Developing an Intelligent System for Prediction of Optimal Dose of Warfarin in Iranian Adult Patients with Artificial Heart Valve

Abstract

Introduction: Artificial intelligence (AI) research within medicine is growing rapidly. AI is poised to transform medical practice. AI has been studied in several areas of healthcare and medical practice, including diagnosing, treating and caring of patients. Warfarin is one of the most commonly prescribed oral anticoagulant. Among all anticoagulants, warfarin has long been listed among the top ten drugs causing adverse drug events. Due to narrow therapeutic range and significant side effects, warfarin dosage determination becomes a challenging task in clinical practice. The purpose of this study was to determine exact dose of warfarin needed for patients with artificial heart valve using artificial neural networks (ANN).Development: To achieved the best model, some multi-layer perceptron ANNs were constructed with different structures. The dataset used included 846 patients who had been referred to the PT clinic in Tehran heart center in the second six months of the year 2013. Finally, the best structure of ANN for warfarin dose was investigated and used for prediction system developments. In this paper the implementation of ANNs and proposed system in MatLab environment are described.Application: The effectiveness of ANNs were evaluated in terms of classification performance using 10fold cross-validation procedure and the results showed that the best model is a network that has 7 neurons in its hidden layer with an average absolute error of 0.1, disturbance rate of 0.33 and regression of 0.87. Conclusion: The achieved results reveal that ANN-based system is a suitable tool for warfarin dose prediction in Iranian patients with an artificial heartvalve. However, no system can be guaranteed to achieve 100% accuracy, but using such methods can reduce medical errors and thereby improve health care and patient safety.