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Deep Learning for Liver Fibrosis Triage in MASLD Using Longitudinal Electronic Health Records (NIMIT-AI)

26. juni 2026 oppdatert av: Tawesak Tanwandee, Siriraj Hospital

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.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Studietype

Observasjonsmessig

Registrering (Faktiske)

1351

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Thailand
    • Bangkok
      • Bangkok Noi, Bangkok, Thailand, 10700
        • Faculty of Medicine Siriraj Hospital

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

N/A

Prøvetakingsmetode

Ikke-sannsynlighetsprøve

Studiepopulasjon

Adults with confirmed metabolic dysfunction-associated steatotic liver disease (MASLD) receiving outpatient hepatology care at Siriraj Hospital, a 2,500-bed tertiary academic medical centre in Bangkok, Thailand. The population reflects a high metabolic comorbidity burden typical of urban Thai patients, with elevated rates of type 2 diabetes, obesity, and cardiometabolic multimorbidity.

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

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Kohorter og intervensjoner

Gruppe / Kohort
Intervensjon / Behandling
Primary longitudinal cohort (≥2 visits)
Diagnostisk test: Longitudinal electronic health record analysis
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.
Singleton sensitivity analysis cohort (1 visit)
Diagnostisk test: Longitudinal electronic health record analysis
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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tidsramme
Area under the receiver operating characteristic curve (AUROC) for significant fibrosis (F≥2) identification
Tidsramme: Assessed at end of observation period (December 2022)
Assessed at end of observation period (December 2022)

Sekundære resultatmål

Resultatmål
Tidsramme
Sensitivity-constrained positive predictive value (PPV) for significant fibrosis (F≥2) at optimised classification threshold
Tidsramme: Assessed at end of observation period (December 2022)
Assessed at end of observation period (December 2022)
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)
Assessed at end of observation period (December 2022)
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)
Assessed at end of observation period (December 2022)
Integrated discrimination improvement (IDI) of NIMIT-AI versus FIB-4
Tidsramme: Assessed at end of observation period (December 2022)
Assessed at end of observation period (December 2022)
Attention weight distribution across visit positions for temporal interpretability of NIMIT-AI predictions
Tidsramme: Assessed at end of observation period (December 2022)
Assessed at end of observation period (December 2022)
SHAP (SHapley Additive exPlanations) feature importance values for global model interpretability across fibrosis classes
Tidsramme: Assessed at end of observation period (December 2022)
Assessed at end of observation period (December 2022)

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Siriraj Hospital

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. januar 2018

Primær fullføring (Faktiske)

31. desember 2022

Studiet fullført (Faktiske)

16. juni 2024

Datoer for studieregistrering

Først innsendt

18. juni 2026

Først innsendt som oppfylte QC-kriteriene

26. juni 2026

Først lagt ut (Faktiske)

30. juni 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

30. juni 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

26. juni 2026

Sist bekreftet

1. juni 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 338/2569(SIRB1)

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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