天内严重出血的预测模型。通过曲线下面积(AUC)评估指标研究预测模型的性能。在273例患者中,25.6%的患者在中位随访期542天[四分位间距(IQR)205 - 1044天]内共发生142次严重出血。Auto-Crisp评估的最佳预测模型对接下来3天、7天和30天内出血的AUC值分别为0.792、0.788和0.776。
本研究中创建的基于Auto-Crisp的预测模型在预测MCS患者近期严重出血方面具有可接受的性能。然而,需要进一步验证该应用程序,以便在其他研究项目中评估Auto-Crisp。