在接受维持血液透析的患者中,用计算机辅助处方激素生成刺激剂:用于人工智能模型选择的随机对照试验
Lee-Moay Lim1,2, Ming-Yen Lin1, Chan Hsu3
1Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
JAMIA open
|March 31, 2025
概括
一个人工智能 (AI) 模型,REEM树,通过优化红色素形成刺激剂 (ESA) 剂量,证明在治疗血液透析患者的贫血方面与医生一样有效. 这种人工智能方法有助于安全地保持目标血红蛋白水平.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 人工智能在医学中的应用
- 临床试验研究 临床试验研究
背景情况:
- 血液透析 (HD) 患者的贫血管理通常涉及红色素形成刺激剂 (ESAs).
- 使用机器学习 (ML) 预测最佳的ESA剂量仍然是一个挑战.
- 评估当代人工智能 (AI) 模型对ESA剂量处方至关重要.
研究的目的:
- 评估人工智能模型在给HD患者处方ESA剂量的有效性.
- 将人工智能驱动的ESA剂量与医生指导的建议进行比较.
- 确定AI能否维持HD贫血管理的血红蛋白目标水平.
主要方法:
- 一个双盲,随机对照试验,将传统医生 (Dr) 组与人工智能组进行比较.
- 人工智能组使用随机效应 (REEM) 树,混合效应随机森林 (MERF) 和长短期记忆 (LSTM) 网络进行ESA剂量预测.
- 主要结果:保持血红蛋白 (Hb) 接近11g/dL (±0.25g/dL);次要结果:Hb在10-12g/dL之间.
主要成果:
- 104名参与者完成了这项研究;平均Hb水平为10.8g/dL (AI) 和10.9g/dL (Dr).
- 在AI组的69.7%和Dr组的73.5%实现了目标Hb水平 (10-12g/dL).
- 只有REEM树人工智能模型满足了初级和二级结果的非劣势标准;在组之间没有显著的不良事件有所不同.
结论:
- 在REEM树AI模型中,在HD患者的ESA剂量管理中,REEM树AI模型证明与医生主导的管理没有劣势.
- 人工智能有效地帮助维持治疗性血红蛋白水平在目标范围内.
- 这项研究支持AI在优化血液透析患者贫血治疗方面的潜力.
相关概念视频
01:27Dialysis
236
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
236
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
331
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
331
01:11Renal Failure: Dose Adjustments
45
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
45
01:22iPS Cell Differentiation
2.6K
The ability of induced pluripotent stem cells or iPSCs to differentiate into most body cell types has stimulated repair and regenerative medicine research over the past few decades. iPSC-derived blood cells, hepatocytes, beta islet cells, cardiomyocytes, neurons, and other cell types can repair injuries or regenerate damaged tissue in diseases such as diabetes and neurodegenerative disorders.
2.6K
01:16Non-equilibrium in the Cell
4.1K
An important concept in studying metabolism and energy is that of chemical equilibrium. Most chemical reactions are reversible. They can proceed in both directions, releasing energy into their environment in one direction, and absorbing it from the environment in the other direction. The same is true for the chemical reactions involved in cell metabolism, such as the breaking down and building up of proteins into and from individual amino acids, respectively. Reactants within a closed system...
4.1K
01:33Hormonal Regulation
32.8K
The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
32.8K