Machine learning algorithms successfully predicted de novo cancer therapy-related cardiac dysfunction using clinically relevant variables (AUROC 0.802; 95% CI, 0.797-0.807).
Observational (n=4,309)
No
Can machine learning algorithms accurately predict cancer therapy-related cardiac dysfunction in oncology patients using electronic medical record data?
Machine learning algorithms using routine electronic medical record data can effectively predict the risk of cancer therapy-related cardiac dysfunction, offering a tool for cardiac risk stratification in oncology patients.
Effect estimate: AUROC 0.802 (95% CI 0.797-0.807)
Background The growing awareness of cardiovascular toxicity from cancer therapies has led to the emerging field of cardio-oncology, which centers on preventing, detecting, and treating patients with cardiac dysfunction before, during, or after cancer treatment. Early detection and prevention of cancer therapy-related cardiac dysfunction (CTRCD) play important roles in precision cardio-oncology. Methods and Results This retrospective study included 4309 cancer patients between 1997 and 2018 whose laboratory tests and cardiovascular echocardiographic variables were collected from the Cleveland Clinic institutional electronic medical record database (Epic Systems). Among these patients, 1560 (36%) were diagnosed with at least 1 type of CTRCD, and 838 (19%) developed CTRCD after cancer therapy (de novo). We posited that machine learning algorithms can be implemented to predict CTRCDs in cancer patients according to clinically relevant variables. Classification models were trained and evaluated for 6 types of cardiovascular outcomes, including coronary artery disease (area under the receiver operating characteristic curve AUROC, 0.821; 95% CI, 0.815-0.826), atrial fibrillation (AUROC, 0.787; 95% CI, 0.782-0.792), heart failure (AUROC, 0.882; 95% CI, 0.878-0.887), stroke (AUROC, 0.660; 95% CI, 0.650-0.670), myocardial infarction (AUROC, 0.807; 95% CI, 0.799-0.816), and de novo CTRCD (AUROC, 0.802; 95% CI, 0.797-0.807). Model generalizability was further confirmed using time-split data. Model inspection revealed several clinically relevant variables significantly associated with CTRCDs, including age, hypertension, glucose levels, left ventricular ejection fraction, creatinine, and aspartate aminotransferase levels. Conclusions This study suggests that machine learning approaches offer powerful tools for cardiac risk stratification in oncology patients by utilizing large-scale, longitudinal patient data from healthcare systems.
Zhou et al. (2020) conducted an observational in Cancer therapy-related cardiac dysfunction (n=4,309). Machine learning algorithms was evaluated on Prediction of de novo cancer therapy-related cardiac dysfunction (AUROC 0.802, 95% CI 0.797-0.807). Machine learning algorithms successfully predicted de novo cancer therapy-related cardiac dysfunction using clinically relevant variables (AUROC 0.802; 95% CI, 0.797-0.807).