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https://www.arca.fiocruz.br/handle/icict/64659
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2150-12-31
Sustainable Development Goals
04 Educação de qualidadeCollections
- MG - IRR - Preprint [54]
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PREDICTION OF INHIBITOR DEVELOPMENT IN PREVIOUSLY UNTREATED AND MINIMALLY TREATED CHILDREN WITH SEVERE AND MODERATELY-SEVERE HEMOPHILIA A USING A MACHINE-LEARNING NETWORK
Author
Affilliation
Fundação Oswaldo Cruz. Instituto René Rachou. Belo Horizonte, MG, Brazil/Department of Clinical Epidemiology. Leiden University Medical Centre. Leiden, the Netherlands
School of Economics. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brazil
Fundação Hemominas. Belo Horizonte, MG, Brazil
Instituto de Hematologia Arthur de Siqueira Cavalcanti. Rio de Janeiro, RJ, Brazil
Centro de Hematologia e Hemoterapia do Paraná. Curitiba, PR, Brazil
Centro de Hematologia e Hemoterapia de Santa Catarina. Florianópolis, SC, Brazil
Faculty of Medicine. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brazil
Faculty of Medicine. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brazil
Fundação Hemominas. Belo Horizonte, MG, Brazil
Universidade Federal de Minas Gerais. Departamento de Ciência da Computação. Belo Horizonte, MG, Brazil
Faculty of Medicine. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brazil
School of Economics. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brazil
Fundação Hemominas. Belo Horizonte, MG, Brazil
Instituto de Hematologia Arthur de Siqueira Cavalcanti. Rio de Janeiro, RJ, Brazil
Centro de Hematologia e Hemoterapia do Paraná. Curitiba, PR, Brazil
Centro de Hematologia e Hemoterapia de Santa Catarina. Florianópolis, SC, Brazil
Faculty of Medicine. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brazil
Faculty of Medicine. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brazil
Fundação Hemominas. Belo Horizonte, MG, Brazil
Universidade Federal de Minas Gerais. Departamento de Ciência da Computação. Belo Horizonte, MG, Brazil
Faculty of Medicine. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brazil
Abstract
Background: Prediction of inhibitor development in patients with hemophilia A (HA) remains a challenge. Objectives: To construct a predictive model for inhibitor development in HA using a network of clinical variables and biomarkers based on the individual similarity network. Methods: Previously untreated and minimally treated children with severe/moderately severe HA, participants of the HEMFIL Cohort Study, were followed up until reaching 75 exposure days (EDs) without inhibitor (INH-) or upon inhibitor development (INH+). Clinical data and biological samples were collected before the start of factor (F)VIII replacement (T0). A predictive model (HemfilNET) was built to compare the networks and potential global topological differences between INH- and INH+ at T0, considering the network robustness. For validation, the "leave-one-out" cross-validation technique was employed. Accuracy, precision, recall, and F1-score were used as evaluation metrics for the machine-learning model. Results: We included 95 children with HA (CHA), of whom 31 (33%) developed inhibitors. The algorithm, featuring 37 variables, identified distinct patterns of networks at T0 for INH+ and INH-. The accuracy of the model was 74.2% for CHA INH+ and 98.4% for INH-. By focusing the analysis on CHA with high-risk F8 mutations for inhibitor development, the accuracy in identifying CHA INH+ increased to 82.1%. Conclusion: Our machine-learning algorithm demonstrated an overall accuracy of 90.5% for predicting inhibitor development in CHA, which further improved when restricting the analysis to CHA with a high-risk F8 genotype. However, our model requires validation in other cohorts. Yet, missing data for some variables hindered more precise predictions.
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