scholarly journals Using Deep Learning for Individual-Level Predictions of Adherence with Growth Hormone Therapy

Author(s):  
Matheus Araujo ◽  
Paula van Dommelen ◽  
Ekaterina Koledova ◽  
Jaideep Srivastava

The problem of consistent therapy adherence is a current challenge for health informatics, and its solution can increase the success rate of treatments. Here we show a methodology to predict, at individual-level, future therapy adherence for patients receiving daily injections of growth hormone (GH) therapy for GH deficiency. Our proposed model is able to generate predictions of future adherence using a recurrent neural network with adherence data recorded by easypodTM, a connected autoinjection device. The model was trained with a multi-year long dataset with 2500 patients, from January 2007 to June 2019. When testing, the model reached an average sensitivity of 0.70 and a specificity of 0.88 per patient when predicting non-adherence (<85%) periods. When evaluated with thousands of therapy segments extracted from a test set, our model reached an AUC-PR score of 0.79 and AUC-ROC of 0.90; both metrics were consistently better than traditional approaches, such as simple average model. Using this model, we can perform precise early identification of patients who are likely to become non-adherent patients. This opens a path for healthcare practitioners to personalize GH therapy at any stage of the patients’ journey and improve shared decision making with patients and caregivers to achieve optimal outcomes.

PEDIATRICS ◽  
1999 ◽  
Vol 104 (Supplement_5) ◽  
pp. 1004-1010
Author(s):  
David B. Allen

The consequences of severe growth hormone deficiency (GHD) in adults and the beneficial effects of GH replacement therapy are clear. However, the majority of children who have a diagnosis of GHD and who are treated with GH do not have permanent GHD and will not require treatment during adulthood. Several issues must be considered in selecting candidates for adult GH treatment and transitioning their care from pediatrics to adult medicine. Counseling about possible lifelong treatment should focus on children with panhypopituitarism and those with severe isolated GHD that is associated with central nervous system abnormalities. When to terminate growth-promoting GH therapy should be guided by balancing the high cost of late-adolescent treatment with the attainment of reasonable statural goals. Retesting for GH secretion is appropriate for all candidates for adult GH therapy; the GH axis can be tested within weeks after the cessation of treatment, but confirming an emerging adult GHD state with body composition, blood lipid, and quality-of-life assessments may require 1 year or more of observation. Selecting patients for lifelong adult GH replacement therapy will present diagnostic, therapeutic, and ethical problems similar to those in treating childhood GHD. The experience and expertise of pediatric endocrinologists in diagnosing and treating GHD should be offered and used in identifying and transitioning appropriate patients to adult GH therapy.


2018 ◽  
Vol 27 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Toshihiko Mori ◽  
Eri Nishino ◽  
Tomomi Jitsukawa ◽  
Emiko Hoshino ◽  
Satoshi Hirakawa ◽  
...  

2017 ◽  
Vol 46 (2) ◽  
pp. 761-772 ◽  
Author(s):  
Hironori Nagasaka ◽  
Ichiro Morioka ◽  
Mayuko Takuwa ◽  
Mariko Nakacho ◽  
Mayumi Yoshida ◽  
...  

Objective To investigate the basal amino acid metabolism and impact of growth hormone (GH) therapy in short-stature children born small for gestational age (short SGA children). Methods In this age-matched case-control study, the basal blood levels of amino acids, asymmetric dimethylarginine (ADMA), and nitrite/nitrate (NOx) were compared between 24 short SGA children and 25 age-matched normal children. Changes in these parameters were assessed for 12 months in 12 short SGA children initiating GH therapy (Group A) and 12 age-matched short SGA children without GH therapy (Group B). Results The arginine levels were significantly lower in the short SGA than in normal children. The ADMA levels were significantly higher and NOx levels were significantly lower in the short SGA than normal children. In Group A, the ADMA level was significantly lower and NOx level was significantly higher at 6 months than at baseline. At 12 months, the ADMA level in Group A began to increase, but the NOx level remained the same. Group B showed no significant changes. Conclusions This study is the first to show that ADMA is promoted and nitric oxide is suppressed in short SGA children and that GH therapy affects the production of ADMA and nitric oxide.


2005 ◽  
Vol 15 (2) ◽  
pp. 156-164 ◽  
Author(s):  
A. Minczykowski ◽  
M. Gryczynska ◽  
K. Ziemnicka ◽  
R. Czepczynski ◽  
J. Sowinski ◽  
...  

2004 ◽  
pp. 325-332 ◽  
Author(s):  
T Mahajan ◽  
A Crown ◽  
S Checkley ◽  
A Farmer ◽  
S Lightman

OBJECTIVE: Some growth hormone deficient adults (GHDAs) have an impaired quality of life, which may improve with growth hormone (GH) treatment. The objective of our study was to make an in-depth psychiatric evaluation of patients with adult-onset (AO) and childhood-onset (CO) GH deficiency (GHD), and to assess the time course of changes in their quality of life and symptoms of depression in response to GH treatment. DESIGN: The study design was a 4-month, double-blind, cross-over, placebo-controlled trial of GH therapy. METHODS:We used a detailed psychiatric interview to characterise 25 patients with proven GHD at baseline. They were reassessed at monthly intervals during treatment with GH or placebo, using the Nottingham Health Profile and two well-recognised depression rating scales. RESULTS: 11/18 (61%) of the patients with AO-GHD, but 0/7 of the patients with CO-GHD, were found to have atypical depression at baseline. There were significant improvements in the depression rating scale scores after 2 months of GH therapy, with significant improvements in emotional reaction and social isolation scores from 1 month, and in energy levels and sleep disturbance from 2 and 3 months respectively. CONCLUSIONS: The results of our study confirm that a large proportion of GHDAs have unequivocal psychiatric morbidity, and suggest that a response to treatment can be seen after a short trial of GH therapy. We hypothesise that this rapid improvement of symptoms of atypical depression represents a direct central effect of GH therapy.


2000 ◽  
Vol 85 (10) ◽  
pp. 3720-3725 ◽  
Author(s):  
Giovanni Amato ◽  
Gherardo Mazziotti ◽  
Carolina Di Somma ◽  
Eleonora Lalli ◽  
Giuseppina De Felice ◽  
...  

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