Am J Ophthalmol. 2021 Aug;228:72-79. doi: 10.1016/j.ajo.2021.03.044. Epub 2021 May 11.
The purpose of this study was to determine classification criteria for multiple sclerosis-associated intermediate uveitis.
Machine learning of cases with multiple sclerosis-associated intermediate uveitis and 4 other intermediate uveitides.
Cases of intermediate 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 in the training set to determine a parsimonious set of criteria that minimized the misclassification rate among the intermediate uveitides. The resulting criteria were evaluated in the validation set.
A total of 589 cases of intermediate uveitides, including 112 cases of multiple sclerosis-associated intermediate uveitis, were evaluated by machine learning. The overall accuracy for intermediate uveitides was 99.8% in the training set and 99.3% in the validation set (95% confidence interval: 96.1-99.9). Key criteria for multiple sclerosis-associated intermediate uveitis included unilateral or bilateral intermediate uveitis and multiple sclerosis diagnosed by the McDonald criteria. Key exclusions included syphilis and sarcoidosis. The misclassification rates for multiple sclerosis-associated intermediate uveitis were 0 % in the training set and 0% in the validation set.
The criteria for multiple sclerosis-associated intermediate uveitis had a low misclassification rate and appeared to perform sufficiently well enough for use in clinical and translational research.
本研究旨在确定多发性硬化相关性中间葡萄膜炎的分类标准。
对多发性硬化相关性中间葡萄膜炎病例与其他 4 种中间葡萄膜炎病例进行机器学习。
在信息学设计的初步数据库中收集中间葡萄膜炎病例,并使用正式共识技术对达成诊断超多数共识的病例构建最终数据库。将病例分为训练集和验证集。在训练集中,使用多项逻辑回归进行机器学习,以确定一组简约标准,使中间葡萄膜炎的分类错误率最小化。在验证集中评估得出的标准。
共评估了 589 例中间葡萄膜炎病例,包括 112 例多发性硬化相关性中间葡萄膜炎病例。机器学习在训练集中对中间葡萄膜炎的总体准确率为 99.8%,在验证集中为 99.3%(95%置信区间:96.1-99.9)。多发性硬化相关性中间葡萄膜炎的关键标准包括单侧或双侧中间葡萄膜炎和符合麦克唐纳标准的多发性硬化诊断。关键排除标准包括梅毒和结节病。在训练集和验证集中,多发性硬化相关性中间葡萄膜炎的分类错误率均为 0%。
多发性硬化相关性中间葡萄膜炎的标准具有较低的分类错误率,似乎足以用于临床和转化研究。