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人工智能在预测慢性肾脏病预后中的应用。一项系统评价与Meta分析。

Artificial intelligence in predicting chronic kidney disease prognosis. A systematic review and meta-analysis.

作者信息

Pan Qinyu, Tong Mengli

机构信息

Hangzhou TCM Hospital, Affiliated to Zhejiang Chinese Medical University, Hangzhou, China.

出版信息

Ren Fail. 2024 Dec;46(2):2435483. doi: 10.1080/0886022X.2024.2435483. Epub 2024 Dec 11.

Abstract

BACKGROUND

Chronic kidney disease (CKD) is a common condition that can lead to serious health complications. Artificial Intelligence (AI) has shown the potential to improve the prediction of CKD progression, offering increased accuracy over traditional methods. Therefore, this systematic review and meta-analysis examine the diagnostic performance of various AI models in predicting CKD.

METHOD

Search was performed in different databases for studies reporting the diagnostic accuracy of AI-based prediction models for the progression of CKD. Meanwhile, pre-defined eligibility criteria were used for the selection of studies. Pooled sensitivity, specificity, and area under curve (AUC) were calculated utilizing Meta-disc 1.4. Quality assessment was performed using the prediction model risk of bias assessment tool (PROBAST).

RESULTS

A total of 33 studies were included. The pooled sensitivity of prediction tools was 0.43 (95% CI, 0.41-0.44, = 99.3%,  < 0.01). A significant difference ( < 0.01) was also observed in the pooled specificity 0.92 (95% CI, 0.91-0.92, = 99.5%). Positive likelihood ratio (PLP) and negative likelihood ratio (NLR) were 5.12 (95% CI: 3.60-7.27, = 91.3%,  < 0.01) and 0.28 (95% CI: 0.21-0.37, = 99.3%,  < 0.01), respectively and AUC was 0.89, suggesting a diagnostic accuracy of AI-based prediction models for the progression of CKD.

CONCLUSIONS

This study demonstrates the promising potential of AI models in predicting CKD progression. However, further efforts are needed to optimize model performance, particularly in balancing sensitivity and specificity to ensure generalizability across diverse populations. Limitations of this study include the potential for overfitting in certain AI models due to imbalanced datasets. The high heterogeneity and the lack of standardized predictors limit the generalizability of findings across different populations.

摘要

背景

慢性肾脏病(CKD)是一种常见疾病,可导致严重的健康并发症。人工智能(AI)已显示出改善CKD进展预测的潜力,比传统方法具有更高的准确性。因此,本系统评价和荟萃分析考察了各种AI模型在预测CKD方面的诊断性能。

方法

在不同数据库中检索报告基于AI的CKD进展预测模型诊断准确性的研究。同时,使用预先定义的纳入标准筛选研究。利用Meta-disc 1.4计算合并敏感度、特异度和曲线下面积(AUC)。使用预测模型偏倚风险评估工具(PROBAST)进行质量评估。

结果

共纳入33项研究。预测工具的合并敏感度为0.43(95%CI,0.41 - 0.44,I² = 99.3%,P < 0.01)。合并特异度0.92(95%CI,0.91 - 0.92,I² = 99.5%)也观察到显著差异(P < 0.01)。阳性似然比(PLR)和阴性似然比(NLR)分别为5.12(95%CI:3.60 - 7.27,I² = 91.3%,P < 0.01)和0.28(95%CI:0.21 - 0.37,I² = 99.3%,P < 0.01),AUC为0.89,表明基于AI的预测模型对CKD进展具有诊断准确性。

结论

本研究证明了AI模型在预测CKD进展方面具有广阔的潜力。然而,需要进一步努力优化模型性能,特别是在平衡敏感度和特异度方面,以确保在不同人群中的可推广性。本研究的局限性包括由于数据集不平衡,某些AI模型可能存在过拟合。高度的异质性和缺乏标准化的预测指标限制了研究结果在不同人群中的可推广性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/249f/11636155/f3f3124a0f77/IRNF_A_2435483_F0001_C.jpg

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