Deep Learning for Liver Fibrosis Triage in MASLD Using Longitudinal Electronic Health Records (NIMIT-AI)
NIMIT-AI: Neural Inference for Metabolic-liver Integrated Trajectories: Leveraging Deep Learning to Enhance Reliability in MASLD Triage
This study looks at a new computer program called NIMIT-AI (Neural Inference for Metabolic-liver Integrated Trajectories, Artificial Intelligence) that helps doctors find liver scarring early in patients with fatty liver disease.
Fatty liver disease, also called metabolic dysfunction-associated steatotic liver disease (MASLD), is a common condition where fat builds up in the liver. Over time, this can cause scarring (fibrosis). Finding scarring early helps doctors treat it before it gets worse.
Right now, doctors use a blood test score called FIB-4 to check for scarring. But this score misses many patients and cannot be calculated when blood test results are incomplete.
NIMIT-AI works differently. It reads a patient's blood test results over multiple visits, not just one visit, to spot patterns that suggest liver scarring. It was tested on 969 patients seen at Siriraj Hospital in Bangkok, Thailand between 2018 and 2022.
In testing, NIMIT-AI found liver scarring more accurately than FIB-4. It also worked even when some blood test results were missing, which happens often in real clinics.
This study did not ask patients to do anything extra. It used health records that were already collected as part of regular care.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Kontakter og lokationer
Studiesteder
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Bangkok
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Bangkok Noi, Bangkok, Thailand, 10700
- Faculty of Medicine Siriraj Hospital
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Prøveudtagningsmetode
Studiebefolkning
Beskrivelse
Inclusion Criteria:
- Age ≥18 years at index visit
- Confirmed MASLD diagnosis per Delphi consensus criteria
- At least one outpatient visit with concurrent laboratory data and FibroScan liver stiffness measurement within observation window (2018-2022)
- Receiving care at Division of Gastroenterology, Faculty of Medicine Siriraj Hospital, Mahidol University
Exclusion Criteria:
- Alternative chronic liver disease aetiology (autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis, Wilson's disease, haemochromatosis)
- Chronic viral hepatitis (hepatitis B or C surface antigen positivity)
- Prior liver transplantation
- Active extrahepatic malignancy at baseline
- Insufficient longitudinal data for outcome ascertainment
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
Antal grupper/kohorter
Kohorter og interventioner
Gruppe / kohorteGruppe / kohorte |
Intervention / BehandlingIntervention / Behandling |
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Primary longitudinal cohort (≥2 visits)
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NIMIT-AI, a gated recurrent unit deep learning model, analyzed serial outpatient laboratory results from electronic health records collected over a 5-year observation window (2018-2022) at Siriraj Hospital.
The model processed up to 10 sequential visits per patient using 18 clinical features including liver enzymes, metabolic markers, comorbidity flags, and medication exposures to predict liver fibrosis stage without requiring elastography.
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Singleton sensitivity analysis cohort (1 visit)
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NIMIT-AI, a gated recurrent unit deep learning model, analyzed serial outpatient laboratory results from electronic health records collected over a 5-year observation window (2018-2022) at Siriraj Hospital.
The model processed up to 10 sequential visits per patient using 18 clinical features including liver enzymes, metabolic markers, comorbidity flags, and medication exposures to predict liver fibrosis stage without requiring elastography.
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tidsramme |
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Area under the receiver operating characteristic curve (AUROC) for significant fibrosis (F≥2) identification
Tidsramme: Assessed at end of observation period (December 2022)
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Assessed at end of observation period (December 2022)
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Tidsramme |
|---|---|
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Sensitivity-constrained positive predictive value (PPV) for significant fibrosis (F≥2) at optimised classification threshold
Tidsramme: Assessed at end of observation period (December 2022)
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Assessed at end of observation period (December 2022)
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Diagnostic performance for compensated advanced chronic liver disease (F3-F4 cACLD) reported as one-vs-rest AUROC
Tidsramme: Assessed at end of observation period (December 2022)
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Assessed at end of observation period (December 2022)
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Net reclassification improvement (NRI) of NIMIT-AI versus FIB-4 at guideline-recommended threshold (1.30)
Tidsramme: Assessed at end of observation period (December 2022)
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Assessed at end of observation period (December 2022)
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Integrated discrimination improvement (IDI) of NIMIT-AI versus FIB-4
Tidsramme: Assessed at end of observation period (December 2022)
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Assessed at end of observation period (December 2022)
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Attention weight distribution across visit positions for temporal interpretability of NIMIT-AI predictions
Tidsramme: Assessed at end of observation period (December 2022)
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Assessed at end of observation period (December 2022)
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SHAP (SHapley Additive exPlanations) feature importance values for global model interpretability across fibrosis classes
Tidsramme: Assessed at end of observation period (December 2022)
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Assessed at end of observation period (December 2022)
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 338/2569(SIRB1)
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