A Risk Calculator for the Pulmonary Arterial Hypertension Based on a Bayesian Network

Abstract

Pulmonary arterial hypertension (PAH) is a severe and often deadly disease, originating from an increase in pulmonary vascular resistance. Its prevention and treatment are of vital importance to public health. A group of medical researchers proposed a calculator for estimating the risk of dying from PAH, available for a variety of computing platforms and widely used by health-care professionals. The PAH Risk Calculator is based on the Cox's Proportional Hazard (CPH) Model, a popular statistical technique used in risk estimation and survival analysis, based on data from a thoroughly collected and maintained Registry to Evaluate Early and Long-term Pulmonary Arterial Hypertension Disease Management (REVEAL Registry). In this paper, we propose an alternative approach to calculating the risk of PAH that is based on a Bayesian network (BN) model. Our first step has been to create a BN model that mimics the CPH model at the foundation of the current PAH Risk Calculator. The BN-based calculator reproduces the results of the current PAH Risk Calculator exactly. Because Bayesian networks do not require the somewhat restrictive assumptions of the CPH model and can readily combine data with expert knowledge, we expect that our approach will lead to an improvement over the current calculator. We plan to (1) learn the parameters of the BN model from the data captured in the REVEAL Registry, and (2) enhance the resulting BN model with medical expert knowledge. We have been collaborating closely on both tasks with the authors of the original PAH Risk Calculator.