Training and Performance of an Electrocardiogram-Enabled Machine Learning Model for Detection of Advanced Chronic Liver Disease.

Rattan, Puru; Ahn, Joseph C; Chara, Beatriz Sordi; Mullan, Aidan F; Liu, Kan; Attia, Zachi I; Friedman, Paul A; Allen, Alina et al. · Am J Gastroenterol · 2025

retrospective_cohort · Level III

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Abstract

Building on prior results, we hypothesized that an electrocardiogram (ECG)-enabled machine learning (ML) model could be used to detect advanced chronic liver disease (CLD). A cohort with CLD and 12-lead ECGs was matched with controls from electronic health records. A ML model was trained as a binary classifier. There are 12,930 patients with CLD and 64,577 controls in the cohort. The model's discriminative ability to classify CLD showed an area under the receiver-operating characteristic curve 0.858 (95% confidence interval: 0.850-0.866), and at the chosen threshold, CLD ECGs had 12 times higher odds of being classified as CLD (diagnostic odds ratio 12.33, 95% confidence interval: 11.16-13.63). An ECG-enabled ML model affords great promise in identifying advanced CLD in low resource areas.

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