Temporal validation of a Generalized Additive² Model (GA²M) to assess the risk of Chronic Kidney Disease (CKD).

Abstract

To assess the temporal validity of a model predicting the risk of Chronic Kidney Disease (CKD) using Generalized Additive² Models (GA²M). We adopted the Italian Health Search Database (HSD) with which the original algorithm was developed and validated by comparing different machine learnings models. We selected all patients aged >=15 being active in HSD in 2019. They were followed up until December 2022 so being updated with three years of data collection. Those with prior diagnosis of CKD were excluded. A GA²M-based algorithm for CKD prediction was applied to this cohort in order to compare observed and predicted risk. Area Under Curve (AUC) and Average Precision (AP) were calculated. We obtained an AUC and AP equal to 88% and 30%, respectively. The prediction accuracy of the algorithm was largely consistent with that obtained in our prior work which was based on a different time-window for data collection. We therefore underlined and demonstrated the relevance of temporal validation for this prediction tool. The GA²M confirmed its high accuracy in prediction of CKD. As such, the respective patient- and population-based informatic tools might be implemented in primary care.