Machine Learning Classifier Models Can Identify ARDS Phenotypes Using Readily Available Clinical Data

Sinha, Prasun; Churpek, Matthew M; Calfee, CS

doi:10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a1014

Cited by 10 publications

(12 citation statements)

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“…ARDS is known to be a heterogeneous syndrome with different sub-phenotypes that are characterized by different clinical features, inflammatory cytokine profiles, physiology and differential response to interventions [ 6 , 7 ]. COVID-19 is no exception to this rule.…”

Section: Plus çA Change Plus C’est La Même Chose…mentioning

confidence: 99%

How severe COVID-19 infection is changing ARDS management

2020

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Section: Plus çA Change Plus C’est La Même Chose…mentioning

confidence: 99%

How severe COVID-19 infection is changing ARDS management

2020

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“…A parsimonious model of different combinations of three or four biomarkers (interleukin (IL)-6 or IL-8, bicarbonate, tumour necrosis factor receptor 1 or protein C, possibly in combination with vasopressor use) as well as a machine learning algorithm that used readily available clinical data was able to accurately identify the LCA phenotypes and showed adequate predictive enrichment in post hoc analysis of the above described RCTs [64,65].…”

Section: Differential Treatment Responses Between Biological Phenotypesmentioning

confidence: 99%

Precision medicine in acute respiratory distress syndrome: workshop report and recommendations for future research

et al. 2021

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Acute respiratory distress syndrome (ARDS) is a devastating critical illness that can be triggered by a wide range of insults and remains associated with a high mortality of around 40%. The search for targeted treatment for ARDS has been disappointing, possibly due to the enormous heterogeneity within the syndrome. In this perspective from the European Respiratory Society research seminar on “Precision medicine in ARDS”, we will summarise the current evidence for heterogeneity, explore the evidence in favour of precision medicine and provide a roadmap for further research in ARDS. There is evident variation in the presentation of ARDS on three distinct levels: 1) aetiological; 2) physiological and 3) biological, which leads us to the conclusion that there is no typical ARDS. The lack of a common presentation implies that intervention studies in patients with ARDS need to be phenotype aware and apply a precision medicine approach in order to avoid the lack of success in therapeutic trials that we faced in recent decades. Deeper phenotyping and integrative analysis of the sources of variation might result in identification of additional treatable traits that represent specific pathobiological mechanisms, or so-called endotypes.

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“…First, there is considerable heterogeneity in ARDS itself. Several recent research directions are exploring whether different treatments can be given according to different phenotypes of ARDS [ 114 , 115 ]. Therefore, future research should be based on ARDS patients whose phenotype pathology is more aligned with the mechanisms of aspirin.…”

Section: Meta-analysis Of Clinical Studiesmentioning

confidence: 99%

Antiplatelet Therapy for Acute Respiratory Distress Syndrome

Chen

Tung

et al. 2020

Biomedicines

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Acute respiratory distress syndrome (ARDS) is a common and devastating syndrome that contributes to serious morbidities and mortality in critically ill patients. No known pharmacologic therapy is beneficial in the treatment of ARDS, and the only effective management is through a protective lung strategy. Platelets play a crucial role in the pathogenesis of ARDS, and antiplatelet therapy may be a potential medication for ARDS. In this review, we introduce the overall pathogenesis of ARDS, and then focus on platelet-related mechanisms underlying the development of ARDS, including platelet adhesion to the injured vessel wall, platelet-leukocyte-endothelium interactions, platelet-related lipid mediators, and neutrophil extracellular traps. We further summarize antiplatelet therapy, including aspirin, glycoprotein IIb/IIIa receptor antagonists, and P2Y12 inhibitors for ARDS in experimental and clinical studies and a meta-analysis. Novel aspirin-derived agents, aspirin-triggered lipoxin, and aspirin-triggered resolvin D1 are also described here. In this narrative review, we summarize the current knowledge of the role of platelets in the pathogenesis of ARDS, and the potential benefits of antiplatelet therapy for the prevention and treatment of ARDS.

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Machine Learning Classifier Models Can Identify ARDS Phenotypes Using Readily Available Clinical Data

Cited by 10 publications

References 0 publications

How severe COVID-19 infection is changing ARDS management

How severe COVID-19 infection is changing ARDS management

Precision medicine in acute respiratory distress syndrome: workshop report and recommendations for future research

Antiplatelet Therapy for Acute Respiratory Distress Syndrome

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