Tuesday, August 1, 2023

Cardiac Risk Stratification in Renal Transplantation Using a Form of Artificial Intelligence.

In this study, we found that an expert network (a combination of a neural network and an expert system) was effective at risk-stratifying patients for renal transplantation.

Abstract. The purpose of this study was to determine if an expert network, a form of artificial intelligence, could effectively stratify cardiac risk in candidates for renal transplant. Input into the expert network consisted of clinical risk factors and thallium-201 stress test data. Clinical risk factor screening alone identified 95 of 189 patients as high risk. These 95 patients underwent thallium-201stress testing, and 53 had either reversible or fixed defects. The other 42 patients were classified as low risk. This algorithm made up the ‘‘expert system,’’ and during the 4-year follow-up period had a sensitivity of 82%, specificity of 77%, and accuracy of 78%. An artificial neural network was added to the expert system, creating an expert network. Input into the neural network consisted of both clinical variables and thallium-201stress test data. There were 5 hidden nodes and the out-put (endpoint) was cardiac death. The expert network increased the specificity of the expert system alone from 77% to 90% (p < 0.001), the accuracy from 78% to 89% (p < 0.005), and maintained the overall sensitivity at 88%. An expert network based on clinical risk factor screening and thallium-201 stress testing had an accuracy of 89% in predicting the 4-year cardiac mortality among 189 renal transplant candidates.

Citation:  Heston, Thomas F, Norman, Douglas J, Barry, John M, Bennett, William M, & Wilson, Richard A. (1997). Cardiac Risk Stratification in Renal Transplantation Using a Form of Artificial Intelligence. American Journal of Cardiology, 79, 415–417. https://doi.org/10.5281/zenodo.8126728