Longitudinal clinical data improve survival prediction after hematopoietic cell transplantation using machine learning

Yiwang Zhou, Jesse Smith, Dinesh Keerthi, Cai Li, Yilun Sun, Suraj Sarvode Mothi, David C. Shyr, Barbara Spitzer, Andrew Harris, Avijit Chatterjee, Subrata Chatterjee, Roni Shouval, Swati Naik, Alice Bertaina, Jaap Jan Boelens, Brandon M. Triplett, Li Tang, Akshay Sharma*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Serial prognostic evaluation after allogeneic hematopoietic cell transplantation (allo-HCT) might help identify patients at high risk of lethal organ dysfunction. Current prediction algorithms based on models that do not incorporate changes to patients’ clinical condition after allo-HCT have limited predictive ability. We developed and validated a robust risk-prediction algorithm to predict short- and long-term survival after allo-HCT in pediatric patients that includes baseline biological variables and changes in the patients’ clinical status after allo-HCT. The model was developed using clinical data from children and young adults treated at a single academic quaternary-care referral center. The model was created using a randomly split training data set (70% of the cohort), internally validated (remaining 30% of the cohort) and then externally validated on patient data from another tertiary-care referral center. Repeated clinical measurements performed from 30 days before allo-HCT to 30 days afterwards were extracted from the electronic medical record and incorporated into the model to predict survival at 100 days, 1 year, and 2 years after allo-HCT. Naïve-Bayes machine learning models incorporating longitudinal data were significantly better than models constructed from baseline variables alone at predicting whether patients would be alive or deceased at the given time points. This proof-of-concept study demonstrates that unlike traditional prognostic tools that use fixed variables for risk assessment, incorporating dynamic variability using clinical and laboratory data improves the prediction of mortality in patients undergoing allo-HCT.

Original languageEnglish
Pages (from-to)686-698
Number of pages13
JournalBlood advances
Volume8
Issue number3
DOIs
StatePublished - 13 Feb 2024
Externally publishedYes

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