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This study presents KFDeep, a deep learning model designed for dynamic prediction of kidney failure using longitudinal electronic health record data across multiple external cohorts. While the application is medical rather than technological, the core contribution lies in advancing machine learning techniques for handling temporal trends and real-time decision support within clinical settings. For an audience focused on AI applications, this work highlights practical deployments where deep learning models integrate directly into hospital systems to improve diagnostic accuracy without increasing operational costs.
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Development and Validation of a Dynamic Kidney Failure Prediction Model based on Deep Learning: A Real-World Study with External Validation

arXiv3 min read

arXiv:2501.16388v3 Announce Type: replace Abstract: Background: Chronic kidney disease (CKD), a progressive disease with high morbidity and mortality, has become a significant global public health problem. Most existing models are static and fail to capture temporal trends in disease progression, limiting their ability to inform timely interventions. We address this gap by developing a dynamic model that leverages common longitudinal clinical indicators from real-world electronic health records (EHRs) for real-time kidney failure prediction. Findings: A retrospective cohort of 4,587 patients from the CK-NET-Yinzhou Dataset was used for model development (2,752 patients for training, 917 patients for validation) and internal validation (918 patients). External validation was performed in three cohorts: the prospective PKUFH cohort (934 patients), the C-STRIDE cohort (1,570 patients), and the iCaReMe cohort (498 patients). The model demonstrated competitive performance across the internal and three external validation cohorts, achieving AUROCs of 0.9311 (95% CI, 0.8873-0.9749), 0.8141 (0.7728-0.8554), 0.8427 (0.8213-0.8641), and 0.9359 (0.9031-0.9687), respectively. The model also demonstrated progressively improving dynamic predictions, good calibration, and clinically consistent interpretability. KFDeep has been deployed on an open-access website and in primary care settings. Interpretation: The KFDeep model enables dynamic prediction of kidney failure without increasing clinical examination costs. It has been integrated into existing hospital systems, providing physicians with a continuously updated decision-support tool in routine care.

Abstract:Background: Chronic kidney disease (CKD), a progressive disease with high morbidity and mortality, has become a significant global public health problem. Most existing models are static and fail to capture temporal trends in disease progression, limiting their ability to inform timely interventions. We address this gap by developing a dynamic model that leverages common longitudinal clinical indicators from real-world electronic health records (EHRs) for real-time kidney failure prediction. Findings: A retrospective cohort of 4,587 patients from the CK-NET-Yinzhou Dataset was used for model development (2,752 patients for training, 917 patients for validation) and internal validation (918 patients). External validation was performed in three cohorts: the prospective PKUFH cohort (934 patients), the C-STRIDE cohort (1,570 patients), and the iCaReMe cohort (498 patients). The model demonstrated competitive performance across the internal and three external validation cohorts, achieving AUROCs of 0.9311 (95% CI, 0.8873-0.9749), 0.8141 (0.7728-0.8554), 0.8427 (0.8213-0.8641), and 0.9359 (0.9031-0.9687), respectively. The model also demonstrated progressively improving dynamic predictions, good calibration, and clinically consistent interpretability. KFDeep has been deployed on an open-access website and in primary care settings. Interpretation: The KFDeep model enables dynamic prediction of kidney failure without increasing clinical examination costs. It has been integrated into existing hospital systems, providing physicians with a continuously updated decision-support tool in routine care.

Machine Learning (cs.LG); Applications (stat.AP)

arXiv:2501.16388 [cs.LG]

(or arXiv:2501.16388v3 [cs.LG] for this version)

https://doi.org/10.48550/arXiv.2501.16388 Focus to learn more arXiv-issued DOI via DataCite

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Full text under the publisher's open licence · 304 words

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