School of Medicine, Iran University of Medical Science, Tehran, Iran.
Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
BMC Bioinformatics. 2023 Dec 15;24(1):478. doi: 10.1186/s12859-023-05567-8.
BACKGROUND: Irritable bowel syndrome (IBS) is a common chronic functional gastrointestinal disorder associated with a wide range of clinical symptoms. Some researchers have used cluster analysis (CA), a group of non-supervised learning methods that identifies homogenous clusters within different entities based on their similarity. OBJECTIVE AND METHODS: This literature review aims to identify published articles that apply CA to IBS patients. We searched relevant keywords in PubMed, Embase, Web of Science, and Scopus. We reviewed studies in terms of the selected variables, participants' characteristics, data collection, methodology, number of clusters, clusters' profiles, and results. RESULTS: Among the 14 articles focused on the heterogeneity of IBS, eight of them utilized K-means Cluster Analysis (K-means CA), four employed Hierarchical Cluster Analysis, and only two studies utilized Latent Class Analysis. Seven studies focused on clinical symptoms, while four articles examined anocolorectal functions. Two studies were centered around immunological findings, and only one study explored microbial composition. The number of clusters obtained ranged from two to seven, showing variation across the studies. Males exhibited lower symptom severity and fewer psychological findings. The association between symptom severity and rectal perception suggests that altered rectal perception serves as a biological indicator of IBS. Ultra-slow waves observed in IBS patients are linked to increased activity of the anal sphincter, higher anal pressure, dystonia, and dyschezia. CONCLUSION: IBS has different subgroups based on different factors. Most IBS patients have low clinical severity, good QoL, high rectal sensitivity, delayed left colon transit time, increased systemic cytokines, and changes in microbial composition, including increased Firmicutes-associated taxa and depleted Bacteroidetes-related taxa. However, the number of clusters is inconsistent across studies due to the methodological heterogeneity. CA, a valuable non-supervised learning method, is sensitive to hyperparameters like the number of clusters and random initialization of cluster centers. The random nature of these parameters leads to diverse outcomes even with the same algorithm. This has implications for future research and practical applications, necessitating further studies to improve our understanding of IBS and develop personalized treatments.
背景:肠易激综合征(IBS)是一种常见的慢性功能性胃肠道疾病,与广泛的临床症状相关。一些研究人员使用了聚类分析(CA),这是一组无监督学习方法,可以根据相似性在不同实体中识别同质聚类。
目的和方法:本文献综述旨在确定应用 CA 分析肠易激综合征患者的已发表文章。我们在 PubMed、Embase、Web of Science 和 Scopus 中搜索了相关关键字。我们从选择的变量、参与者特征、数据收集、方法学、聚类数量、聚类特征和结果等方面对研究进行了审查。
结果:在 14 篇专注于 IBS 异质性的文章中,有 8 篇使用了 K 均值聚类分析(K-means CA),4 篇使用了层次聚类分析,只有 2 篇研究使用了潜在类别分析。7 项研究侧重于临床症状,4 项研究检查了肛肠功能。2 项研究集中于免疫发现,仅有 1 项研究探索了微生物组成。获得的聚类数量从 2 到 7 不等,各研究之间存在差异。男性表现出较低的症状严重程度和较少的心理发现。症状严重程度与直肠感觉之间的关系表明,改变的直肠感觉是 IBS 的生物学指标。在 IBS 患者中观察到的超慢波与肛门括约肌活动增加、肛压升高、张力障碍和排便困难有关。
结论:IBS 基于不同的因素存在不同的亚组。大多数 IBS 患者的临床严重程度较低,生活质量较好,直肠敏感性较高,左结肠转运时间延迟,全身细胞因子增加,微生物组成发生变化,包括厚壁菌门相关分类群增加和拟杆菌门相关分类群减少。然而,由于方法学的异质性,各研究之间的聚类数量不一致。CA 是一种有价值的无监督学习方法,对聚类数量和聚类中心的随机初始化等超参数敏感。这些参数的随机性导致即使使用相同的算法也会产生不同的结果。这对未来的研究和实际应用有影响,需要进一步研究以提高我们对 IBS 的理解并开发个性化治疗方法。
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