Journal
LIFE-BASEL
Volume 12, Issue 6, Pages -Publisher
MDPI
DOI: 10.3390/life12060776
Keywords
heart failure; machine learning; mortality risk; patient phenotypes; prognosis
Categories
Funding
- JSPS Kakenhi Basic Research Fund [C 21K10287]
- Competitive Research Fund of The University of Aizu [2021-P-5]
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This study utilized machine learning to identify three phenotypes of heart failure patients, stratifying them based on survival curves and mortality risk effectively. By training on the derivation dataset, these phenotypes were successfully applied to new patients in the validation dataset, with age and creatinine clearance rate identified as the top two most important predictors.
Identifying patient prognostic phenotypes facilitates precision medicine. This study aimed to explore phenotypes of patients with heart failure (HF) corresponding to prognostic condition (risk of mortality) and identify the phenotype of new patients by machine learning (ML). A unsupervised ML was applied to explore phenotypes of patients in a derivation dataset (n = 562) based on their medical records. Thereafter, supervised ML models were trained on the derivation dataset to classify these identified phenotypes. Then, the trained classifiers were further validated on an independent validation dataset (n = 168). Finally, Shapley additive explanations were used to interpret decision making of phenotype classification. Three patient phenotypes corresponding to stratified mortality risk (high, low, and intermediate) were identified. Kaplan-Meier survival curves among the three phenotypes had significant difference (pairwise comparison p < 0.05). Hazard ratio of all-cause mortality between patients in phenotype 1 (n = 91; high risk) and phenotype 3 (n = 329; intermediate risk) was 2.08 (95%CI 1.29-3.37, p = 0.003), and 0.26 (95%CI 0.11-0.61, p = 0.002) between phenotype 2 (n = 142; low risk) and phenotype 3. For phenotypes classification by random forest, AUCs of phenotypes 1, 2, and 3 were 0.736 +/- 0.038, 0.815 +/- 0.035, and 0.721 +/- 0.03, respectively, slightly better than the decision tree. Then, the classifier effectively identified the phenotypes for new patients in the validation dataset with significant difference on survival curves and hazard ratios. Finally, age and creatinine clearance rate were identified as the top two most important predictors. ML could effectively identify patient prognostic phenotypes, facilitating reasonable management and treatment considering prognostic condition.
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