整合临床数据和患者报告结果,利用机器学习分析多发性硬化症的性别差异和病情进展。

Minerva Viguera Moreno, Maria Eugenia Marzo Sola, Ricardo Sanchez de Madariaga, Fernando Martin-Sanchez
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摘要

多发性硬化症(MS)是一种复杂的神经退行性疾病,预后多变,使有效的管理和治疗变得复杂。本研究利用机器学习(ML)技术,通过分析与患者报告结果(PROMs)相结合的临床数据,加深对疾病进展的理解,并揭示多发性硬化症的性别差异。我们开展了一项前瞻性队列研究,涉及西班牙一家二级医院的 250 名多发性硬化症患者,历时 18 个月。我们使用 REDCap 进行数据管理,收集了全面的人口统计学、临床和 PROMs 数据。我们的分析采用了决策树、随机森林和支持向量机算法,根据疾病演变情况对患者进行分类,并推断出扩展残疾状态量表(EDSS)的水平。此外,我们还采用倾向得分匹配来分析性别差异,重点关注临床结果和生活质量指标。研究结果表明,通过 ML 整合不同的数据集将显著提高诊断准确性,并为临床医生的决策提供支持。我们的模型在多发性硬化症类型分类和残疾程度预测方面具有很高的准确性,证明了 ML 在个性化治疗规划方面的潜力。此外,我们的研究结果表明,在疾病进展和治疗反应方面存在明显的性别差异。这些见解主张在多发性硬化症的治疗中采用针对不同性别的方法,并强调了个性化医疗的重要性。这项研究强调了 ML 在通过综合数据分析加强对多发性硬化症的理解和管理方面的变革潜力。
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Integrating Clinical Data and Patient-Reported Outcomes for Analyzing Gender Differences and Progression in Multiple Sclerosis Using Machine Learning.

Multiple sclerosis (MS) is a complex neurodegenerative disease with a variable prognosis that complicates effective management and treatment. This study leverages machine learning (ML) to enhance the understanding of disease progression and uncover gender-based differences in MS by analyzing clinical data integrated with patient-reported outcomes (PROMs). We conducted a prospective cohort study involving 250 MS patients at a secondary care hospital in Spain over an 18-month period. Using REDCap for data management, we collected comprehensive demographic, clinical, and PROMs data. Our analysis utilized Decision Trees, Random Forest, and Support Vector Machine algorithms to classify patients based on disease evolution and infer Expanded Disability Status Scale (EDSS) levels. Additionally, we employed propensity score matching to analyze gender differences, focusing on clinical outcomes and quality of life measures. The results could indicate that integrating diverse data sets through ML would significantly improve the diagnostic accuracy and serve as a support for clinician's decision making. Our models achieved high accuracy in classifying MS types and predicting disability levels, demonstrating the potential of ML in personalized treatment planning. Furthermore, our findings suggest notable gender differences in disease progression and response to treatment. These insights advocate for a gender-specific approach in MS management and highlight the importance of personalized medicine. This study underscores the transformative potential of ML in enhancing the understanding and management of MS through integrated data analysis.

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