Machine learning analyses constructed a novel model to predict recurrent thrombosis in adults with essential thrombocythemia
Machine learning analyses constructed a novel model to predict recurrent thrombosis in adults with essential thrombocythemia
复制标题
DOI：
10.1007/s11239-023-02833-7
复制
发表时间：
2023-05
影响因子：
4
通讯作者：
Jia Chen;Huan Dong;R. Fu;Xiaofan Liu;F. Xue;Wei Liu;Yunfei Chen;Ting Sun;Mankai Ju;Xinyue Dai;Huiyuan Li;Wentian Wang;Ying Chi;R. Yang;Lei Zhang
中科院分区：
文献类型：
--
作者：
Jia Chen;Huan Dong;R. Fu;Xiaofan Liu;F. Xue;Wei Liu;Yunfei Chen;Ting Sun;Mankai Ju;Xinyue Dai;Huiyuan Li;Wentian Wang;Ying Chi;R. Yang;Lei Zhang
目前的研究涉及 318 名既往有血栓形成的原发性血小板增多症 (ET) 患者，旨在确定可预测血栓复发的危险因素。整个队列被随机分为推导队列和验证队列。在推导队列中采用随机森林法、内置递归特征消除模型的支持向量机以及logistic多变量分析，最终选择心血管危险因素（CVF）和带标准差的红细胞分布宽度（RDW-SD）作为独立预测因子。随后，我们设计了一个 3 层模型（低风险：0 分；中等风险：1-1.5 分；高风险：2.5 分），它在所有队列中都显示出良好的区分度。此外，该模型与无再血栓生存期 (rTFS) 显着相关（推导队列中 p = 0.0007；验证队列中 p = 0.0019）。在整个队列中，细胞减灭疗法比单独使用抗血小板药物的 10 年 rTFS 更有效（p = 0.0336）。干扰素 (IFN)、羟基脲 (HU) 和 IFN + HU 治疗之间的 10 年 rTFS 没有观察到显着差异 (p = 0.444)。本研究有助于识别需要密切监测的个体，并为既往有血栓形成的 ET 患者复发提供有价值的风险信号。
The current study involving 318 essential thrombocythemia (ET) patients with prior thrombosis was designed to identify risk factors that were predictive of recurrent thrombosis. The whole cohort was randomly split into derivation and validation cohorts. The random forest method, support vector machine with built-in recursive feature elimination model, and logistic multivariable analysis were performed in the derivation cohort, and cardiovascular risk factor (CVF) and RBC distribution width with standard deviation (RDW-SD) were finally selected as independent predictors. Subsequently we devise a 3-tiered model (low risk: 0 points; intermediate risk: 1-1.5 points; and high risk: 2.5 points) and it showed good discrimination in all cohorts. Moreover, the model was significantly correlated with rethrombosis-free survival (rTFS) (p = 0.0007 in the derivation cohort; p = 0.0019 in the validation cohort). In the whole cohort, cytoreductive therapy was more effective than antiplatelet agents alone for 10-year rTFS (p = 0.0336). No significant difference in 10-year rTFS was observed among interferon (IFN), hydroxyurea (HU), and IFN + HU therapy (p = 0.444). The present study helps identify individuals who need close monitoring and provides valuable risk signals for recurrence in ET patients with prior thrombosis.