PROTECT: optima4BP 2.0: prediction of Optimal Treatment and Route to achieve and maintain BP Target

需要的在美国，4000万高血压（HTN）患者的血压（BP）不受控制。 血压高于临床目标甚至几个月也会增加中风（35-40%）、心力衰竭（HF）（高达 心肌梗死（MI）（15-25%）。医生-护士-药剂师资源密集型演示 实现和保持BP目标已经显示出有希望的结果，但他们的实际部署被发现 不可持续的长期。因此，迫切需要一个流程标准化和可持续的解决方案。 溶液为了满足这一需求，Optima Integrated Health开发了optima 4 BP 1.0。这是一流的 人工智能（AI），模拟治疗医生进行的临床推理过程， 针对BP目标优化抗HTN治疗。就像医生一样，optima 4 BP 1.0无法确定 预先提供所需的最佳治疗（OT），以达到并维持BP目标1-2年。保护 [optima 4 BP 2.0：预测达到和维持BP目标的最佳治疗和途径]建议 建立个性化的OT。OT可以用来选择最短和最安全的治疗方法 为达到和保持BP目标而需要的路线修改。第二阶段目标。构建optima 4 BP 2.0。 一阶段第一阶段的前期工作表明，k-最近邻（kNN），一种AI模型，可以预测≥ 与医生决定相比，正确的抗HTN治疗的置信度为80%。 第二阶段。optima 4 BP 2.0将预测最佳治疗和路线，以达到和维持BP目标。 最佳治疗数据挖掘源程序。CIMT将使用SPRINT（全身血压 干预试验，2015年）和雅阁（控制糖尿病心血管风险行动，2010年）临床试验 数据它们代表了最新的抗HTN治疗管理国家指南的基础。 目标1.构建kNN。假说. kNN可以预测患者与最佳患者的接近度（临床相关性）。 治疗（OT）。里程碑达到≥ 90%的医生决策预测准确度。I期数据 准备方案将应用于SPRINT &雅阁数据。然后，kNN包围学习 将建立一个函数，通过比较 从第一阶段开发和测试的3种计算方法中选择。 目标二。建立最佳治疗途径（OTR）。假说.了解当前和最佳 治疗（OT），可以建立一个OTR。里程碑最安全的途径：实现100%排除导致 类似患者人群中的不良事件。最短路径：减少≥30%的 与医生途径相比，治疗发生了变化。OTR将通过比较 通过计算的相似性评估确定每个候选治疗与OT的相似程度。 optima 4 BP 2.0旨在建立一个流程标准化和可持续的解决方案，目标是 降低中风、HF、MI和不受控制的高血压导致的死亡的发生率。

Need. In the US, 40 million patients with hypertension (HTN) have their blood pressure (BP) uncontrolled. BP above clinical Target even for a few months increases the risk for stroke (35-40%), heart failure (HF) (up to 64%), myocardial infarction (MI) (15-25%). Physician-nurse-pharmacist resource-intensive demonstrations in achieving & maintaining BP Target have shown promising results, but their real-life deployment was found unsustainable long-term. As a result, a process-standardized and sustainable solution is acutely needed. Solution. In response to this need, Optima Integrated Health developed optima4BP 1.0. It is a first-in-class artificial intelligence (AI) that simulates the process of clinical reasoning undertaken by the treating physician in optimizing the anti-HTN treatment towards BP Target. Just like the physician, optima4BP 1.0 cannot determine upfront the needed Optimal Treatment (OT) to achieve & maintain BP Target for 1-2 years. PROTECT [optima4BP 2.0: prediction of Optimal Treatment and route to achieve and maintain BP Target] proposes to establish upfront the personalized OT. The OT can then be used to select the shortest and safest treatment modification route needed to achieve & maintain BP Target. Phase II Goal. Build optima4BP 2.0. Phase I. Phase I Prior Work demonstrated that k-Nearest Neighbor (kNN), an AI model, can predict with ≥ 80% confidence the correct anti-HTN treatment, when compared to physician decision. Phase II. optima4BP 2.0 will predict the Optimal Treatment and route to achieve & maintain BP Target. Optimal Treatment data-mining source. PROTECT will use the SPRINT (Systolic Blood Pressure Intervention Trial, 2015) and ACCORD (Action to Control Cardiovascular Risk in Diabetes, 2010) clinical trial data. They represent the foundation of the most current anti-HTN treatment management national guidelines. Aim 1. Build kNN. Hypothesis. kNN can predict the proximity (clinical relevance) of a patient to an Optimal Treatment (OT). Milestone. Achieve ≥ 90% accuracy of prediction to physician decision. Phase I Data Preparation protocol will be applied to the SPRINT & ACCORD data. Then, the kNN Ensemble Learning function will be built to select the Optimal Treatment with the highest demonstrated efficacy by comparing the choice from 3 computational approaches developed and tested during Phase I. Aim 2. Build the Optimal Treatment Route (OTR). Hypothesis. Knowing the Current and Optimal Treatment (OT), an OTR can be built. Milestone. Safest Route: Achieve 100% exclusion of treatments that led to an adverse event in similar patient populations. Shortest Route: Achieve ≥30% reduction in number of treatment changes compared to physician route. The OTR will be built by comparing at each Step on the Route how similar each Candidate Treatment is to the OT through a computed similarity assessment. optima4BP 2.0 aims to establish a process-standardized & sustainable solution with the goal of reducing the incidence of stroke, HF, MI and death resulting from uncontrolled hypertension.