Machine learning-based improvement of an online rheumatology referral and triage system.

Rheport is an online rheumatology referral system allowing automatic appointment triaging of new rheumatology patient referrals according to the respective probability of an inflammatory rheumatic disease (IRD). Previous research reported that Rheport was well accepted among IRD patients. Its accuracy was, however, limited, currently being based on an expert-based weighted sum score. This study aimed to evaluate whether machine learning (ML) models could improve this limited accuracy. Data from a national rheumatology registry (RHADAR) was used to train and test nine different ML models to correctly classify IRD patients. Diagnostic performance was compared of ML models and the current algorithm was compared using the area under the receiver operating curve (AUROC). Feature importance was investigated using shapley additive explanation (SHAP). A complete data set of 2265 patients was used to train and test ML models. 30.5% of patients were diagnosed with an IRD, 69.3% were female. The diagnostic accuracy of the current Rheport algorithm (AUROC of 0.534) could be improved with all ML models, (AUROC ranging between 0.630 and 0.737). Targeting a sensitivity of 90%, the logistic regression model could double current specificity (17% vs. 33%). Finger joint pain, inflammatory marker levels, psoriasis, symptom duration and female sex were the five most important features of the best performing logistic regression model for IRD classification. In summary, ML could improve the accuracy of a currently used rheumatology online referral system. Including further laboratory parameters and enabling individual feature importance adaption could increase accuracy and lead to broader usage.

Informations de copyright

Copyright © 2022 Knitza, Janousek, Kluge, von der Decken, Kleinert, Vorbrüggen, Kleyer, Simon, Hueber, Muehlensiepen, Vuillerme, Schett, Eskofier, Welcker and Bartz-Bazzanella.

Déclaration de conflit d'intérêts

Qinum and RheumaDatenRhePort developed and hold rights for Rheport. WV, CD, and PB-B were involved in the development of Rheport. JK was a member of the scientific board of RheumaDatenRhePort. WV, CD, SK, PB-B, and MW were members of RheumaDatenRhePort GbR. RHADAR GbR received honoraria from UCB Pharma GmbH, Sandoz Deutschland/Hexal AG, Lilly GmbH, and Galapagos Biopharma Germany GmbH, and research support from Novartis Pharma GmbH. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.