1. Biopsy-Free Prediction of Pathologic Type of Primary Nephrotic Syndrome Using a Machine Learning Algorithm
- Author
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Hui Xu, Ben Lu, Zhi-Jiang Yao, Min-Feng Zhu, and Cuifang Li
- Subjects
Adult ,Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Nephrotic Syndrome ,Model prediction ,Biopsy ,030232 urology & nephrology ,Disease ,030204 cardiovascular system & hematology ,Pathologic type ,Machine learning ,computer.software_genre ,lcsh:RC870-923 ,Machine Learning ,Primary nephrotic syndrome ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,medicine ,lcsh:Dermatology ,Humans ,Histology type ,medicine.diagnostic_test ,business.industry ,General Medicine ,Gold standard (test) ,lcsh:RL1-803 ,medicine.disease ,Prognosis ,lcsh:Diseases of the genitourinary system. Urology ,Renal pathology ,Nephrology ,lcsh:RC666-701 ,Female ,Renal biopsy ,Artificial intelligence ,Machine learning algorithm ,Cardiology and Cardiovascular Medicine ,business ,Nephrotic syndrome ,computer ,Algorithm ,Algorithms - Abstract
Background/Aims: Renal biopsy is the gold standard to determine the pathologic type of primary nephrotic syndrome, which is critical for diagnosis, choice of treatment and evaluation of prognosis. However, in some cases, renal biopsy cannot be performed. Methods: To explore the possibility of predicting the histology type of primary nephrotic syndrome without the need for biopsy, we trained and validated a machine learning algorithm using data from 222 patients with biopsy-confirmed primary nephrotic syndrome treated at our hospital between May 2008 and January 2016. The model was then tested prospectively on another sample of 63 patients with biopsy-confirmed primary nephrotic syndrome. Results: Overall accuracy of prediction from the retrospective set of 222 patients was 62.2% across all types of nephrotic syndrome. The accuracy of model prediction for the prospectively collected dataset of 63 patients was 61.9%. The algorithm identified 17 of 33 variables as contributing strongly to type of renal pathology. Conclusion: To our knowledge, this is the first such application of machine learning to predict the pathologic type of primary nephrotic syndrome, which may be clinically useful by itself as well as helpful for guiding future efforts at machine learning-based prediction in other disease contexts.
- Published
- 2017