临床特征的机器学习辅助查,用于预测难以治疗的类风湿性关节炎
Jiří Baloun1,2, Lucie Andrés Cerezo1,2, Tereza Kropáčková1,2
1Institute of Rheumatology, Na Slupi 450/4, Prague, 128 00, Czechia.
Scientific reports
|October 6, 2025
概括
机器学习模型可以使用临床数据预测难以治疗的 (D2T) 类风湿性关节炎 (RA). 通过这些模型,通过早期识别D2T RA,可以及时进行干预,以改善患者的治疗结果.
科学领域:
- 类风湿病学 类风湿病学
- 人工智能在医学中的应用
- 临床预测建模临床预测建模
背景情况:
- 类风湿性关节炎 (RA) 管理的目标是缓解,但有些患者会发展出难以治疗的 (D2T) RA.
- 提前预测D2T RA对于优化治疗策略和改善长期预后至关重要.
研究的目的:
- 提前识别预测符合难以治疗 (D2T) 类风湿性关节炎 (RA) 定义风险的临床特征.
- 开发和验证用于早期D2T RA预测的机器学习模型.
主要方法:
- 来自ATTRA注册表的RA患者的回顾性分析启动了生物 (b-) 或向合成 (ts-) 疾病修饰性抗风湿药物 (DMARDs).
- 使用各种机器学习技术 (例如随机森林,XGBoost) 开发预测模型.
- 利用Shapley增量解释 (SHAP) 值来解释模型预测并识别关键预测变量.
主要成果:
- 机器学习模型实现了0.606-0.747的精度范围和0.656-0.832的AUC,用于预测D2T RA.
- 关键预测变量包括疾病活性指标 (DAS28-ESR,CDAI,CRP),患者报告的结果 (HAQ) 和b/tsDMARD治疗持续时间.
- 在满足正式标准前长达一年的时间内,确定了可预测D2T RA的临床特征.
结论:
- 在基线和最多一年之前评估的临床特征可以预测D2T RA的发展.
- 早期识别D2T RA指标对于及时的治疗干预至关重要.
- 这些发现支持主动管理策略,以改善D2T RA风险的RA患者的长期结果.
相关概念视频
01:11Genome-wide Association Studies-GWAS
Genome-wide association studies or GWAS are used to identify whether common SNPs are associated with certain diseases. Suppose specific SNPs are more frequently observed in individuals with a particular disease than those without the disease. In that case, those SNPs are said to be associated with the disease. Chi-square analysis is performed to check the probability of the allele likely to be associated with the disease.
GWAS does not require the identification of the target gene involved in...
GWAS does not require the identification of the target gene involved in...
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...