TY - JOUR
T1 - Artificial intelligence modelling to assess the risk of cardiovascular disease in oncology patients
AU - Al-Droubi, Samer S.
AU - Jahangir, Eiman
AU - Kochendorfer, Karl M.
AU - Krive, Marianna
AU - Laufer-Perl, Michal
AU - Gilon, Dan
AU - Okwuosa, Tochukwu M.
AU - Gans, Christopher P.
AU - Arnold, Joshua H.
AU - Bhaskar, Shakthi T.
AU - Yasin, Hesham A.
AU - Krive, Jacob
N1 - Publisher Copyright:
© 2023 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2023/8/1
Y1 - 2023/8/1
N2 - Aims: There are no comprehensive machine learning (ML) tools used by oncologists to assist with risk identification and referrals to cardio-oncology. This study applies ML algorithms to identify oncology patients at risk for cardiovascular disease for referrals to cardio-oncology and to generate risk scores to support quality of care. Methods and results: De-identified patient data were obtained from Vanderbilt University Medical Center. Patients with breast, kidney, and B-cell lymphoma cancers were targeted. Additionally, the study included patients who received immunotherapy drugs for treatment of melanoma, lung cancer, or kidney cancer. Random forest (RF) and artificial neural network (ANN) ML models were applied to analyse each cohort: A total of 20 023 records were analysed (breast cancer, 6299; B-cell lymphoma, 9227; kidney cancer, 2047; and immunotherapy for three covered cancers, 2450). Data were divided randomly into training (80%) and test (20%) data sets. Random forest and ANN performed over 90% for accuracy and area under the curve (AUC). All ANN models performed better than RF models and produced accurate referrals. Conclusion: Predictive models are ready for translation into oncology practice to identify and care for patients who are at risk of cardiovascular disease. The models are being integrated with electronic health record application as a report of patients who should be referred to cardio-oncology for monitoring and/or tailored treatments. Models operationally support cardio-oncology practice. Limited validation identified 86% of the lymphoma and 58% of the kidney cancer patients with major risk for cardiotoxicity who were not referred to cardio-oncology.
AB - Aims: There are no comprehensive machine learning (ML) tools used by oncologists to assist with risk identification and referrals to cardio-oncology. This study applies ML algorithms to identify oncology patients at risk for cardiovascular disease for referrals to cardio-oncology and to generate risk scores to support quality of care. Methods and results: De-identified patient data were obtained from Vanderbilt University Medical Center. Patients with breast, kidney, and B-cell lymphoma cancers were targeted. Additionally, the study included patients who received immunotherapy drugs for treatment of melanoma, lung cancer, or kidney cancer. Random forest (RF) and artificial neural network (ANN) ML models were applied to analyse each cohort: A total of 20 023 records were analysed (breast cancer, 6299; B-cell lymphoma, 9227; kidney cancer, 2047; and immunotherapy for three covered cancers, 2450). Data were divided randomly into training (80%) and test (20%) data sets. Random forest and ANN performed over 90% for accuracy and area under the curve (AUC). All ANN models performed better than RF models and produced accurate referrals. Conclusion: Predictive models are ready for translation into oncology practice to identify and care for patients who are at risk of cardiovascular disease. The models are being integrated with electronic health record application as a report of patients who should be referred to cardio-oncology for monitoring and/or tailored treatments. Models operationally support cardio-oncology practice. Limited validation identified 86% of the lymphoma and 58% of the kidney cancer patients with major risk for cardiotoxicity who were not referred to cardio-oncology.
KW - Cardio-oncology
KW - Cardiotoxicity
KW - Cardiovascular disease
KW - Cardiovascular risk assessment
KW - Machine learning
KW - Medical artificial intelligence
UR - http://www.scopus.com/inward/record.url?scp=85168706481&partnerID=8YFLogxK
U2 - 10.1093/ehjdh/ztad031
DO - 10.1093/ehjdh/ztad031
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C2 - 37538144
AN - SCOPUS:85168706481
SN - 2634-3916
VL - 4
SP - 302
EP - 315
JO - European Heart Journal - Digital Health
JF - European Heart Journal - Digital Health
IS - 4
ER -