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基于人工智能技术的遗传性代谢病新生儿筛查辅助诊断系统的建立及临床试验

[Establishment of an auxiliary diagnosis system of newborn screening for inherited metabolic diseases based on artificial intelligence technology and a clinical trial].

作者信息

Yang R L, Yang Y L, Wang T, Xu W Z, Yu G, Yang J B, Sun Q L, Gu M S, Li H B, Zhao D H, Pei J Y, Jiang T, He J, Zou H, Mao X M, Geng G X, Qiang R, Tian G L, Wang Y, Wei H W, Zhang X G, Wang H, Tian Y P, Zou L, Kong Y Y, Zhou Y X, Ou M C, Yao Z R, Zhou Y L, Zhu W B, Huang Y L, Wang Y H, Huang C D, Tan Y, Li L, Shang Q, Zheng H, Lyu S L, Wang W J, Yao Y, Le J, Shu Q

机构信息

Department of Genetics and Metabolism, the Children's Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China.

Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.

出版信息

Zhonghua Er Ke Za Zhi. 2021 Apr 2;59(4):286-293. doi: 10.3760/cma.j.cn112140-20201209-01089.

Abstract

To establish a disease risk prediction model for the newborn screening system of inherited metabolic diseases by artificial intelligence technology. This was a retrospectively study. Newborn screening data (5 907 547) from February 2010 to May 2019 from 31 hospitals in China and verified data (=3 028) from 34 hospitals of the same period were collected to establish the artificial intelligence model for the prediction of inherited metabolic diseases in neonates. The validity of the artificial intelligence disease risk prediction model was verified by 360 814 newborns screening data from January 2018 to September 2018 through a single-blind experiment. The effectiveness of the artificial intelligence disease risk prediction model was verified by comparing the detection rate of clinically confirmed cases, the positive rate of initial screening and the positive predictive value between the clinicians and the artificial intelligence prediction model of inherited metabolic diseases. A total of 3 665 697 newborns screening data were collected including 3 019 cases positive data to establish the 16 artificial intelligence models for 32 inherited metabolic diseases. The single-blind experiment (=360 814) showed that 45 clinically diagnosed infants were detected by both artificial intelligence model and clinicians. A total of 2 684 cases were positive in tandem mass spectrometry screening and 1 694 cases were with high risk in artificial intelligence prediction model of inherited metabolic diseases, with the positive rates of tandem 0.74% (2 684/360 814)and 0.46% (1 694/360 814), respectively. Compared to clinicians, the positive rate of newborns was reduced by 36.89% (990/2 684) after the application of the artificial intelligence model, and the positive predictive values of clinicians and artificial intelligence prediction model of inherited metabolic diseases were 1.68% (45/2 684) and 2.66% (45/1 694) respectively. An accurate, fast, and the lower false positive rate auxiliary diagnosis system for neonatal inherited metabolic diseases by artificial intelligence technology has been established, which may have an important clinical value.

摘要

通过人工智能技术建立遗传性代谢疾病新生儿筛查系统的疾病风险预测模型。这是一项回顾性研究。收集了2010年2月至2019年5月中国31家医院的新生儿筛查数据(5907547例)以及同期34家医院的验证数据(=3028例),以建立预测新生儿遗传性代谢疾病的人工智能模型。通过单盲实验,利用2018年1月至2018年9月的360814例新生儿筛查数据验证了人工智能疾病风险预测模型的有效性。通过比较临床确诊病例的检出率、初筛阳性率以及临床医生与遗传性代谢疾病人工智能预测模型之间的阳性预测值,验证了人工智能疾病风险预测模型的有效性。共收集了3665697例新生儿筛查数据,其中包括3019例阳性数据,建立了针对32种遗传性代谢疾病的16个人工智能模型。单盲实验(=360814例)显示,人工智能模型和临床医生均检测出45例临床诊断婴儿。串联质谱筛查中共2684例呈阳性,遗传性代谢疾病人工智能预测模型中有1694例高危,串联阳性率分别为0.74%(2684/360814)和0.46%(1694/360814)。与临床医生相比,应用人工智能模型后新生儿阳性率降低了36.89%(990/2684),临床医生和遗传性代谢疾病人工智能预测模型的阳性预测值分别为1.68%(45/2684)和2.66%(45/1694)。通过人工智能技术建立了一种准确、快速且假阳性率较低的新生儿遗传性代谢疾病辅助诊断系统,该系统可能具有重要的临床价值。

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