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Meta-analysis of machine learning models for the diagnosis of central precocious puberty based on clinical, hormonal
Yilin Chen1, Xueqin Huang2, Lu Tian2
1Department of Thoracic Surgery, Chongqing General Hospital, Chongqing University, Chongqing, China.
Insights
Machine learning models using clinical, hormonal, and imaging data show excellent diagnostic value for central precocious puberty (CPP). These AI tools effectively confirm or exclude CPP, offering a promising alternative to traditional tests.
Area of Science:
- Endocrinology
- Artificial Intelligence in Medicine
- Pediatric Health
Background:
- Central precocious puberty (CPP) diagnosis relies on the costly and time-consuming GnRH stimulation test.
- Machine learning (ML) models using clinical, hormonal, and imaging data are emerging for CPP identification.
- Varied ML methods in existing studies hinder direct comparison and understanding of their diagnostic value.
Purpose of the Study:
- To conduct a meta-analysis evaluating the diagnostic value of ML models for CPP.
- To assess ML models utilizing clinical, hormonal, and imaging data for CPP diagnosis.
- To determine the pooled performance metrics of ML models in identifying CPP.
Main Methods:
- Comprehensive literature search for ML models diagnosing CPP (up to December 2023).
- Calculation of pooled sensitivity, specificity, likelihood ratios, and AUC from SROC curves.
- Assessment of heterogeneity using I² test and meta-regression; publication bias evaluated via Deeks funnel plot.
Main Results:
- Six studies were included in the meta-analysis.
- Pooled sensitivity was 0.82 (95% CI 0.62-0.93) and pooled specificity was 0.85 (95% CI 0.80-0.90).
- The area under the curve (AUC) was 0.90 (95% CI 0.87-0.92), indicating good diagnostic value.
Conclusions:
- ML models using clinical and imaging data demonstrate excellent diagnostic capabilities for CPP.
- These models exhibit high sensitivity, specificity, and AUC, confirming their utility.
- Future research should address geographical limitations to improve applicability and reliability for CPP differentiation and treatment.
Background:
Central precocious puberty (CPP) is a common endocrine disorder in children, and its diagnosis primarily relies on the gonadotropin-releasing hormone (GnRH) stimulation test, which is expensive and time-consuming. With the widespread application of artificial intelligence in medicine, some studies have utilized clinical, hormonal (laboratory) and imaging data-based machine learning (ML) models to identify CPP. However, the results of these studies varied widely and were challenging to directly compare, mainly due to diverse ML methods. Therefore, the diagnostic value of clinical, hormonal (laboratory) and imaging data-based ML models for CPP remains elusive. The aim of this study was to investigate the diagnostic value of ML models based on clinical, hormonal (laboratory) and imaging data for CPP through a meta-analysis of existing studies.
Methods:
We conducted a comprehensive search for relevant English articles on clinical, hormonal (laboratory) and imaging data-based ML models for diagnosing CPP, covering the period from the database creation date to December 2023. Pooled sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-), summary receiver operating characteristic (SROC) curve, and area under the curve (AUC) were calculated to assess the diagnostic value of clinical, hormonal (laboratory) and imaging data-based ML models for diagnosing CPP. The I2 test was employed to evaluate heterogeneity, and the source of heterogeneity was investigated through meta-regression analysis. Publication bias was assessed using the Deeks funnel plot asymmetry test.
Results:
Six studies met the eligibility criteria. The pooled sensitivity and specificity were 0.82 (95% confidence interval (CI) 0.62-0.93) and 0.85 (95% CI 0.80-0.90), respectively. The LR+ was 6.00, and the LR- was 0.21, indicating that clinical, hormonal (laboratory) and imaging data-based ML models exhibited an excellent ability to confirm or exclude CPP. Additionally, the SROC curve showed that the AUC of the clinical, hormonal (laboratory) and imaging data-based ML models in the diagnosis of CPP was 0.90 (95% CI 0.87-0.92), demonstrating good diagnostic value for CPP.
Conclusion:
Based on the outcomes of our meta-analysis, clinical and imaging data-based ML models are excellent diagnostic tools with high sensitivity, specificity, and AUC in the diagnosis of CPP. Despite the geographical limitations of the study findings, future research endeavors will strive to address these issues to enhance their applicability and reliability, providing more precise guidance for the differentiation and treatment of CPP.
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