Multistep validation of a post-ERCP pancreatitis prediction system integrating multimodal data: a multicenter study.
Gastrointest Endosc
; 100(3): 464-472.e17, 2024 Sep.
Article
en En
| MEDLINE
| ID: mdl-38583541
ABSTRACT
BACKGROUND AND AIMS:
The impact of various categories of information on the prediction of post-ERCP pancreatitis (PEP) remains uncertain. We comprehensively investigated the risk factors associated with PEP by constructing and validating a model incorporating multimodal data through multiple steps.METHODS:
Cases (n = 1916) of ERCP were retrospectively collected from multiple centers for model construction. Through literature research, 49 electronic health record (EHR) features and 1 image feature related to PEP were identified. The EHR features were categorized into baseline, diagnosis, technique, and prevention strategies, covering pre-ERCP, intra-ERCP, and peri-ERCP phases. We first incrementally constructed models 1 to 4 incorporating these 4 feature categories and then added the image feature into models 1 to 4 and developed models 5 to 8. All models underwent testing and comparison using both internal and external test sets. Once the optimal model was selected, we conducted comparisons among multiple machine learning algorithms.RESULTS:
Compared with model 2 that incorporated baseline and diagnosis features, adding technique and prevention strategies (model 4) greatly improved the sensitivity (63.89% vs 83.33%, P < .05) and specificity (75.00% vs 85.92%, P < .001). A similar tendency was observed in the internal and external tests. In model 4, the top 3 features ranked by weight were previous pancreatitis, nonsteroidal anti-inflammatory drug use, and difficult cannulation. The image-based feature has the highest weight in models 5 to 8. Finally, model 8 used a random forest algorithm and showed the best performance.CONCLUSIONS:
We first developed a multimodal prediction model for identifying PEP with a clinical-acceptable performance. The image and technique features are crucial for PEP prediction.
Texto completo:
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Bases de datos:
MEDLINE
Asunto principal:
Pancreatitis
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Colangiopancreatografia Retrógrada Endoscópica
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Aprendizaje Automático
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Gastrointest Endosc
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Gastrointest. endosc
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Gastrointestinal endoscopy
Año:
2024
Tipo del documento:
Article
País de afiliación:
China