论文标题

通过合奏学习预测口服食物挑战结果

Prediction of Oral Food Challenge Outcomes via Ensemble Learning

论文作者

Zhang, Justin, Lee, Deborah, Jungles, Kylie, Shaltis, Diane, Najarian, Kayvan, Ravikumar, Rajan, Sanders, Georgiana, Gryak, Jonathan

论文摘要

由于现有临床测试的局限性,口服食物挑战(OFC)对于准确诊断食物过敏至关重要。但是,有些患者不愿接受OFC,而那些愿意在农村/社区医疗保健环境中无法使用过敏症的患者。尽管它成功地预测了其他临床环境中的患者结果,但机器学习对食物过敏的应用很少。因此,在这项研究中,我们试图利用机器学习方法来进行OFC结果预测。回顾性数据是从共同接受1,284个OFC的1,12例患者那里收集的,包括临床因素,包括血清特异性免疫球蛋白E(IGE),总IGE,IGE,皮肤刺测试(SPTS),合并症,性别,性别和年龄。使用这些功能,构建了多种机器学习模型,以预测三种常见过敏原的OFC结果:花生,鸡蛋和牛奶。每种过敏原的最佳性能模型是随机森林(鸡蛋)的合奏或使用凹形和凸内核(Lucck)(花生,牛奶)模型学习,该模型分别预测了曲线(AUC)下的面积为0.91、0.96和0.94,分别用于预测Peanut,鸡蛋和牛奶的CC量产。此外,所有此类模型具有敏感性和特异性值89%。通过Shapley添加说明(SHAP)的模型解释表明,特定的IgE以及SPTS的Wheal和Flare值高度预测了OFC结果。该分析的结果表明,整体学习有可能预测OFC结果,并揭示了相关的临床因素进行进一步研究。

Oral Food Challenges (OFCs) are essential to accurately diagnosing food allergy due to the limitations of existing clinical testing. However, some patients are hesitant to undergo OFCs, while those willing suffer from limited access to allergists in rural/community healthcare settings. Despite its success in predicting patient outcomes in other clinical settings, few applications of machine learning to food allergy have been developed. Thus, in this study, we seek to leverage machine learning methodologies for OFC outcome prediction. Retrospective data was gathered from 1,112 patients who collectively underwent a total of 1,284 OFCs, and consisted of clinical factors including serum-specific Immunoglobulin E (IgE), total IgE, skin prick tests (SPTs), comorbidities, sex, and age. Using these features, multiple machine learning models were constructed to predict OFC outcomes for three common allergens: peanut, egg, and milk. The best performing model for each allergen was an ensemble of random forest (egg) or Learning Using Concave and Convex Kernels (LUCCK) (peanut, milk) models, which achieved an Area under the Curve (AUC) of 0.91, 0.96, and 0.94, in predicting OFC outcomes for peanut, egg, and milk, respectively. Moreover, all such models had sensitivity and specificity values 89%. Model interpretation via SHapley Additive exPlanations (SHAP) indicates that specific IgE, along with wheal and flare values from SPTs, are highly predictive of OFC outcomes. The results of this analysis suggest that ensemble learning has the potential to predict OFC outcomes and reveal relevant clinical factors for further study.

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