Adult Hematologic Malignancies & Stem Cell Transplant Section, Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, OH.
University Hospitals Cleveland Medical Center, Cleveland, OH.
JCO Clin Cancer Inform. 2023 Sep;7:e2300078. doi: 10.1200/CCI.23.00078.
The gold standard for monitoring response status in patients with multiple myeloma (MM) is serum and urine protein electrophoresis which quantify M-spike proteins; however, the turnaround time for results is 3-7 days which delays treatment decisions. We hypothesized that machine learning (ML) could integrate readily available clinical and laboratory data to rapidly and accurately predict patient M-spike values.
A retrospective chart review was performed using the deidentified, electronic medical records of 171 patients with MM.
Random forest (RF) analysis identified the weighted value of each independent variable (N = 43) integrated into the ML algorithm. Pearson and Spearman coefficients indicated that the ML-predicted M-spike values correlated highly with laboratory-measured serum protein electrophoresis values. Feature selected RF modeling revealed that only two variables-the first lagged M-spike and serum total protein-accurately predicted the M-spike.
Taken together, our results demonstrate the feasibility and prognostic potential of ML tools that integrate electronic data to longitudinally monitor disease burden. ML tools support the seamless, secure exchange of patient information to expedite and personalize clinical decision making and overcome geographic, financial, and social barriers that currently limit the access of underserved populations to cancer care specialists so that the benefits of medical progress are not limited to selected groups.
多发性骨髓瘤(MM)患者监测反应状态的金标准是血清和尿液蛋白电泳,其可定量 M 峰蛋白;然而,结果的周转时间为 3-7 天,这会延迟治疗决策。我们假设机器学习(ML)可以整合现成的临床和实验室数据,快速准确地预测患者的 M 峰值。
使用 171 名 MM 患者的匿名电子病历进行回顾性图表审查。
随机森林(RF)分析确定了集成到 ML 算法中的每个独立变量(N=43)的加权值。Pearson 和 Spearman 系数表明,ML 预测的 M 峰值与实验室测量的血清蛋白电泳值高度相关。特征选择 RF 模型显示,只有两个变量-第一个滞后 M 峰和血清总蛋白-可以准确预测 M 峰。
总之,我们的结果表明,整合电子数据以纵向监测疾病负担的 ML 工具具有可行性和预测潜力。ML 工具支持患者信息的无缝、安全交换,以加快和个性化临床决策,并克服当前限制服务不足人群获得癌症护理专家的地理、财务和社会障碍,以便医学进步的好处不限于特定群体。