Predictive Analytics in Hemodialysis: Enabling Precision Care for Patient with ESKD

基于机器学习（ML）的临床预测模型（CPM）在过去已经激增 几年后，它将成为医疗保健的核心组成部分。这些工具显示出巨大的希望， 告知提供者和患者即将发生的健康结果，最终允许 更个性化的病人护理。在我们的父代R 01中，我们正在开发基于ML的死亡率 血液透析患者的预测模型。该工具的目标是预测短期 和长期死亡风险，以促进患者之间的共同决策， 提供商重要的是，基于ML的CPM中存在许多固有的伦理问题。这些 包括考虑道德表现（即，算法偏差），道德使用（即，确保 输出得到正确解释）和道德执行（即，该工具被适当地集成 临床工作流程中。对于目前的NOSI，我们建议探讨道德使用的问题 基于ML的CPM为此，我们将对患者及其护理人员进行焦点小组讨论， 供应商和数据科学家。我们将解决基于ML的CPM中的信任问题， 了解风险和最佳风险沟通，与CPM和AI/ML工具进行交互， 使用CPM来增强患者的能力，促进共同决策。我们将比较 各选区的回应。我们将利用我们的研究结果来制定以实践为导向的指导方针 它针对基于ML的CPM的开发人员和用户。

Machine learning (ML) based clinical prediction models (CPMs) have proliferated over the past few years, becoming a central component of healthcare. These tools show great promise in informing both providers and patients of impending health outcomes, ultimately allowing for greater personalization of patient care. In our parent R01 we are developing a ML based mortality prediction model for patients undergoing hemodialysis. The goal of this tool is to predict both short and long term mortality risk in order to promote shared decision making between patients and providers. Importantly, there are a number of ethical concerns inherent in ML based CPMs. These include consideration of ethical performance (i.e., algorithmic bias), ethical usage (i.e., ensuring outputs are properly interpreted) and ethical implementation (i.e., the tool is properly integrated into the clinical workflow. For this current NOSI we propose to explore questions of ethical usage of ML based CPMs. To do this, we will conduct focus group of patients & their caregivers, providers and data scientists. We will address questions of trust in ML based CPMs, understanding of risk and optimal risk communication, interaction with CPMs and AI/ML tools and usage of CPMs to empower patients and promote shared decision-making. We will compare responses across constituencies. We will use our findings to develop practice oriented guidances that target both develops and users of ML based CPMs.