TY - JOUR
T1 - A prediction model for asthma exacerbations after stopping asthma biologics
AU - Inselman, Jonathan W.
AU - Jeffery, Molly M.
AU - Maddux, Jacob T.
AU - Lam, Regina W.
AU - Shah, Nilay D.
AU - Rank, Matthew A.
AU - Ngufor, Che G.
N1 - Publisher Copyright:
© 2022 American College of Allergy, Asthma & Immunology
PY - 2023/3
Y1 - 2023/3
N2 - Background: Little is known regarding the prediction of the risks of asthma exacerbation after stopping asthma biologics. Objective: To develop and validate a predictive model for the risk of asthma exacerbations after stopping asthma biologics using machine learning models. Methods: We identified 3057 people with asthma who stopped asthma biologics in the OptumLabs Database Warehouse and considered a wide range of demographic and clinical risk factors to predict subsequent outcomes. The primary outcome used to assess success after stopping was having no exacerbations in the 6 months after stopping the biologic. Elastic-net logistic regression (GLMnet), random forest, and gradient boosting machine models were used with 10-fold cross-validation within a development (80%) cohort and validation cohort (20%). Results: The mean age of the total cohort was 47.1 (SD, 17.1) years, 1859 (60.8%) were women, 2261 (74.0%) were White, and 1475 (48.3%) were in the Southern region of the United States. The elastic-net logistic regression model yielded an area under the curve (AUC) of 0.75 (95% confidence interval [CI], 0.71-0.78) in the development and an AUC of 0.72 in the validation cohort. The random forest model yielded an AUC of 0.75 (95% CI, 0.68-0.79) in the development cohort and an AUC of 0.72 in the validation cohort. The gradient boosting machine model yielded an AUC of 0.76 (95% CI, 0.72-0.80) in the development cohort and an AUC of 0.74 in the validation cohort. Conclusion: Outcomes after stopping asthma biologics can be predicted with moderate accuracy using machine learning methods.
AB - Background: Little is known regarding the prediction of the risks of asthma exacerbation after stopping asthma biologics. Objective: To develop and validate a predictive model for the risk of asthma exacerbations after stopping asthma biologics using machine learning models. Methods: We identified 3057 people with asthma who stopped asthma biologics in the OptumLabs Database Warehouse and considered a wide range of demographic and clinical risk factors to predict subsequent outcomes. The primary outcome used to assess success after stopping was having no exacerbations in the 6 months after stopping the biologic. Elastic-net logistic regression (GLMnet), random forest, and gradient boosting machine models were used with 10-fold cross-validation within a development (80%) cohort and validation cohort (20%). Results: The mean age of the total cohort was 47.1 (SD, 17.1) years, 1859 (60.8%) were women, 2261 (74.0%) were White, and 1475 (48.3%) were in the Southern region of the United States. The elastic-net logistic regression model yielded an area under the curve (AUC) of 0.75 (95% confidence interval [CI], 0.71-0.78) in the development and an AUC of 0.72 in the validation cohort. The random forest model yielded an AUC of 0.75 (95% CI, 0.68-0.79) in the development cohort and an AUC of 0.72 in the validation cohort. The gradient boosting machine model yielded an AUC of 0.76 (95% CI, 0.72-0.80) in the development cohort and an AUC of 0.74 in the validation cohort. Conclusion: Outcomes after stopping asthma biologics can be predicted with moderate accuracy using machine learning methods.
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U2 - 10.1016/j.anai.2022.11.025
DO - 10.1016/j.anai.2022.11.025
M3 - Article
C2 - 36509405
AN - SCOPUS:85146064723
SN - 1081-1206
VL - 130
SP - 305
EP - 311
JO - Annals of Allergy, Asthma and Immunology
JF - Annals of Allergy, Asthma and Immunology
IS - 3
ER -