Am J Ophthalmol. 2021 Aug;228:80-88. doi: 10.1016/j.ajo.2021.03.058. Epub 2021 May 11.
To determine classification criteria for Behçet disease uveitis.
Machine learning of cases with Behçet disease and 5 other panuveitides.
Cases of panuveitides were collected in an informatics-designed preliminary database, and a final database was constructed of cases achieving supermajority agreement on the diagnosis, using formal consensus techniques. Cases were split into a training set and a validation set. Machine learning using multinomial logistic regression was used on the training set to determine a parsimonious set of criteria that minimized the misclassification rate among the intermediate uveitides. The resulting criteria were evaluated on the validation set.
One thousand twelve cases of panuveitides, including 194 cases of Behçet disease with uveitis, were evaluated by machine learning. The overall accuracy for panuveitides was 96.3% in the training set and 94.0% in the validation set (95% confidence interval 89.0, 96.8). Key criteria for Behçet disease uveitis were a diagnosis of Behçet disease using the International Study Group for Behçet Disease criteria and a compatible uveitis, including (1) anterior uveitis; (2) anterior chamber and vitreous inflammation; (3) posterior uveitis with retinal vasculitis and/or focal infiltrates; or (4) panuveitis with retinal vasculitis and/or focal infiltrates. The misclassification rates for Behçet disease uveitis were 0.6% in the training set and 0% in the validation set, respectively.
The criteria for Behçet disease uveitis had a low misclassification rate and seemed to perform sufficiently well for use in clinical and translational research.
确定白塞病葡萄膜炎的分类标准。
对白塞病及其他5种全葡萄膜炎病例进行机器学习。
在一个信息学设计的初步数据库中收集全葡萄膜炎病例,并使用正式的共识技术构建一个最终数据库,该数据库由在诊断上达成绝大多数一致意见的病例组成。病例被分为训练集和验证集。在训练集上使用多项逻辑回归进行机器学习,以确定一组简约的标准,使中间葡萄膜炎的错误分类率最小化。在验证集上对所得标准进行评估。
通过机器学习评估了1012例全葡萄膜炎病例,包括194例伴有葡萄膜炎的白塞病病例。训练集中全葡萄膜炎的总体准确率为96.3%,验证集中为94.0%(95%置信区间89.0, 96.8)。白塞病葡萄膜炎的关键标准是使用国际白塞病研究组标准诊断为白塞病以及伴有符合条件的葡萄膜炎,包括:(1)前葡萄膜炎;(2)前房和玻璃体炎症;(3)伴有视网膜血管炎和/或局灶性浸润的后葡萄膜炎;或(4)伴有视网膜血管炎和/或局灶性浸润的全葡萄膜炎。训练集中白塞病葡萄膜炎的错误分类率分别为0.6%,验证集中为0%。
白塞病葡萄膜炎的标准错误分类率较低,似乎在临床和转化研究中表现良好。