Machine Learning Algorithms for Predicting and Risk Profiling of Cardiac Surgery-Associated Acute Kidney Injury
Using a large national database of cardiac surgical procedures, we applied machine learning (ML) to risk stratification and profiling for cardiac surgery-associated acute kidney injury. We compared performance of ML to established scoring tools. Four ML algorithms were used, including logistic regre...
| Main Authors: | , , , , , |
|---|---|
| Format: | Journal Article |
| Language: | English |
| Published: |
ELSEVIER INC
2021
|
| Subjects: | |
| Online Access: | http://purl.org/au-research/grants/nhmrc/1136372 http://hdl.handle.net/20.500.11937/93772 |
| _version_ | 1848765785819840512 |
|---|---|
| author | Penny-Dimri, J.C. Bergmeir, C. Reid, Christopher Williams-Spence, J. Cochrane, A.D. Smith, J.A. |
| author_facet | Penny-Dimri, J.C. Bergmeir, C. Reid, Christopher Williams-Spence, J. Cochrane, A.D. Smith, J.A. |
| author_sort | Penny-Dimri, J.C. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Using a large national database of cardiac surgical procedures, we applied machine learning (ML) to risk stratification and profiling for cardiac surgery-associated acute kidney injury. We compared performance of ML to established scoring tools. Four ML algorithms were used, including logistic regression (LR), gradient boosted machine (GBM), K-nearest neighbor, and neural networks (NN). These were compared to the Cleveland Clinic score, and a risk score developed on the same database. Five-fold cross-validation repeated 20 times was used to measure the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. Risk profiles from GBM and NN were generated using Shapley additive values. A total of 97,964 surgery events in 96,653 patients were included. For predicting postoperative renal replacement therapy using pre- and intraoperative data, LR, GBM, and NN achieved an AUC (standard deviation) of 0.84 (0.01), 0.85 (0.01), 0.84 (0.01) respectively outperforming the highest performing scoring tool with 0.81 (0.004). For predicting cardiac surgery-associated acute kidney injury, LR, GBM, and NN each achieved 0.77 (0.01), 0.78 (0.01), 0.77 (0.01) respectively outperforming the scoring tool with 0.75 (0.004). Compared to scores and LR, shapely additive values analysis of black box model predictions was able to generate patient-level explanations for each prediction. ML algorithms provide state-of-the-art approaches to risk stratification. Explanatory modeling can exploit complex decision boundaries to aid the clinician in understanding the risks specific to individual patients. |
| first_indexed | 2025-11-14T11:40:46Z |
| format | Journal Article |
| id | curtin-20.500.11937-93772 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:40:46Z |
| publishDate | 2021 |
| publisher | ELSEVIER INC |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-937722024-01-09T07:16:32Z Machine Learning Algorithms for Predicting and Risk Profiling of Cardiac Surgery-Associated Acute Kidney Injury Penny-Dimri, J.C. Bergmeir, C. Reid, Christopher Williams-Spence, J. Cochrane, A.D. Smith, J.A. Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Artificial intelligence Machine learning Emerging technology Cardiac surgery-associated acute kidney injury ACUTE-RENAL-FAILURE ERYTHROPOIETIN MODELS Artificial intelligence Cardiac surgery-associated acute kidney injury Emerging technology Machine learning Acute Kidney Injury Algorithms Cardiac Surgical Procedures Humans Logistic Models Machine Learning Risk Factors Humans Cardiac Surgical Procedures Logistic Models Risk Factors Algorithms Acute Kidney Injury Machine Learning Using a large national database of cardiac surgical procedures, we applied machine learning (ML) to risk stratification and profiling for cardiac surgery-associated acute kidney injury. We compared performance of ML to established scoring tools. Four ML algorithms were used, including logistic regression (LR), gradient boosted machine (GBM), K-nearest neighbor, and neural networks (NN). These were compared to the Cleveland Clinic score, and a risk score developed on the same database. Five-fold cross-validation repeated 20 times was used to measure the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. Risk profiles from GBM and NN were generated using Shapley additive values. A total of 97,964 surgery events in 96,653 patients were included. For predicting postoperative renal replacement therapy using pre- and intraoperative data, LR, GBM, and NN achieved an AUC (standard deviation) of 0.84 (0.01), 0.85 (0.01), 0.84 (0.01) respectively outperforming the highest performing scoring tool with 0.81 (0.004). For predicting cardiac surgery-associated acute kidney injury, LR, GBM, and NN each achieved 0.77 (0.01), 0.78 (0.01), 0.77 (0.01) respectively outperforming the scoring tool with 0.75 (0.004). Compared to scores and LR, shapely additive values analysis of black box model predictions was able to generate patient-level explanations for each prediction. ML algorithms provide state-of-the-art approaches to risk stratification. Explanatory modeling can exploit complex decision boundaries to aid the clinician in understanding the risks specific to individual patients. 2021 Journal Article http://hdl.handle.net/20.500.11937/93772 10.1053/j.semtcvs.2020.09.028 English http://purl.org/au-research/grants/nhmrc/1136372 http://purl.org/au-research/grants/nhmrc/1092642 ELSEVIER INC restricted |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Artificial intelligence Machine learning Emerging technology Cardiac surgery-associated acute kidney injury ACUTE-RENAL-FAILURE ERYTHROPOIETIN MODELS Artificial intelligence Cardiac surgery-associated acute kidney injury Emerging technology Machine learning Acute Kidney Injury Algorithms Cardiac Surgical Procedures Humans Logistic Models Machine Learning Risk Factors Humans Cardiac Surgical Procedures Logistic Models Risk Factors Algorithms Acute Kidney Injury Machine Learning Penny-Dimri, J.C. Bergmeir, C. Reid, Christopher Williams-Spence, J. Cochrane, A.D. Smith, J.A. Machine Learning Algorithms for Predicting and Risk Profiling of Cardiac Surgery-Associated Acute Kidney Injury |
| title | Machine Learning Algorithms for Predicting and Risk Profiling of Cardiac Surgery-Associated Acute Kidney Injury |
| title_full | Machine Learning Algorithms for Predicting and Risk Profiling of Cardiac Surgery-Associated Acute Kidney Injury |
| title_fullStr | Machine Learning Algorithms for Predicting and Risk Profiling of Cardiac Surgery-Associated Acute Kidney Injury |
| title_full_unstemmed | Machine Learning Algorithms for Predicting and Risk Profiling of Cardiac Surgery-Associated Acute Kidney Injury |
| title_short | Machine Learning Algorithms for Predicting and Risk Profiling of Cardiac Surgery-Associated Acute Kidney Injury |
| title_sort | machine learning algorithms for predicting and risk profiling of cardiac surgery-associated acute kidney injury |
| topic | Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Artificial intelligence Machine learning Emerging technology Cardiac surgery-associated acute kidney injury ACUTE-RENAL-FAILURE ERYTHROPOIETIN MODELS Artificial intelligence Cardiac surgery-associated acute kidney injury Emerging technology Machine learning Acute Kidney Injury Algorithms Cardiac Surgical Procedures Humans Logistic Models Machine Learning Risk Factors Humans Cardiac Surgical Procedures Logistic Models Risk Factors Algorithms Acute Kidney Injury Machine Learning |
| url | http://purl.org/au-research/grants/nhmrc/1136372 http://purl.org/au-research/grants/nhmrc/1136372 http://hdl.handle.net/20.500.11937/93772 |