Personalising monitoring for chemotherapy patients through predicting deterioration in renal and hepatic function
Chambers, Pinkie Watson, Matthew Bridgewater, John Forster, Martin D Roylance, Rebecca Burgoyne, Rebecca Masento, Sebastian Steventon, Luke Harmsworth King, James Duncan, Nick
Chambers, Pinkie
Watson, Matthew
Bridgewater, John
Forster, Martin D
Roylance, Rebecca
Burgoyne, Rebecca
Masento, Sebastian
Steventon, Luke
Harmsworth King, James
Duncan, Nick
Citations
Altmetric:
Affiliation
Other Contributors
Publication date
2023-08-23
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
Background: In those receiving chemotherapy, renal and hepatic dysfunction can increase the risk of toxicity and should therefore be monitored. We aimed to develop a machine learning model to identify those patients that need closer monitoring, enabling a safer and more efficient service.
Methods: We used retrospective data from a large academic hospital, for patients treated with chemotherapy for breast cancer, colorectal cancer and diffuse-large B-cell lymphoma, to train and validate a Multi-Layer Perceptrons (MLP) model to predict the outcomes of unacceptable rises in bilirubin or creatinine. To assess the performance of the model, validation was performed using patient data from a separate, independent hospital using the same variables. Using this dataset, we evaluated the sensitivity and specificity of the model.
Results: 1214 patients in total were identified. The training set had almost perfect sensitivity and specificity of >0.95; the area under the curve (AUC) was 0.99 (95% CI 0.98-1.00) for creatinine and 0.97 (95% CI: 0.95-0.99) for bilirubin. The validation set had good sensitivity (creatinine: 0.60, 95% CI: 0.55-0.64, bilirubin: 0.54, 95% CI: 0.52-0.56), and specificity (creatinine 0.98, 95% CI: 0.96-0.99, bilirubin 0.90, 95% CI: 0.87-0.94) and area under the curve (creatinine: 0.76, 95% CI: 0.70, 0.82, bilirubin 0.72, 95% CI: 0.68-0.76).
Conclusions: We have demonstrated that a MLP model can be used to reduce the number of blood tests required for some patients at low risk of organ dysfunction, whilst improving safety for others at high risk.
Citation
Chambers P, Watson M, Bridgewater J, Forster MD, Roylance R, Burgoyne R, Masento S, Steventon L, Harmsworth King J, Duncan N, Al Moubayed N. Personalising monitoring for chemotherapy patients through predicting deterioration in renal and hepatic function. Cancer Med. 2023 Aug 23. doi: 10.1002/cam4.6418. Epub ahead of print. PMID: 37610318.
Type
Article