Prediction of all-cause mortality in haemodialysis patients using a Bayesian network - Archive ouverte HAL
Article Dans Une Revue Nephrology Dialysis Transplantation Année : 2020

Prediction of all-cause mortality in haemodialysis patients using a Bayesian network

Résumé

BACKGROUND: All-cause mortality in haemodialysis (HD) is high, reaching 15.6% in the first year according to the European Renal Association. METHODS: A new clinical tool to predict all-cause mortality in HD patients is proposed. It uses a post hoc analysis of data from the prospective cohort study Photo-Graph V3. A total of 35 variables related to patient characteristics, laboratory values and treatments were used as predictors of all-cause mortality. The first step was to compare the results obtained using a logistic regression to those obtained by a Bayesian network. The second step aimed to increase the performance of the best prediction model using synthetic data. Finally, a compromise between performance and ergonomics was proposed by reducing the number of variables to be entered in the prediction tool. RESULTS: Among the 9010 HD patients included in the Photo-Graph V3 study, 4915 incident patients with known medical status at 2 years were analysed. All-cause mortality at 2 years was 34.1%. The Bayesian network provided the most reliable prediction. The final optimized models that used 14 variables had areas under the receiver operating characteristic curves of 0.78 ± 0.01, sensitivity of 72 ± 2%, specificity of 69 ± 2%, predictive positive value of 70 ± 1% and negative predictive value of 71 ± 2% for the prediction of all-cause mortality. CONCLUSIONS: Using artificial intelligence methods, a new clinical tool to predict all-cause mortality in incident HD patients is proposed. The latter can be used for research purposes before its external validation at: https://www.hed.cc/? a=twoyearsallcausemortalityhemod&n=2-years%20All-cause%20Mortality%20Hemodialysis.neta.

Dates et versions

hal-02901761 , version 1 (17-07-2020)

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Citer

M. M. Siga, M. Ducher, N. Florens, H. Roth, N. Mahloul, et al.. Prediction of all-cause mortality in haemodialysis patients using a Bayesian network. Nephrology Dialysis Transplantation, 2020, ⟨10.1093/ndt/gfz295⟩. ⟨hal-02901761⟩
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