特发性肺纤维化肺移植受者术后严重原发性移植物功能障碍预后模型的建立

Establishment of prognostic model for severe primary graft dysfunction in patients with idiopathic pulmonary fibrosis after lung transplantation

  • 摘要:
      目的  探索性构建基于机器学习算法预测特发性肺纤维化(IPF)肺移植受者术后原发性移植物功能障碍(PGD)的预后模型。
      方法  回顾性分析226例行肺移植手术的IPF患者的资料。所有入组患者按7∶3随机划分为训练集和测试集。利用正则化logistic回归、随机森林、支持向量机和人工神经网络4种方法,通过变量筛选、构建模型、模型调优流程构建模型。使用受试者工作特征曲线下面积(AUC)、阳性预测值、阴性预测值和准确度进行模型性能评估。
      结果  共筛选出16个关键特征用于建模。4种预后模型的AUC值均>0.7。DeLong检验和McNemar检验发现模型间性能差异无统计学意义(均为P>0.05)。
      结论  基于4种机器学习算法初步构建了肺移植术后3级PGD的预后模型。各模型整体预测性能相似,均可对IPF患者肺移植术后3级PGD进行较好的预测。

     

    Abstract:
      Objective  To explore the establishment of a prognostic model based on machine learning algorithm to predict primary graft dysfunction (PGD) in patients with idiopathic pulmonary fibrosis (IPF) after lung transplantation.
      Methods  Clinical data of 226 IPF patients who underwent lung transplantation were retrospectively analyzed. All patients were randomly divided into the training and test sets at a ratio of 7:3. Using regularized logistic regression, random forest, support vector machine and artificial neural network, the prognostic model was established through variable screening, model establishment and model optimization. The performance of this prognostic model was assessed by the area under the receiver operating characteristic curve (AUC), positive predictive value, negative predictive value and accuracy.
      Results  Sixteen key features were selected for model establishment. The AUC of the four prognostic models all exceeded 0.7. DeLong and McNemar tests found no significant difference in the performance among different models (both P>0.05).
      Conclusions  Based on four machine learning algorithms, the prognostic model for grade 3 PGD after lung transplantation is preliminarily established. The overall prediction performance of each model is similar, which may predict the risk of grade 3 PGD in IPF patients after lung transplantation.

     

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