Causal Phenotyping for Susceptibility to Cardiotoxicity from Antineoplastic Breast Cancer Medications

AMIA Annu Symp Proc. 2018 Apr 16:2017:1655-1664. eCollection 2017.

Abstract

Cardiotoxicity is a relatively common and particularly important adverse event caused by chemotherapy for breast cancer patients. Typical associative phenotypes, such as risk factors associated with diabetes, can often be detected solely based on the data elements existing in electronic health records; however, causal phenotypes, such as risk factors causing cardiotoxicity, require establishing causation between chemotherapy and determining new heart disease, and cannot be directly observedfrom EHR. We propose three phenotyping algorithms to assess breast cancer patients' susceptibility to cardiotoxicity caused by five first-line antineoplastic drugs: (1) causal phenotype model to predict the patients' risk of cardiotoxicity as the difference between the heart disease risks with exposure and nonexposure to the drugs; (2) regular predictive model; (3) combined predictive model of the above two models. Concordances for three methods were 0.60, 0.62, and 0.68. When considering all exposed patients, concordances were 0.66, 0.58 and 0.65 at 280 days after treatment. The study demonstrates the potential utility of causal phenotyping.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Algorithms*
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Breast Neoplasms / drug therapy*
  • Cardiotoxicity*
  • Electronic Health Records
  • Female
  • Heart Diseases / chemically induced
  • Humans
  • Phenotype*
  • Risk Assessment / methods
  • Risk Factors

Substances

  • Antineoplastic Agents