Using machine learning approaches to develop a fast and easy-to-perform diagnostic tool for patients with light chain amyloidosis: a retrospective real-world study.

IF 3 3区 医学 Q2 HEMATOLOGY Annals of Hematology Pub Date : 2024-10-31 DOI:10.1007/s00277-024-06015-0
Yang Liu, Xuelin Dou, Xiaojing Yan, Shiyu Ma, Chong Ye, Xiaohong Wang, Jin Lu
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Abstract

Immunoglobulin light chain (AL) amyloidosis is a severe disorder caused by the accumulation of amyloid fibrils, leading to organ failure. Early diagnosis is crucial to prevent irreversible damage, yet it remains a challenge due to nonspecific symptoms that often appear later in the disease progression. A retrospective study analyzed data collected from 133 AL amyloidosis patients and 271 non-AL patients with similar symptoms but different diagnoses between January 1st, 2017, and September 30th, 2022. Demographic data and laboratory test results were collected. Subsequently, significant features were identified by both logistic regression and independent expert clinical ability. Eventually, logistic regression and four machine learning (ML) algorithms were employed to construct a diagnostic model, utilizing fivefold cross-validation and blind set testing to identify the optimal model. The study successfully identified nine independent predictors of AL amyloidosis patients with kidney or cardiac involvement, respectively. Two models were developed to identify key features that distinguish AL amyloidosis from nephrotic syndrome and hypertrophic cardiomyopathy, respectively. The light gradient boosting machine (LightGBM) model emerged as the most effective, demonstrating superior performance with the area under curve (AUC) of 0.90 in both models, alongside high sensitivity, specificity, and F1-score. This research highlights the potential of using a machine learning-based LightGBM model to facilitate early and accurate diagnosis of AL amyloidosis. The model's effectiveness suggests it could be a valuable tool in clinical settings, aiding in the timely identification of AL amyloidosis among patients with non-specific symptoms. Further validation in diverse populations is recommended to establish its universal applicability.

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利用机器学习方法为轻链淀粉样变性患者开发快速易行的诊断工具:一项回顾性真实世界研究。
免疫球蛋白轻链(AL)淀粉样变性是一种由淀粉样纤维堆积引起的严重疾病,可导致器官衰竭。早期诊断对于防止不可逆转的损害至关重要,但由于非特异性症状往往在疾病进展后期才出现,因此早期诊断仍是一项挑战。一项回顾性研究分析了2017年1月1日至2022年9月30日期间收集的133名AL淀粉样变性患者和271名症状相似但诊断不同的非AL患者的数据。研究收集了人口统计学数据和实验室检测结果。随后,通过逻辑回归和独立专家的临床能力确定了重要特征。最后,采用逻辑回归和四种机器学习(ML)算法构建诊断模型,利用五重交叉验证和盲集测试来确定最佳模型。该研究成功鉴定出了九种独立的AL淀粉样变性患者肾脏或心脏受累的预测因子。研究还建立了两个模型,分别用于识别将AL淀粉样变性与肾病综合征和肥厚性心肌病区分开来的关键特征。光梯度增强机(LightGBM)模型是最有效的模型,其性能优越,两个模型的曲线下面积(AUC)均为 0.90,同时灵敏度、特异性和 F1 分数也很高。这项研究强调了使用基于机器学习的 LightGBM 模型促进 AL 淀粉样变性早期准确诊断的潜力。该模型的有效性表明,它可以成为临床环境中的一种有价值的工具,有助于在有非特异性症状的患者中及时发现 AL 淀粉样变性。建议在不同人群中进行进一步验证,以确定其普遍适用性。
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来源期刊
Annals of Hematology
Annals of Hematology 医学-血液学
CiteScore
5.60
自引率
2.90%
发文量
304
审稿时长
2 months
期刊介绍: Annals of Hematology covers the whole spectrum of clinical and experimental hematology, hemostaseology, blood transfusion, and related aspects of medical oncology, including diagnosis and treatment of leukemias, lymphatic neoplasias and solid tumors, and transplantation of hematopoietic stem cells. Coverage includes general aspects of oncology, molecular biology and immunology as pertinent to problems of human blood disease. The journal is associated with the German Society for Hematology and Medical Oncology, and the Austrian Society for Hematology and Oncology.
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