Predicting 1-year successful clinical use of an arteriovenous access for hemodialysis using machine learning
Bibliographic record
Abstract
Arteriovenous (AV) access is important to support long-term hemodialysis; however, a significant proportion fail due to inadequate maturation or other complications. Tools that can predict long-term AV access success may guide clinical decision-making but remain limited. We developed machine learning (ML) algorithms that predict 1-year successful clinical use of an AV access using pre-operative data. The Vascular Quality Initiative (VQI) was used to identify patients who underwent surgical AV fistula/graft creation between 2011-2024. We identified 111 pre-operative demographic, clinical, and anatomic features. Six ML models were trained with 10-fold cross-validation. Overall, 59,674 patients underwent AV access creation and 28,304 (47.4%) had 1-year successful clinical use of their index AV access. The best prediction model was XGBoost, achieving an AUROC of 0.90. In comparison, logistic regression had an AUROC of 0.70. The XGBoost model accurately predicted 1-year successful clinical use of an AV access for hemodialysis, performing better than logistic regression.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".