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青少年特发性关节炎相关慢性前葡萄膜炎的分类标准。

Classification Criteria for Juvenile Idiopathic Arthritis-Associated Chronic Anterior Uveitis.

出版信息

Am J Ophthalmol. 2021 Aug;228:192-197. doi: 10.1016/j.ajo.2021.03.055. Epub 2021 May 11.

Abstract

PURPOSE

To determine classification criteria for juvenile idiopathic arthritis (JIA)-associated chronic anterior uveitis (CAU).

DESIGN

Machine learning of cases with JIA CAU and 8 other anterior uveitides.

METHODS

Cases of anterior uveitides 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 anterior uveitides. The resulting criteria were evaluated on the validation set.

RESULTS

One thousand eighty-three cases of anterior uveitides, including 202 cases of JIA CAU, were evaluated by machine learning. The overall accuracy for anterior uveitides was 97.5% in the training set and 96.7% in the validation set (95% confidence interval 92.4, 98.6). Key criteria for JIA CAU included (1) chronic anterior uveitis (or, if newly diagnosed, insidious onset) and (2) JIA, except for the systemic, rheumatoid factor-positive polyarthritis, and enthesitis-related arthritis variants. The misclassification rates for JIA CAU were 2.4% in the training set and 0% in the validation set.

CONCLUSIONS

The criteria for JIA CAU had a low misclassification rate and seemed to perform well enough for use in clinical and translational research.

摘要

目的

确定青少年特发性关节炎(JIA)相关慢性前葡萄膜炎(CAU)的分类标准。

设计

对JIA相关CAU病例及其他8种前葡萄膜炎进行机器学习。

方法

在前葡萄膜炎病例信息学设计的初步数据库中收集病例,并使用正式的共识技术构建最终数据库,其中病例在诊断上达成了绝大多数一致意见。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,使前葡萄膜炎之间的错误分类率最小化。在验证集上对所得标准进行评估。

结果

通过机器学习评估了1083例前葡萄膜炎病例,包括202例JIA相关CAU病例。训练集中前葡萄膜炎的总体准确率为97.5%,验证集中为96.7%(95%置信区间92.4, 98.6)。JIA相关CAU的关键标准包括:(1)慢性前葡萄膜炎(或者,如果是新诊断的,则为隐匿性发作)以及(2)JIA,但不包括全身型、类风湿因子阳性多关节炎和附着点炎相关关节炎亚型。JIA相关CAU在训练集中的错误分类率为2.4%,在验证集中为0%。

结论

JIA相关CAU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,足以应用。

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