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Machine learning validation of the AVAS classification compared to ultrasound mapping in a multicentre study

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LAWRIE Katerina WALDAUF Petr BALAZ Peter BORTEL Radosalv LACERDA Ricardo AITKEN Emma LETACHOWICZ Krzysztof D’ORIA Mario DI MASO Vittorio STASKO Pavel GOMES Antonio FONTAINHAS Joana PEKAŘ Matej SRDELIC Alena VAVASC Study Group O’NEILL Stephen

Rok publikování 2025
Druh Článek v odborném periodiku
Časopis / Zdroj SCIENTIFIC REPORTS
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
www https://www.nature.com/articles/s41598-025-86456-3
Doi https://doi.org/10.1038/s41598-025-86456-3
Klíčová slova AVAS classification; machine learning validation; ultrasound mapping
Popis The Arteriovenous Access Stage (AVAS) classification simplifies information about suitability of vessels for vascular access (VA). It’s been previously validated in a clinical study. Here, AVAS performance was tested against multiple ultrasound mapping measurements using machine learning. A prospective multicentre international study (NCT04796558) with patient recruitment from March 2021-July 2024. Demographics, risk factors, vessels parameters, types of predicted and created VA (pVA, cVA) were collected. We modelled pVA and cVA using the Random Forest algorithm. Model performance was estimated and compared using Bayesian generalized linear models. ROC AUC with 95% credible intervals was the performance metric. 1151 patients were included. ROC AUC for pVA prediction by AVAS was 0.79 (0.77;0.82) and by mapping was 0.85 (0.83;0.88). ROC AUC for cVA prediction by AVAS was 0.71 (0.69;0.74) and by mapping was 0.8 (0.78;0.83). Using AVAS with other parameters increased the ROC AUC to 0.87 for pVA (0.84;0.89) and 0.82 (0.79;0.84) for cVA. Using mapping with other parameters increased the ROC AUC to 0.88 for pVA (0.86;0.91) and 0.85 (0.83;0.88) for cVA. Multiple mapping measurements showed higher performance at VA prediction than AVAS. However, AVAS is simpler and quicker, so may be preferable for routine clinical practice.

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