DeepVAQ : an adaptive deep learning for prediction of vascular access quality in hemodialysis patients

Chronic kidney disease is a prevalent global health issue, particularly in advanced stages requiring dialysis. Vascular access (VA) quality is crucial for the well-being of hemodialysis (HD) patients, ensuring optimal blood transfer through a dialyzer machine. The ultrasound dilution technique (UDT) is used as the gold standard for assessing VA quality; however, its limited availability due to high costs impedes its widespread adoption. We aimed to develop a novel deep learning model specifically designed to predict VA quality from Photoplethysmography (PPG) sensors.

Clinical data were retrospectively gathered from 398 HD patients, spanning from February 2021 to February 2022. The DeepVAQ model leverages a convolutional neural network (CNN) to process PPG sensor data, pinpointing specific frequencies and patterns that are indicative of VA quality. Meticulous training and fine-tuning were applied to ensure the model's accuracy and reliability. Validation of the DeepVAQ model was carried out against established diagnostic standards using key performance metrics, including accuracy, specificity, precision, F-score, and area under the receiver operating characteristic curve (AUC).

DeepVAQ demonstrated superior performance, achieving an accuracy of 0.9213 and a specificity of 0.9614. Its precision and F-score stood at 0.8762 and 0.8364, respectively, with an AUC of 0.8605. In contrast, traditional models like Decision Tree, Naive Bayes, and kNN demonstrated significantly lower performance across these metrics. This comparison underscores DeepVAQ's enhanced capability in accurately predicting VA quality compared to existing methodologies.

Exemplifying the potential of artificial intelligence in healthcare, particularly in the realm of deep learning, DeepVAQ represents a significant advancement in non-invasive diagnostics. Its precise multi-class classification ability for VA quality in hemodialysis patients holds substantial promise for improving patient outcomes, potentially leading to a reduction in mortality rates.