{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T23:21:48Z","timestamp":1784330508046,"version":"3.55.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intradialytic hypotension (IDH) is a serious complication of chronic hemodialysis (HD). BestShape is a novel artificial intelligence-driven system developed recently for real-time prediction of IDH. This study aimed to report the clinical results and health-economic benefits following the implementation of BestShape.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Medical records from two institutions in Taiwan that incorporated BestShape into all HD practices were retrospectively reviewed. Data from HD sessions from January 2020 to December 2023, following BestShape implementation, constituted the \u201cBestShape group.\u201d Data from January 2016 through the end of 2019 served as the historical control group. The primary outcome was IDH frequency, and secondary outcomes were rates of cardiopulmonary resuscitation (CPR), falls, mortality, medical personnel satisfaction, and estimated cost reduction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 213\u2009071 HD sessions of 18\u2009141 patients were included (BestShape 152\u2009792 sessions; control 60\u2009279 sessions). The mean monthly IDH rate significantly reduced from 27% in 2019 to 21% in 2023 (P\u00a0&amp;lt;\u00a0.001). The need for CPR during dialysis decreased from eight to three times per month, and post-dialysis falls decreased from 21 to seven times. The estimated annual cost savings by implementing BestShape were USD 115\u2009658. The mortality rate during HD was not significantly different before and after BestShape implementation (8% vs 9.3%, P\u00a0=\u00a0.260). Medical personnel expressed satisfaction with BestShape, with a mean satisfaction score of 86.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preliminary clinical data show BestShape is associated with reductions in IDH, CPR, and falls in patients undergoing HD, and a reduction in healthcare costs and high medical personnel satisfaction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ckj\/sfaf323","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T12:35:24Z","timestamp":1761568524000},"source":"Crossref","is-referenced-by-count":3,"title":["The BestShape artificial intelligence system for real-time prediction of intradialytic hypotension\u2014clinical outcomes after four-year follow-up"],"prefix":"10.1093","volume":"18","author":[{"given":"Cheng-Jui","family":"Lin","sequence":"first","affiliation":[{"name":"MacKay Memorial Hospital Division of Nephrology, Department of Internal Medicine, , Taipei ,","place":["Taiwan"]},{"name":"Mackay Medical College Department of Medicine, , New Taipei ,","place":["Taiwan"]},{"name":"Mackay Junior College of Medicine, Nursing and Management , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong-Mou","family":"Shih","sequence":"additional","affiliation":[{"name":"MacKay Memorial Hospital Division of Nephrology, Department of Internal Medicine, , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying-Ying","family":"Chen","sequence":"additional","affiliation":[{"name":"MacKay Memorial Hospital Division of Nephrology, Department of Internal Medicine, , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiow-Huey","family":"Chen","sequence":"additional","affiliation":[{"name":"MacKay Memorial Hospital Division of Hemodialysis and Peritoneal Dialysis, Department of Nursing, , Taipei and New Taipei city ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Fang","family":"Su","sequence":"additional","affiliation":[{"name":"MacKay Memorial Hospital Division of Hemodialysis and Peritoneal Dialysis, Department of Nursing, , Taipei and New Taipei city ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Homtin","family":"Chen","sequence":"additional","affiliation":[{"name":"MacKay Memorial Hospital Department of Information Technology, , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Jen","family":"Wu","sequence":"additional","affiliation":[{"name":"MacKay Memorial Hospital Division of Nephrology, Department of Internal Medicine, , Taipei ,","place":["Taiwan"]},{"name":"Mackay Junior College of Medicine, Nursing and Management , Taipei 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