Cross-site transportability of an explainable artificial intelligence model for acute kidney injury prediction.

Journal: Nature communications
Published Date:

Abstract

Artificial intelligence (AI) has demonstrated promise in predicting acute kidney injury (AKI), however, clinical adoption of these models requires interpretability and transportability. Non-interoperable data across hospitals is a major barrier to model transportability. Here, we leverage the US PCORnet platform to develop an AKI prediction model and assess its transportability across six independent health systems. Our work demonstrates that cross-site performance deterioration is likely and reveals heterogeneity of risk factors across populations to be the cause. Therefore, no matter how accurate an AI model is trained at the source hospital, whether it can be adopted at target hospitals is an unanswered question. To fill the research gap, we derive a method to predict the transportability of AI models which can accelerate the adaptation process of external AI models in hospitals.

Authors

  • Xing Song
    Department of Internal Medicine, Division of Medical Informatics, University of Kansas Medical Center, Kansas City, Kansas, USA.
  • Alan S L Yu
    Division of Nephrology and Hypertension and the Kidney Institute, University of Kansas, Medical Center, Kansas City, Kansas, USA. Electronic address: ayu@kumc.edu.
  • John A Kellum
    Center for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
  • Lemuel R Waitman
    Department of Internal Medicine, Division of Medical Informatics, University of Kansas Medical Center, Kansas City, Missouri, USA.
  • Michael E Matheny
    Vanderbilt University School of Medicine, Nashville, TN.
  • Steven Q Simpson
    Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
  • Yong Hu
    Big Data Decision Institute, Jinan University, Guangzhou, China.
  • Mei Liu
    Department of Internal Medicine, Division of Medical Informatics, University of Kansas Medical Center, Kansas City, Missouri, USA.