Can machine learning improve patient selection for cardiac resynchronization therapy?

RationaleMultiple clinical trials support the effectiveness of cardiac resynchronization therapy (CRT); however, optimal patient selection remains challenging due to substantial treatment heterogeneity among patients who meet the clinical practice guidelines.ObjectiveTo apply machine learning to create an algorithm that predicts CRT outcome using electronic health record (EHR) data avaible before the procedure.Methods and resultsWe applied machine learning and natural language processing to the EHR of 990 patients who received CRT at two academic hospitals between 2004-2015. The primary outcome was reduced CRT benefit, defined as ConclusionsA machine learning model that leveraged readily available EHR data and clinical notes identified a subset of CRT patients who may not benefit from CRT before the procedure.