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Predictors on outcomes of cardiovascular disease of male patients in Malaysia using Bayesian network analysis

Objectives: Despite extensive advances in medical and surgical treatment, cardiovascular disease (CVD) remains the leading cause of mortality worldwide. Identifying the significant predictors will help clinicians with the prognosis of the disease and patient management. This study aims to identify a...

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Main Authors: Juhan, Nurliyana, Zubairi, Yong Zulina, Mahmood Zuhdi, Ahmad Syadi, Mohd. Khalid, Zarina
Format: Article
Language:English
Published: BioMed Central Ltd 2023
Subjects:
QA Mathematics
Online Access:http://eprints.utm.my/105571/1/ZarinaMohdKhalid2023_PredictorsOnOutcomesOfCardiovascularDisease.pdf
http://eprints.utm.my/105571/
http://dx.doi.org/10.1136/bmjopen-2022-066748
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spelling my.utm.1055712024-05-06T06:27:46Z http://eprints.utm.my/105571/ Predictors on outcomes of cardiovascular disease of male patients in Malaysia using Bayesian network analysis Juhan, Nurliyana Zubairi, Yong Zulina Mahmood Zuhdi, Ahmad Syadi Mohd. Khalid, Zarina QA Mathematics Objectives: Despite extensive advances in medical and surgical treatment, cardiovascular disease (CVD) remains the leading cause of mortality worldwide. Identifying the significant predictors will help clinicians with the prognosis of the disease and patient management. This study aims to identify and interpret the dependence structure between the predictors and health outcomes of ST-elevation myocardial infarction (STEMI) male patients in Malaysian setting. Design: Retrospective study. Setting: Malaysian National Cardiovascular Disease Database-Acute Coronary Syndrome (NCVD-ACS) registry years 2006-2013, which consists of 18 hospitals across the country. Participants: 7180 male patients diagnosed with STEMI from the NCVD-ACS registry. Primary and secondary outcome measures: A graphical model based on the Bayesian network (BN) approach has been considered. A bootstrap resampling approach was integrated into the structural learning algorithm to estimate probabilistic relations between the studied features that have the strongest influence and support. Results: The relationships between 16 features in the domain of CVD were visualised. From the bootstrap resampling approach, out of 250, only 25 arcs are significant (strength value =0.85 and the direction value =0.50). Age group, Killip class and renal disease were classified as the key predictors in the BN model for male patients as they were the most influential variables directly connected to the outcome, which is the patient status. Widespread probabilistic associations between the key predictors and the remaining variables were observed in the network structure. High likelihood values are observed for patient status variable stated alive (93.8%), Killip class I on presentation (66.8%), patient younger than 65 (81.1%), smoker patient (77.2%) and ethnic Malay (59.2%). The BN model has been shown to have good predictive performance. Conclusions: The data visualisation analysis can be a powerful tool to understand the relationships between the CVD prognostic variables and can be useful to clinicians. BioMed Central Ltd 2023 Article PeerReviewed application/pdf en http://eprints.utm.my/105571/1/ZarinaMohdKhalid2023_PredictorsOnOutcomesOfCardiovascularDisease.pdf Juhan, Nurliyana and Zubairi, Yong Zulina and Mahmood Zuhdi, Ahmad Syadi and Mohd. Khalid, Zarina (2023) Predictors on outcomes of cardiovascular disease of male patients in Malaysia using Bayesian network analysis. BMJ Open, 13 (11). pp. 1-7. ISSN 2044-6055 http://dx.doi.org/10.1136/bmjopen-2022-066748 DOI : 10.1136/bmjopen-2022-066748
institution Universiti Teknologi Malaysia
building UTM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Teknologi Malaysia
content_source UTM Institutional Repository
url_provider http://eprints.utm.my/
language English
topic QA Mathematics
spellingShingle QA Mathematics
Juhan, Nurliyana
Zubairi, Yong Zulina
Mahmood Zuhdi, Ahmad Syadi
Mohd. Khalid, Zarina
Predictors on outcomes of cardiovascular disease of male patients in Malaysia using Bayesian network analysis
description Objectives: Despite extensive advances in medical and surgical treatment, cardiovascular disease (CVD) remains the leading cause of mortality worldwide. Identifying the significant predictors will help clinicians with the prognosis of the disease and patient management. This study aims to identify and interpret the dependence structure between the predictors and health outcomes of ST-elevation myocardial infarction (STEMI) male patients in Malaysian setting. Design: Retrospective study. Setting: Malaysian National Cardiovascular Disease Database-Acute Coronary Syndrome (NCVD-ACS) registry years 2006-2013, which consists of 18 hospitals across the country. Participants: 7180 male patients diagnosed with STEMI from the NCVD-ACS registry. Primary and secondary outcome measures: A graphical model based on the Bayesian network (BN) approach has been considered. A bootstrap resampling approach was integrated into the structural learning algorithm to estimate probabilistic relations between the studied features that have the strongest influence and support. Results: The relationships between 16 features in the domain of CVD were visualised. From the bootstrap resampling approach, out of 250, only 25 arcs are significant (strength value =0.85 and the direction value =0.50). Age group, Killip class and renal disease were classified as the key predictors in the BN model for male patients as they were the most influential variables directly connected to the outcome, which is the patient status. Widespread probabilistic associations between the key predictors and the remaining variables were observed in the network structure. High likelihood values are observed for patient status variable stated alive (93.8%), Killip class I on presentation (66.8%), patient younger than 65 (81.1%), smoker patient (77.2%) and ethnic Malay (59.2%). The BN model has been shown to have good predictive performance. Conclusions: The data visualisation analysis can be a powerful tool to understand the relationships between the CVD prognostic variables and can be useful to clinicians.
format Article
author Juhan, Nurliyana
Zubairi, Yong Zulina
Mahmood Zuhdi, Ahmad Syadi
Mohd. Khalid, Zarina
author_facet Juhan, Nurliyana
Zubairi, Yong Zulina
Mahmood Zuhdi, Ahmad Syadi
Mohd. Khalid, Zarina
author_sort Juhan, Nurliyana
title Predictors on outcomes of cardiovascular disease of male patients in Malaysia using Bayesian network analysis
title_short Predictors on outcomes of cardiovascular disease of male patients in Malaysia using Bayesian network analysis
title_full Predictors on outcomes of cardiovascular disease of male patients in Malaysia using Bayesian network analysis
title_fullStr Predictors on outcomes of cardiovascular disease of male patients in Malaysia using Bayesian network analysis
title_full_unstemmed Predictors on outcomes of cardiovascular disease of male patients in Malaysia using Bayesian network analysis
title_sort predictors on outcomes of cardiovascular disease of male patients in malaysia using bayesian network analysis
publisher BioMed Central Ltd
publishDate 2023
url http://eprints.utm.my/105571/1/ZarinaMohdKhalid2023_PredictorsOnOutcomesOfCardiovascularDisease.pdf
http://eprints.utm.my/105571/
http://dx.doi.org/10.1136/bmjopen-2022-066748
_version_ 1800082631067435008
score 13.211869

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