Comparison of a neural network approach with five traditional methods for predicting creatinine clearance in patients with human immunodeficiency virus infection

Study Objective. To compare the results of an artificial neural network app roach with those of five published creatinine clearance (Cl-cr) prediction equations and with the measured (true) Cl-cr in patients infected with the human immunodeficiency virus (HIV). Design. Six-month prospective study. Settings. Two university medical centers. Patients. Sixty-five HIV-infected patients: 18 relatively healthy outpatien ts and 47 inpatients. Interventions. All subjects had urine collected for 24 hours to determine C l-cr. Measurements and Main Results. The 16 input variables were age, ideal body weight, actual body weight, body surface area, height, and the following bl ood chemistries: sodium, potassium, aspartate aminotransferase, alanine ami notransferase, red blood cell count, platelet count, white blood cell count , glucose, serum creatinine, blood urea nitrogen, and albumin. The only out put variable was Cl-cr. A training set of 55 subjects was used to develop t he relationship between input variables and the output variable. The traine d neural network was then used to predict Cl-cr of a validation set of 10 s ubjects. Mean differences between predicted Cl-cr and actual Cl-cr (bias) w ere 4.1, 28.7, 29.4, 26.0, 31.8, and 55.8 ml/min/1.73 m(2) for the artifici al neural network, Cockcroft and Gault, Jelliffe 1,Jelliffe 2, Mawer et al, and Hull et al methods, respectively. Conclusion. The accuracy of predicting Cl-cr in subjects with HIV infection by the artificial neural network is superior to that of the five equations that are currently used in clinical settings.