Details

Autor(en) / Beteiligte

• CASTAÑO, ADAM
• HEITNER, STEPHEN B.
• MASRI, AHMAD
• HUDA, AHSAN
• CALAMBUR, VEENA
• BRUNO, MARIANNA
• SCHUMACHER, JENNIFER
• EMIR, BIROL
• ISHERWOOD, CATHERINE
• SHAH, SANJIV J.

Titel

EstimATTR: A Simplified, Machine-Learning-Based Tool to Predict the Risk of Wild-Type Transthyretin Amyloid Cardiomyopathy

Ist Teil von

• Journal of cardiac failure, 2024-06, Vol.30 (6), p.778-787

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2024

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• •A machine learning algorithm was adapted into a tool to estimate risk of ATTRwt-CM in hypothetical patient scenarios.•The adapted model performed well in classifying patients with ATTRwt-CM and patients with HF.•This novel framework could serve as a simple and easily implementable tool to aid the clinical assessment of patient risk for ATTRwt-CM. Wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM), an increasingly recognized cause of heart failure (HF), often remains undiagnosed until later stages of the disease. A previously developed machine learning algorithm was simplified to create a random forest model based on 11 selected phenotypes predictive of ATTRwt-CM to estimate ATTRwt-CM risk in hypothetical patient scenarios. Using U.S. medical claims datasets (IQVIA), International Classification of Diseases codes were extracted to identify a training cohort of patients with ATTRwt-CM (cases) or nonamyloid HF (controls). After assessment in a 20% test sample of the training cohort, model performance was validated in cohorts of patients with International Classification of Diseases codes for ATTRwt-CM or cardiac amyloidosis vs nonamyloid HF derived from medical claims (IQVIA) or electronic health records (Optum). The simplified model performed well in identifying patients with ATTRwt-CM vs nonamyloid HF in the test sample, with an accuracy of 74%, sensitivity of 77%, specificity of 72%, and area under the curve of 0.82; robust performance was also observed in the validation cohorts. This simplified machine learning model accurately estimated the empirical probability of ATTRwt-CM in administrative datasets, suggesting it may serve as an easily implementable tool for clinical assessment of patient risk for ATTRwt-CM in the clinical setting. Wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM for short) is a frequently overlooked cause of heart failure. Finding ATTRwt-CM early is important because the disease can worsen rapidly without treatment. Researchers developed a computer program that predicts the risk of ATTRwt-CM in patients with heart failure. In this study, the program was used to check for 11 medical conditions linked to ATTRwt-CM in the medical claims records of patients with heart failure. The program was 74% accurate in identifying ATTRwt-CM in patients with heart failure and was then used to develop an educational online tool for doctors (the wtATTR-CM estimATTR). The proportions of patients with ATTRwt-CM and odds ratios associated with ATTRwt-CM:nonamyloid HF for the 11 phenotypes included in the simplified random forest model. ATTRwt, wild-type transthyretin amyloidosis; ATTRwt-CM, wild-type transthyretin amyloid cardiomyopathy; HFpEF, heart failure with preserved ejection fraction; LVEF, left ventricular ejection fraction. [Display omitted]