A Machine Learning Model to Successfully Predict Future Diagnosis of Chronic Myelogenous Leukemia With Retrospective Electronic Health Records Data.

Chronic myelogenous leukemia Decision support techniques Decision trees Logistic regression Machine learning Prediction model studies Predictions and projections Statistical data analyses

Journal

American journal of clinical pathology
ISSN: 1943-7722
Titre abrégé: Am J Clin Pathol
Pays: England
ID NLM: 0370470

Informations de publication

Date de publication:
08 Nov 2021
Historique:
pubmed: 30 6 2021
medline: 7 1 2022
entrez: 29 6 2021
Statut: ppublish

Résumé

Chronic myelogenous leukemia (CML) is a clonal stem cell disorder accounting for 15% of adult leukemias. We aimed to determine if machine learning models could predict CML using blood cell counts prior to diagnosis. We identified patients with a diagnostic test for CML (BCR-ABL1) and at least 6 consecutive prior years of differential blood cell counts between 1999 and 2020 in the largest integrated health care system in the United States. Blood cell counts from different time periods prior to CML diagnostic testing were used to train, validate, and test machine learning models. The sample included 1,623 patients with BCR-ABL1 positivity rate 6.2%. The predictive ability of machine learning models improved when trained with blood cell counts closer to time of diagnosis: 2 to 5 years area under the curve (AUC), 0.59 to 0.67, 0.5 to 1 years AUC, 0.75 to 0.80, at diagnosis AUC, 0.87 to 0.92. Blood cell counts collected up to 5 years prior to diagnostic workup of CML successfully predicted the BCR-ABL1 test result. These findings suggest a machine learning model trained with blood cell counts could lead to diagnosis of CML earlier in the disease course compared to usual medical care.

Sections du résumé

BACKGROUND BACKGROUND
Chronic myelogenous leukemia (CML) is a clonal stem cell disorder accounting for 15% of adult leukemias. We aimed to determine if machine learning models could predict CML using blood cell counts prior to diagnosis.
METHODS METHODS
We identified patients with a diagnostic test for CML (BCR-ABL1) and at least 6 consecutive prior years of differential blood cell counts between 1999 and 2020 in the largest integrated health care system in the United States. Blood cell counts from different time periods prior to CML diagnostic testing were used to train, validate, and test machine learning models.
RESULTS RESULTS
The sample included 1,623 patients with BCR-ABL1 positivity rate 6.2%. The predictive ability of machine learning models improved when trained with blood cell counts closer to time of diagnosis: 2 to 5 years area under the curve (AUC), 0.59 to 0.67, 0.5 to 1 years AUC, 0.75 to 0.80, at diagnosis AUC, 0.87 to 0.92.
CONCLUSIONS CONCLUSIONS
Blood cell counts collected up to 5 years prior to diagnostic workup of CML successfully predicted the BCR-ABL1 test result. These findings suggest a machine learning model trained with blood cell counts could lead to diagnosis of CML earlier in the disease course compared to usual medical care.

Identifiants

pubmed: 34184028
pii: 6310949
doi: 10.1093/ajcp/aqab086
doi:

Substances chimiques

Fusion Proteins, bcr-abl EC 2.7.10.2

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1142-1148

Informations de copyright

© American Society for Clinical Pathology, 2021.

Auteurs

Ronald G Hauser (RG)

Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA.
Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA.

Denise Esserman (D)

Yale School of Public Health, Department of Biostatistics, New Haven, CT, USA.

Lauren A Beste (LA)

Veterans Affairs Puget Sound Healthcare System, Seattle, WA, USA.
Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.

Shawn Y Ong (SY)

Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA.
Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA.

Denis G Colomb (DG)

Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA.
Department of Medical Informatics, Yale School of Medicine, New Haven, CT, USA.

Ankur Bhargava (A)

Department of Preventive Medicine, University of Kentucky, Lexington, KY, USA.

Roxanne Wadia (R)

Department of Pathology, Yale School of Medicine, New Haven, CT, USA.

Michal G Rose (MG)

Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA.
Department of Cancer Center, Yale School of Medicine, New Haven, CT, USA.
Department of Section of Medical Oncology, Department of Medicine, Yale School of Medicine, New Haven, CT, USA.

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