Predictive model of ibuprofen treatment failure in very preterm infants with patent ductus arteriosus using machine learning techniques.

BACKGROUND

The approach to patent ductus arteriosus (PDA) remains controversial. We aim to develop an algorithm to predict ibuprofen treatment failure (TF) using machine learning (ML) techniques.

METHODS

Secondary analysis of a trial of very preterm infants receiving intravenous ibuprofen to treat PDA. A predictive model on TF was developed with ML. The impact of TF on outcomes was analyzed.

RESULTS

One hundred forty-six infants were included. ML techniques showed that a logistic regression model predicted TF with an AUC 0.65. A multiple regression model found that bronchopulmonary dysplasia (BPD) was associated with TF, p = 0.03. Other neonatal outcomes did not differ between the study groups.

CONCLUSIONS

It is feasible to build a predictive model of ibuprofen TF with ML that could assist clinicians during the PDA treatment decision-making process. The identification of responders prior to intervention would mitigate adverse effects in non-responders, providing them with an alternative approach.