A novel method detecting the key clinic factors of portal vein system thrombosis of splenectomy & cardia devascularization patients for cirrhosis & portal hypertension
Authors: Wang Mingzhao , Ding Linglong , Xu Meng , Xie Juanying , Wu Shengli , Xu Shengquan , Yao Yingmin , Liu Qingguang 
Published: December 2019

Abstract
Background
Portal vein system thrombosis (PVST) is potentially fatal for patients if the diagnosis is not timely or the treatment is not proper. There hasn’t been any available technique to detect clinic risk factors to predict PVST after splenectomy in cirrhotic patients. The aim of this study is to detect the clinic risk factors of PVST for splenectomy and cardia devascularization patients for liver cirrhosis and portal hypertension, and build an efficient predictive model to PVST via the detected risk factors, by introducing the machine learning method. We collected 92 clinic indexes of splenectomy plus cardia devascularization patients for cirrhosis and portal hypertension, and proposed a novel algorithm named as RFA-PVST (Risk Factor Analysis for PVST) to detect clinic risk indexes of PVST, then built a SVM (support vector machine) predictive model via the detected risk factors. The accuracy, sensitivity, specificity, precision, F-measure, FPR (false positive rate), FNR (false negative rate), FDR (false discovery rate), AUC (area under ROC curve) and MCC (Matthews correlation coefficient) were adopted to value the predictive power of the detected risk factors. The proposed RFA-PVST algorithm was compared to mRMR, SVM-RFE, Relief, S-weight and LLEScore. The statistic test was done to verify the significance of our RFA-PVST.

Results
Anticoagulant therapy and antiplatelet aggregation therapy are the top-2 risk clinic factors to PVST, followed by D-D (D dimer), CHOL (Cholesterol) and Ca (calcium). The SVM (support vector machine) model built on the clinic indexes including anticoagulant therapy, antiplatelet aggregation therapy, RBC (Red blood cell), D-D, CHOL, Ca, TT (thrombin time) and Weight factors has got pretty good predictive capability to PVST. It has got the highest PVST predictive accuracy of 0.89, and the best sensitivity, specificity, precision, F-measure, FNR, FPR, FDR and MCC of 1, 0.75, 0.85, 0.92, 0, 0.25, 0.15 and 0.8 respectively, and the comparable good AUC value of 0.84. The statistic test results demonstrate that there is a strong significant difference between our RFA-PVST and the compared algorithms, including mRMR, SVM-RFE, Relief, S-weight and LLEScore, that is to say, the risk indicators detected by our RFA-PVST are statistically significant.

Conclusions
The proposed novel RFA-PVST algorithm can detect the clinic risk factors of PVST effectively and easily. Its most contribution is that it can display all the clinic factors in a 2-dimensional space with independence and discernibility as y-axis and x-axis, respectively. Those clinic indexes in top-right corner of the 2-dimensional space are detected automatically as risk indicators. The predictive SVM model is powerful with the detected clinic risk factors of PVST. Our study can help medical doctors to make proper treatments or early diagnoses to PVST patients. This study brings the new idea to the study of clinic treatment for other diseases as well.