计算风险模型用于预测肺结节的2年恶性瘤,使用人口和放射特征
Kunaal S Sarnaik1, Philip A Linden2, Allison Gasnick1
1Department of Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio.
The Journal of thoracic and cardiovascular surgery
|September 17, 2023
概括
专家提供者意见在分类肺病变恶性病变方面表现优于计算模型. 这项研究强调了临床医生的判断在诊断肺癌方面的持续重要性,质疑了当前AI风险模型的附加值.
科学领域:
- 肺部医学 肺部医学
- 医疗信息学 医疗信息学
- 在瘤学瘤学.
背景情况:
- 精确地将肺病变分为恶性或良性的分类对于患者管理至关重要.
- 计算风险模型越来越多地被探索,以帮助诊断过程.
研究的目的:
- 为了比较计算风险模型的诊断性能与经验丰富的提供者意见在分类肺病变恶性病变.
- 通过使用人口,放射和临床数据来确定计算模型是否提供优异的歧视性性能.
主要方法:
- 开发了五种预测风险模型 (单变逻辑回归,多变逻辑回归,随机森林,极端梯度增强,人工神经网络).
- 模型的性能是通过在持有测试组上的接收器操作特征曲线 (AUC) 下的面积来评估的.
- 将AUC值与使用DeLong测试的预剖医生意见确定的基线进行了比较.
主要成果:
- 该研究包括984名患者,其中74.7%被诊断患有恶性瘤.
- 提供者意见基线实现了最高的AUC (0.830),超过了所有开发的计算模型.
- 多变量逻辑回归模型具有最低的AUC (0.659),而其他模型显示中等性能.
结论:
- 使用临床,人口和放射特征的计算模型低于经验丰富的提供者对肺病变恶性瘤分类的意见.
- 这些发现表明,当前的计算模型可能无法为患者护理提供显著的额外洞察力.
- 在评估肺病变恶性病变时,专家临床医生的评估仍然至关重要.
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