Improved glomerular filtration rate estimation by an artificial neural network.

BACKGROUND: Accurate evaluation of glomerular filtration rates (GFRs) is of critical importance in clinical practice. A previous study showed that models based on artificial neural networks (ANNs) could achieve a better performance than traditional equations. However, large-sample cross-sectional su...

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Main Authors: Xun Liu, Xiaohua Pei, Ningshan Li, Yunong Zhang, Xiang Zhang, Jinxia Chen, Linsheng Lv, Huijuan Ma, Xiaoming Wu, Weihong Zhao, Tanqi Lou
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3596400?pdf=render
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author Xun Liu
Xiaohua Pei
Ningshan Li
Yunong Zhang
Xiang Zhang
Jinxia Chen
Linsheng Lv
Huijuan Ma
Xiaoming Wu
Weihong Zhao
Tanqi Lou
author_facet Xun Liu
Xiaohua Pei
Ningshan Li
Yunong Zhang
Xiang Zhang
Jinxia Chen
Linsheng Lv
Huijuan Ma
Xiaoming Wu
Weihong Zhao
Tanqi Lou
author_sort Xun Liu
collection DOAJ
description BACKGROUND: Accurate evaluation of glomerular filtration rates (GFRs) is of critical importance in clinical practice. A previous study showed that models based on artificial neural networks (ANNs) could achieve a better performance than traditional equations. However, large-sample cross-sectional surveys have not resolved questions about ANN performance. METHODS: A total of 1,180 patients that had chronic kidney disease (CKD) were enrolled in the development data set, the internal validation data set and the external validation data set. Additional 222 patients that were admitted to two independent institutions were externally validated. Several ANNs were constructed and finally a Back Propagation network optimized by a genetic algorithm (GABP network) was chosen as a superior model, which included six input variables; i.e., serum creatinine, serum urea nitrogen, age, height, weight and gender, and estimated GFR as the one output variable. Performance was then compared with the Cockcroft-Gault equation, the MDRD equations and the CKD-EPI equation. RESULTS: In the external validation data set, Bland-Altman analysis demonstrated that the precision of the six-variable GABP network was the highest among all of the estimation models; i.e., 46.7 ml/min/1.73 m(2) vs. a range from 71.3 to 101.7 ml/min/1.73 m(2), allowing improvement in accuracy (15% accuracy, 49.0%; 30% accuracy, 75.1%; 50% accuracy, 90.5% [P<0.001 for all]) and CKD stage classification (misclassification rate of CKD stage, 32.4% vs. a range from 47.3% to 53.3% [P<0.001 for all]). Furthermore, in the additional external validation data set, precision and accuracy were improved by the six-variable GABP network. CONCLUSIONS: A new ANN model (the six-variable GABP network) for CKD patients was developed that could provide a simple, more accurate and reliable means for the estimation of GFR and stage of CKD than traditional equations. Further validations are needed to assess the ability of the ANN model in diverse populations.
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spelling doaj.art-fa8492b9f36248338763caff502ca8312022-12-21T19:40:43ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0183e5824210.1371/journal.pone.0058242Improved glomerular filtration rate estimation by an artificial neural network.Xun LiuXiaohua PeiNingshan LiYunong ZhangXiang ZhangJinxia ChenLinsheng LvHuijuan MaXiaoming WuWeihong ZhaoTanqi LouBACKGROUND: Accurate evaluation of glomerular filtration rates (GFRs) is of critical importance in clinical practice. A previous study showed that models based on artificial neural networks (ANNs) could achieve a better performance than traditional equations. However, large-sample cross-sectional surveys have not resolved questions about ANN performance. METHODS: A total of 1,180 patients that had chronic kidney disease (CKD) were enrolled in the development data set, the internal validation data set and the external validation data set. Additional 222 patients that were admitted to two independent institutions were externally validated. Several ANNs were constructed and finally a Back Propagation network optimized by a genetic algorithm (GABP network) was chosen as a superior model, which included six input variables; i.e., serum creatinine, serum urea nitrogen, age, height, weight and gender, and estimated GFR as the one output variable. Performance was then compared with the Cockcroft-Gault equation, the MDRD equations and the CKD-EPI equation. RESULTS: In the external validation data set, Bland-Altman analysis demonstrated that the precision of the six-variable GABP network was the highest among all of the estimation models; i.e., 46.7 ml/min/1.73 m(2) vs. a range from 71.3 to 101.7 ml/min/1.73 m(2), allowing improvement in accuracy (15% accuracy, 49.0%; 30% accuracy, 75.1%; 50% accuracy, 90.5% [P<0.001 for all]) and CKD stage classification (misclassification rate of CKD stage, 32.4% vs. a range from 47.3% to 53.3% [P<0.001 for all]). Furthermore, in the additional external validation data set, precision and accuracy were improved by the six-variable GABP network. CONCLUSIONS: A new ANN model (the six-variable GABP network) for CKD patients was developed that could provide a simple, more accurate and reliable means for the estimation of GFR and stage of CKD than traditional equations. Further validations are needed to assess the ability of the ANN model in diverse populations.http://europepmc.org/articles/PMC3596400?pdf=render
spellingShingle Xun Liu
Xiaohua Pei
Ningshan Li
Yunong Zhang
Xiang Zhang
Jinxia Chen
Linsheng Lv
Huijuan Ma
Xiaoming Wu
Weihong Zhao
Tanqi Lou
Improved glomerular filtration rate estimation by an artificial neural network.
PLoS ONE
title Improved glomerular filtration rate estimation by an artificial neural network.
title_full Improved glomerular filtration rate estimation by an artificial neural network.
title_fullStr Improved glomerular filtration rate estimation by an artificial neural network.
title_full_unstemmed Improved glomerular filtration rate estimation by an artificial neural network.
title_short Improved glomerular filtration rate estimation by an artificial neural network.
title_sort improved glomerular filtration rate estimation by an artificial neural network
url http://europepmc.org/articles/PMC3596400?pdf=render
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