A predictive machine-learning model for clinical decision-making in washed microbiota transplantation on ulcerative colitis

Background and Aim: Machine learning based on clinical data and treatment protocols for better clinical decision-making is a current research hotspot. This study aimed to build a machine learning model on washed microbiota transplantation (WMT) for ulcerative colitis (UC), providing patients and cli...

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Main Authors: Sheng Zhang, Gaochen Lu, Weihong Wang, Qianqian Li, Rui Wang, Zulun Zhang, Xia Wu, Chenchen Liang, Yujie Liu, Pan Li, Quan Wen, Bota Cui, Faming Zhang
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Computational and Structural Biotechnology Journal
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Online Access:http://www.sciencedirect.com/science/article/pii/S2001037024002800
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author Sheng Zhang
Gaochen Lu
Weihong Wang
Qianqian Li
Rui Wang
Zulun Zhang
Xia Wu
Chenchen Liang
Yujie Liu
Pan Li
Quan Wen
Bota Cui
Faming Zhang
author_facet Sheng Zhang
Gaochen Lu
Weihong Wang
Qianqian Li
Rui Wang
Zulun Zhang
Xia Wu
Chenchen Liang
Yujie Liu
Pan Li
Quan Wen
Bota Cui
Faming Zhang
author_sort Sheng Zhang
collection DOAJ
description Background and Aim: Machine learning based on clinical data and treatment protocols for better clinical decision-making is a current research hotspot. This study aimed to build a machine learning model on washed microbiota transplantation (WMT) for ulcerative colitis (UC), providing patients and clinicians with a new evaluation system to optimize clinical decision-making.MethodsPatients with UC who underwent WMT via mid-gut or colonic delivery route at an affiliated hospital of Nanjing Medical University from April 2013 to June 2022 were recruited. Model ensembles based on the clinical indicators were constructed by machine-learning to predict the clinical response of WMT after one month.ResultsA total of 366 patients were enrolled in this study, with 210 patients allocated for training and internal validation, and 156 patients for external validation. The low level of indirect bilirubin, activated antithrombin III, defecation frequency and cholinesterase and the elderly and high level of creatine kinase, HCO3- and thrombin time were related to the clinical response of WMT at one month. Besides, the voting ensembles exhibited an area under curve (AUC) of 0.769 ± 0.019 [accuracy, 0.754; F1-score, 0.845] in the internal validation; the AUC of the external validation was 0.614 ± 0.017 [accuracy, 0.801; F1-score, 0.887]. Additionally, the model was available at https://wmtpredict.streamlit.app.ConclusionsThis study pioneered the development of a machine learning model to predict the one-month clinical response of WMT on UC. The findings demonstrate the potential value of machine learning applications in the field of WMT, opening new avenues for personalized treatment strategies in gastrointestinal disorders.Trial registrationclinical trials, NCT01790061. Registered 09 February 2013 - Retrospectively registered, https://clinicaltrials.gov/study/NCT01790061
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spelling doaj-art-849e8a9889a84bbfbe5a8eb9b6e61c332025-08-20T02:34:59ZengElsevierComputational and Structural Biotechnology Journal2001-03702024-12-012458359210.1016/j.csbj.2024.08.021A predictive machine-learning model for clinical decision-making in washed microbiota transplantation on ulcerative colitisSheng Zhang0Gaochen Lu1Weihong Wang2Qianqian Li3Rui Wang4Zulun Zhang5Xia Wu6Chenchen Liang7Yujie Liu8Pan Li9Quan Wen10Bota Cui11Faming Zhang12Department of Microbiota Medicine & Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Engineering Research Center for Advanced Microbiota Medicine, Key Lab of Holistic Integrative Enterology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Microbiota Medicine & Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Engineering Research Center for Advanced Microbiota Medicine, Key Lab of Holistic Integrative Enterology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Microbiota Medicine & Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Engineering Research Center for Advanced Microbiota Medicine, Key Lab of Holistic Integrative Enterology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Microbiota Medicine & Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Engineering Research Center for Advanced Microbiota Medicine, Key Lab of Holistic Integrative Enterology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Microbiota Medicine & Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Engineering Research Center for Advanced Microbiota Medicine, Key Lab of Holistic Integrative Enterology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Microbiota Medicine & Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Engineering Research Center for Advanced Microbiota Medicine, Key Lab of Holistic Integrative Enterology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Microbiota Medicine & Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Engineering Research Center for Advanced Microbiota Medicine, Key Lab of Holistic Integrative Enterology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Microbiota Medicine & Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Engineering Research Center for Advanced Microbiota Medicine, Key Lab of Holistic Integrative Enterology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Medicine & Therapeutics, the Chinese University of Hong Kong, Hong Kong, ChinaDepartment of Microbiota Medicine & Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Engineering Research Center for Advanced Microbiota Medicine, Key Lab of Holistic Integrative Enterology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Microbiota Medicine & Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Engineering Research Center for Advanced Microbiota Medicine, Key Lab of Holistic Integrative Enterology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Microbiota Medicine & Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Engineering Research Center for Advanced Microbiota Medicine, Key Lab of Holistic Integrative Enterology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Microbiota Medicine & Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Engineering Research Center for Advanced Microbiota Medicine, Key Lab of Holistic Integrative Enterology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China; National Clinical Research Center for Digestive Diseases, Xi'an, China; Corresponding author at: Department of Microbiota Medicine & Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.Background and Aim: Machine learning based on clinical data and treatment protocols for better clinical decision-making is a current research hotspot. This study aimed to build a machine learning model on washed microbiota transplantation (WMT) for ulcerative colitis (UC), providing patients and clinicians with a new evaluation system to optimize clinical decision-making.MethodsPatients with UC who underwent WMT via mid-gut or colonic delivery route at an affiliated hospital of Nanjing Medical University from April 2013 to June 2022 were recruited. Model ensembles based on the clinical indicators were constructed by machine-learning to predict the clinical response of WMT after one month.ResultsA total of 366 patients were enrolled in this study, with 210 patients allocated for training and internal validation, and 156 patients for external validation. The low level of indirect bilirubin, activated antithrombin III, defecation frequency and cholinesterase and the elderly and high level of creatine kinase, HCO3- and thrombin time were related to the clinical response of WMT at one month. Besides, the voting ensembles exhibited an area under curve (AUC) of 0.769 ± 0.019 [accuracy, 0.754; F1-score, 0.845] in the internal validation; the AUC of the external validation was 0.614 ± 0.017 [accuracy, 0.801; F1-score, 0.887]. Additionally, the model was available at https://wmtpredict.streamlit.app.ConclusionsThis study pioneered the development of a machine learning model to predict the one-month clinical response of WMT on UC. The findings demonstrate the potential value of machine learning applications in the field of WMT, opening new avenues for personalized treatment strategies in gastrointestinal disorders.Trial registrationclinical trials, NCT01790061. Registered 09 February 2013 - Retrospectively registered, https://clinicaltrials.gov/study/NCT01790061http://www.sciencedirect.com/science/article/pii/S2001037024002800Fecal microbiota transplantMachine learningUlcerative colitisClinical indicator
spellingShingle Sheng Zhang
Gaochen Lu
Weihong Wang
Qianqian Li
Rui Wang
Zulun Zhang
Xia Wu
Chenchen Liang
Yujie Liu
Pan Li
Quan Wen
Bota Cui
Faming Zhang
A predictive machine-learning model for clinical decision-making in washed microbiota transplantation on ulcerative colitis
Computational and Structural Biotechnology Journal
Fecal microbiota transplant
Machine learning
Ulcerative colitis
Clinical indicator
title A predictive machine-learning model for clinical decision-making in washed microbiota transplantation on ulcerative colitis
title_full A predictive machine-learning model for clinical decision-making in washed microbiota transplantation on ulcerative colitis
title_fullStr A predictive machine-learning model for clinical decision-making in washed microbiota transplantation on ulcerative colitis
title_full_unstemmed A predictive machine-learning model for clinical decision-making in washed microbiota transplantation on ulcerative colitis
title_short A predictive machine-learning model for clinical decision-making in washed microbiota transplantation on ulcerative colitis
title_sort predictive machine learning model for clinical decision making in washed microbiota transplantation on ulcerative colitis
topic Fecal microbiota transplant
Machine learning
Ulcerative colitis
Clinical indicator
url http://www.sciencedirect.com/science/article/pii/S2001037024002800
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