Machine learning to predict major bleeding during anticoagulation for venous thromboembolism: possibilities and limitations

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dc.contributor.authorMora, Damián
dc.contributor.authorMateo, Jorge
dc.contributor.authorNieto, José A.
dc.contributor.authorBikdeli, Behnood
dc.contributor.authorYamashita, Yugo
dc.contributor.authorBarco, Stefano
dc.contributor.authorJimenez, David
dc.contributor.authorDemelo-Rodriguez, Pablo
dc.contributor.authorRosa, Vladimir
dc.contributor.authorYoo, Hugo Hyung Bok [UNESP]
dc.contributor.authorSadeghipour, Parham
dc.contributor.authorMonreal, Manuel
dc.contributor.authorAdarraga, M. D.
dc.contributor.authorAlberich-Conesa, A.
dc.contributor.authorAlonso-Carrillo, J.
dc.contributor.authorAgudo, P.
dc.contributor.authorAmado, C.
dc.contributor.authorAmorós, S.
dc.contributor.authorArcelus, J. I.
dc.contributor.authorBallaz, A.
dc.contributor.authorBarba, R.
dc.contributor.authorBarbagelata, C.
dc.contributor.authorBarrón, M.
dc.contributor.authorBarrón-Andrés, B.
dc.contributor.authorBlanco-Molina, A.
dc.contributor.authorBotella, E.
dc.contributor.authorCarrero-Arribas, R.
dc.contributor.authorCasado, I.
dc.contributor.authorChasco, L.
dc.contributor.authorCriado, J.
dc.contributor.authordel Toro, J.
dc.contributor.authorDe Ancos, C.
dc.contributor.authorDe Juana-Izquierdo, C.
dc.contributor.authorDemelo-Rodríguez, P.
dc.contributor.authorDíaz-Brasero, A. M.
dc.contributor.authorDíaz-Pedroche, M. C.
dc.contributor.authorDíaz-Peromingo, J. A.
dc.contributor.authorDíaz-Simón, R.
dc.contributor.authorDubois-Silva, A.
dc.contributor.authorEscribano, J. C.
dc.contributor.authorEspósito, F.
dc.contributor.authorFalgá, C.
dc.contributor.authorFarfán-Sedano, A. I.
dc.contributor.authorFernández-Aracil, C.
dc.contributor.authorFernández-Capitán, C.
dc.contributor.authorFernández-Jiménez, B.
dc.contributor.authorFernández-Muixi, J.
dc.contributor.authorFernández-Reyes, J. L.
dc.contributor.authorFont, C.
dc.contributor.authorFrancisco, I.
dc.contributor.authorGaleano-Valle, F.
dc.contributor.authorGarcía, M. A.
dc.contributor.authorGarcía de Herreros, M.
dc.contributor.authorGarcía-Bragado, F.
dc.contributor.authorGarcía-González, C.
dc.contributor.authorGarcía-Ortega, A.
dc.contributor.authorGavín-Sebastián, O.
dc.contributor.authorGil-De Gómez, M.
dc.contributor.authorGil-Díaz, A.
dc.contributor.authorGómez-Cuervo, C.
dc.contributor.authorGómez-Mosquera, A. M.
dc.contributor.authorGonzález-Martínez, J.
dc.contributor.authorGrau, E.
dc.contributor.authorGuirado, L.
dc.contributor.authorGutiérrez, J.
dc.contributor.authorHernández-Blasco, L.
dc.contributor.authorJaras, M. J.
dc.contributor.authorJiménez, D.
dc.contributor.authorJou, I.
dc.contributor.authorJoya, M. D.
dc.contributor.authorLacruz, B.
dc.contributor.authorLainez-Justo, S.
dc.contributor.authorLecumberri, R.
dc.contributor.authorLobo, J. L.
dc.contributor.authorLópez-De la Fuente, M.
dc.contributor.authorLópez-Jiménez, L.
dc.contributor.authorLópez-Miguel, P.
dc.contributor.authorLópez-Núñez, J. J.
dc.contributor.authorLópez-Reyes, R.
dc.contributor.authorLópez-Ruiz, A.
dc.contributor.authorLópez-Sáez, J. B.
dc.contributor.authorLorente, M. A.
dc.contributor.authorLorenzo, A.
dc.contributor.authorLumbierres, M.
dc.contributor.authorMadridano, O.
dc.contributor.authorMaestre, A.
dc.contributor.authorMarcos, M.
dc.contributor.authorMartín-Guerra, J. M.
dc.contributor.authorMartín-Martos, F.
dc.contributor.authorMas-Maresma, L.
dc.contributor.authorMellado, M.
dc.contributor.authorMena, E.
dc.contributor.authorMercado, M. I.
dc.contributor.authorMoisés, J.
dc.contributor.authorMonreal, M.
dc.contributor.authorMuñoz-Blanco, A.
dc.contributor.authorMuñoz-Gamito, G.
dc.contributor.authorNieto, J. A.
dc.contributor.authorNúñez-Fernández, M. J.
dc.contributor.authorOsorio, J.
dc.contributor.authorOtalora, S.
dc.contributor.authorPacheco-Gómez, N.
dc.contributor.authorParra, P.
dc.contributor.authorPedrajas, J. M.
dc.contributor.authorPérez-Ductor, C.
dc.contributor.authorPérez-Pérez, J. L.
dc.contributor.authorPeris, M. L.
dc.contributor.authorPesce, M. L.
dc.contributor.authorPorras, J. A.
dc.contributor.authorPoyo-Molina, J.
dc.contributor.authorPuchades, R.
dc.contributor.authorRiera-Mestre, A.
dc.contributor.authorRivera-Civico, F.
dc.contributor.authorRivera-Gallego, A.
dc.contributor.authorRoca, M.
dc.contributor.authorRodríguez-Cobo, A.
dc.contributor.authorRubio, C. M.
dc.contributor.authorRuiz-Giménez, N.
dc.contributor.authorRuiz-Ruiz, J.
dc.contributor.authorSalgueiro, G.
dc.contributor.authorSancho, T.
dc.contributor.authorSendín, V.
dc.contributor.authorSigüenza, P.
dc.contributor.authorSoler, S.
dc.contributor.authorSuriñach, J. M.
dc.contributor.authorTiberio, G.
dc.contributor.authorTolosa, C.
dc.contributor.authorTorres, M. I.
dc.contributor.authorTrujillo-Santos, J.
dc.contributor.authorUresandi, F.
dc.contributor.authorUsandizaga, E.
dc.contributor.authorValle, R.
dc.contributor.authorVarona, J. F.
dc.contributor.authorVela, J. R.
dc.contributor.authorVidal, G.
dc.contributor.authorVillalobos, A.
dc.contributor.authorVillares, P.
dc.contributor.authorAy, C.
dc.contributor.authorNopp, S.
dc.contributor.authorPabinger, I.
dc.contributor.authorEngelen, M.
dc.contributor.authorVerhamme, P.
dc.contributor.authorVerstraete, A.
dc.contributor.authorYoo, H. H.B.
dc.contributor.authorArguello, J. D.
dc.contributor.authorMontenegro, A. C.
dc.contributor.authorRoa, J.
dc.contributor.authorMalý, R.
dc.contributor.authorAccassat, S.
dc.contributor.authorBertoletti, L.
dc.contributor.authorBura-Riviere, A.
dc.contributor.authorCatella, J.
dc.contributor.authorChopard, R.
dc.contributor.authorCouturaud, F.
dc.contributor.authorEspitia, O.
dc.contributor.authorGrange, C.
dc.contributor.authorLeclercq, B.
dc.contributor.authorLe Mao, R.
dc.contributor.authorMahé, I.
dc.contributor.authorMoustafa, F.
dc.contributor.authorPlaisance, L.
dc.contributor.authorPoenou, G.
dc.contributor.authorSarlon-Bartoli, G.
dc.contributor.authorSuchon, P.
dc.contributor.authorVersini, E.
dc.contributor.authorSchellong, S.
dc.contributor.authorBraester, A.
dc.contributor.authorBrenner, B.
dc.contributor.authorKenet, G.
dc.contributor.authorNajib, D.
dc.contributor.authorTzoran, I.
dc.contributor.authorSadeghipour, P.
dc.contributor.authorBasaglia, M.
dc.contributor.authorBilora, F.
dc.contributor.authorBortoluzzi, C.
dc.contributor.authorBrandolin, B.
dc.contributor.authorCiammaichella, M.
dc.contributor.authorColaizzo, D.
dc.contributor.authorDe Angelis, A.
dc.contributor.authorDentali, F.
dc.contributor.authorDi Micco, P.
dc.contributor.authorGrandone, E.
dc.contributor.authorImbalzano, E.
dc.contributor.authorMerla, S.
dc.contributor.authorPesavento, R.
dc.contributor.authorPrandoni, P.
dc.contributor.authorScarinzi, P.
dc.contributor.authorSiniscalchi, C.
dc.contributor.authorTaflaj, B.
dc.contributor.authorTufano, A.
dc.contributor.authorVisonà, A.
dc.contributor.authorVo Hong, N.
dc.contributor.authorZalunardo, B.
dc.contributor.authorKigitovica, D.
dc.contributor.authorSkride, A.
dc.contributor.authorFonseca, S.
dc.contributor.authorManuel, M.
dc.contributor.authorMeireles, J.
dc.contributor.authorBosevski, M.
dc.contributor.authorZdraveska, M.
dc.contributor.authorBounameaux, H.
dc.contributor.authorMazzolai, L.
dc.contributor.authorAujayeb, A.
dc.contributor.authorCaprini, J. A.
dc.contributor.authorWeinberg, I.
dc.contributor.authorBui, H. M.
dc.contributor.institutionHospital Virgen de la Luz
dc.contributor.institutionUniversidad de Castilla-La Mancha
dc.contributor.institutionHarvard Medical School
dc.contributor.institutionYNHH/Yale Center for Outcomes Research and Evaluation (CORE)
dc.contributor.institutionCardiovascular Research Foundation (CRF)
dc.contributor.institutionKyoto University
dc.contributor.institutionUniversity Hospital Zurich
dc.contributor.institutionUniversity Hospital Mainz
dc.contributor.institutionHospital Ramón y Cajal and Universidad de Alcalá (IRYCIS)
dc.contributor.institutionCIBER de Enfermedades Respiratorias (CIBERES)
dc.contributor.institutionHospital General Universitario Gregorio Marañón
dc.contributor.institutionHospital Universitario Virgen de Arrixaca
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionRajaie Cardiovascular Medical and Research Center
dc.contributor.institutionUniversidad Católica San Antonio de Murcia
dc.date.accessioned2023-07-29T13:48:05Z
dc.date.available2023-07-29T13:48:05Z
dc.date.issued2023-06-01
dc.description.abstractPredictive tools for major bleeding (MB) using machine learning (ML) might be advantageous over traditional methods. We used data from the Registro Informatizado de Enfermedad TromboEmbólica (RIETE) to develop ML algorithms to identify patients with venous thromboembolism (VTE) at increased risk of MB during the first 3 months of anticoagulation. A total of 55 baseline variables were used as predictors. New data prospectively collected from the RIETE were used for further validation. The RIETE and VTE-BLEED scores were used for comparisons. External validation was performed with the COMMAND-VTE database. Learning was carried out with data from 49 587 patients, of whom 873 (1.8%) had MB. The best performing ML method was XGBoost. In the prospective validation cohort the sensitivity, specificity, positive predictive value and F1 score were: 33.2%, 93%, 10%, and 15.4% respectively. F1 value for the RIETE and VTE-BLEED scores were 8.6% and 6.4% respectively. In the external validation cohort the metrics were 10.3%, 87.6%, 3.5% and 5.2% respectively. In that cohort, the F1 value for the RIETE score was 17.3% and for the VTE-BLEED score 9.75%. The performance of the XGBoost algorithm was better than that from the RIETE and VTE-BLEED scores only in the prospective validation cohort, but not in the external validation cohort.en
dc.description.affiliationDepartment of Internal Medicine Hospital Virgen de la Luz
dc.description.affiliationInstitute of Technology Universidad de Castilla-La Mancha
dc.description.affiliationCardiovascular Medicine Division Brigham and Women's Hospital Harvard Medical School
dc.description.affiliationThrombosis Research Group Brigham and Women's Hospital Harvard Medical School
dc.description.affiliationYNHH/Yale Center for Outcomes Research and Evaluation (CORE)
dc.description.affiliationCardiovascular Research Foundation (CRF)
dc.description.affiliationDepartment of Cardiovascular Medicine Graduate School of Medicine Kyoto University
dc.description.affiliationDepartment of Angiology University Hospital Zurich
dc.description.affiliationCenter for Thrombosis and Hemostasis University Hospital Mainz
dc.description.affiliationRespiratory Department Hospital Ramón y Cajal and Universidad de Alcalá (IRYCIS)
dc.description.affiliationCIBER de Enfermedades Respiratorias (CIBERES)
dc.description.affiliationDepartment of Internal Medicine Hospital General Universitario Gregorio Marañón
dc.description.affiliationDepartment of Internal Medicine Hospital Universitario Virgen de Arrixaca
dc.description.affiliationDepartment of Internal Medicine – Pulmonary Division Botucatu Medical School – São Paulo State University (UNESP)
dc.description.affiliationDepartment of Peripheral Vascular Diseases Rajaie Cardiovascular Medical and Research Center
dc.description.affiliationChair of Thromboembolic Diseases Universidad Católica San Antonio de Murcia
dc.description.affiliationUnespDepartment of Internal Medicine – Pulmonary Division Botucatu Medical School – São Paulo State University (UNESP)
dc.format.extent971-981
dc.identifierhttp://dx.doi.org/10.1111/bjh.18737
dc.identifier.citationBritish Journal of Haematology, v. 201, n. 5, p. 971-981, 2023.
dc.identifier.doi10.1111/bjh.18737
dc.identifier.issn1365-2141
dc.identifier.issn0007-1048
dc.identifier.scopus2-s2.0-85151067665
dc.identifier.urihttp://hdl.handle.net/11449/248586
dc.language.isoeng
dc.relation.ispartofBritish Journal of Haematology
dc.sourceScopus
dc.subjecthaemorrhage
dc.subjectmachine learning
dc.subjectoutcomes
dc.subjectpulmonary embolism
dc.subjectvenous thrombosis
dc.titleMachine learning to predict major bleeding during anticoagulation for venous thromboembolism: possibilities and limitationsen
dc.typeArtigo
unesp.author.orcid0000-0003-4947-1666[3]
unesp.author.orcid0000-0002-3096-4711[8]

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Artigos - Clínica Médica - FMB