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Machine Learning Model to Predict Outcome in Acute Hypoxemic Respiratory Failure

Active, not recruiting
Conditions
Acute Hypoxemic Respiratory Failure
Interventions
Other: machine learning analysis
Registration Number
NCT06333002
Lead Sponsor
Dr. Negrin University Hospital
Brief Summary

Acute hypoxemic respiratory failure (AHRF) is the most common cause of admission in the intensive care units (UCIs) worldwide. We will assess the value of machine learning (ML) techniques for early prediction of ICU death in 1,241 patients enrolled in the PANDORA (Prevalence AND Outcome of acute Respiratory fAilure) Study in Spain. The study was registered with ClinicalTrials.gov (NCT03145974). Our aim is to evaluate the minimum number of variables models using logistic regression and four supervised ML algorithms: Random Forest, Extreme Gradient Boosting, Support Vector Machine and Multilayer Perceptron.

Detailed Description

Acute hypoxemic respiratory failure (AHRF) is the most common cause of admission in the intensive care units (UCIs) worldwide. We will assess the value of machine learning (ML) techniques for early prediction of ICU death in AHRF patients on mechanical ventilation (MV). Few studies have investigated the prediction of mortality in patients with AHRF.

For model development, the investigators will extract data for the first 2 days after diagnosis of AHRF from patients included in the de-identified database of the PANDORA cohort. We had a database with 2,000,000 anonymized and dissociated demographics and clinical, data from 1,241 patients with AHRF enrolled in our PANDORA cohort (Prevalence AND Outcome of acute Respiratory fAilure) from 22 Spanish hospitals and coordinated by the principal investigator (JV). The investigators will follow the Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) guidelines for model prediction. We will screen collected variables employing a genetic algorithm variable selection method to achieve parsimony. We evaluated the minimum number of variables models using logistic regression and 4 supervised ML algorithms: Random Forest, Extreme Gradient Boosting, Support Vector Machine and Multilayer Perceptron. We will use a 5-fold cross-validation in the dataset of 1,000 patients selected randomly in training data (80%) and testing data (20%). For external validation, we will use the remaining 241 patients.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
1241
Inclusion Criteria
  • endotracheal intubation plus mechanical ventilation (MV)
  • PaO2/FiO2 ratio ≤300 mmHg under MV with positive end-expiratory pressure (PEEP) ≥5 cmH2O and FiO2 ≥0.3.
Exclusion Criteria
  • Post-operative patients ventilated <24 h
  • Brain death patients.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Derivation cohortmachine learning analysisIt will contain 800 patients randomly selected (80% of 1,000 patients with AHRF)
Validation cohortmachine learning analysisIt will contain 200 patients randomly selected (20% of 1000 patients with AHRF
Confirmatory cohortmachine learning analysisIt will contain the remaining 241 patients randomply selected (por external validation)
Primary Outcome Measures
NameTimeMethod
ICU mortalityup to 100 weeks (from inclusion to death or diascharge from intensive care unit

death in the intensive care unit

Secondary Outcome Measures
NameTimeMethod
MV durationup to 100 weeks (from inclusion to extubation)

duration of mechanical ventilation

Trial Locations

Locations (8)

Hospital Cinico de Valencia

🇪🇸

Valencia, Spain

Hospital Universitario La Paz

🇪🇸

Madrid, Spain

Hospital General Universitario de Ciudad Real

🇪🇸

Ciudad Real, Spain

Hospital Virgen de La Luz

🇪🇸

Cuenca, Spain

Hospital Universitario Puerta de Hierro

🇪🇸

Madrid, Spain

Hospital Universitario Virgen de Arrixaca

🇪🇸

Murcia, Spain

Hospital Universitario NS de Candelaria

🇪🇸

Santa Cruz De Tenerife, Spain

Hospital Universitario Rio Hortega

🇪🇸

Valladolid, Spain

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