Ferroni Patrizia, Zanzotto Fabio M, Riondino Silvia, Scarpato Noemi, Guadagni Fiorella, Roselli Mario
BioBIM (InterInstitutional Multidisciplinary Biobank), IRCCS San Raffaele Pisana, Via di Val Cannuta 247, 00166 Rome, Italy.
Department of Human Sciences & Quality of Life Promotion, San Raffaele Roma Open University, Via di Val Cannuta 247, 00166 Rome, Italy.
Cancers (Basel). 2019 Mar 7;11(3):328. doi: 10.3390/cancers11030328.
Machine learning (ML) has been recently introduced to develop prognostic classification models that can be used to predict outcomes in individual cancer patients. Here, we report the significance of an ML-based decision support system (DSS), combined with random optimization (RO), to extract prognostic information from routinely collected demographic, clinical and biochemical data of breast cancer (BC) patients. A DSS model was developed in a training set ( = 318), whose performance analysis in the testing set ( = 136) resulted in a C-index for progression-free survival of 0.84, with an accuracy of 86%. Furthermore, the model was capable of stratifying the testing set into two groups of patients with low- or high-risk of progression with a hazard ratio (HR) of 10.9 ( < 0.0001). Validation in multicenter prospective studies and appropriate management of privacy issues in relation to digital electronic health records (EHR) data are presently needed. Nonetheless, we may conclude that the implementation of ML algorithms and RO models into EHR data might help to achieve prognostic information, and has the potential to revolutionize the practice of personalized medicine.
机器学习(ML)最近被引入以开发可用于预测个体癌症患者预后的预后分类模型。在此,我们报告了基于ML的决策支持系统(DSS)结合随机优化(RO)从乳腺癌(BC)患者常规收集的人口统计学、临床和生化数据中提取预后信息的重要性。在一个训练集(n = 318)中开发了一个DSS模型,其在测试集(n = 136)中的性能分析得出无进展生存期的C指数为0.84,准确率为86%。此外,该模型能够将测试集分为进展风险低或高的两组患者,风险比(HR)为10.9(P < 0.0001)。目前需要在多中心前瞻性研究中进行验证,并对与数字电子健康记录(EHR)数据相关的隐私问题进行适当管理。尽管如此,我们可以得出结论,将ML算法和RO模型应用于EHR数据可能有助于获得预后信息,并有可能彻底改变个性化医疗的实践。