Clinical trial NCT04918199: Human Versus Computer-based Predictions of Long Allograft Survival
Official title: Computer Based, vs Human Based Assessment of Kidney Allograft Failure Prediction and Stratification
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Kidney Transplant Failure
Keywords: iBox
individual risk prediction
kidney transplantation
long-term allograft outcome
Lead sponsor: Paris Translational Research Center for Organ Transplantation
Sponsor class: OTHER
First posted: 2021-06-08
Enrollment: 400
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: 400 (10%) of the patients were randomly selected with an evaluation available at one-year post-transplant from the Paris Transplant Group cohort, which gathers 4,000 consecutive patients over 18 years of age prospectively enrolled at the time of kidney transplantation from a living or deceased donor at Necker Hospital, Saint-Louis Hospital, Foch Hospital, and Toulouse Hospital between January 1, 2005, and January 1, 2014, in France.

Brief summary: The clinical decision-making after kidney transplantation is mainly driven by patient individual assessment. However, this task remains difficult and uncertain due to the integration of complex and numerous parameters. We aim to evaluate and compare the ability of transplant physicians to predict long term allograft survival compared with a computer-based survival prediction algorithm (iBox system).

Detailed description: 400 kidney transplant recipients among the cohort of 4,000 patients from the Paris Transplant Group prospective kidney transplant cohort (NCT03474003) were randomly selected. We generated an anonymized electronic health record for each included patient including a total of 60 classical kidney transplant prognostic parameters comprising baseline transplant and recipient characteristics, together with post-transplant parameters including allograft function, proteinuria, histology, diagnoses, and immunological profile collected during the first-year post-transplant. The time of risk evaluation for the human and the iBox system were at 1-year post transplant and the death censored allograft survival predictions made at 7 years after risk assessment. We enrolled transplant physicians at various stages of their careers (residents, fellows and seniors) to assign death censored graft survival probabilities at 7 years post risk assessment. The physicians were blinded to the actual patient outcome (allograft failure) and the iBox predictions. The physicians-based predictions will then be compared with the iBox system, a validated computer-based kidney survival prediction system.

Eligibility criteria: Inclusion Criteria:

* transplant evaluation available at one year post-transplant

Exclusion Criteria:

* no

Primary outcomes:
measure: Death censored allograft failure seven years after risk assessment
timeFrame: 7 years
Secondary outcomes:
measure: Evaluation of the parameters' importance in the prediction for physicians
timeFrame: 7 years
measure: Inter-rater agreement
timeFrame: 7 years
Other outcomes:
Locations:
city: Paris
country: France
facility: Paris Translational Centre for Organ Transplantation
state: Île-de-France
Study officials:
References:
citation: Loupy A, Aubert O, Orandi BJ, Naesens M, Bouatou Y, Raynaud M, Divard G, Jackson AM, Viglietti D, Giral M, Kamar N, Thaunat O, Morelon E, Delahousse M, Kuypers D, Hertig A, Rondeau E, Bailly E, Eskandary F, Bohmig G, Gupta G, Glotz D, Legendre C, Montgomery RA, Stegall MD, Empana JP, Jouven X, Segev DL, Lefaucheur C. Prediction system for risk of allograft loss in patients receiving kidney transplants: international derivation and validation study. BMJ. 2019 Sep 17;366:l4923. doi: 10.1136/bmj.l4923.