A predictive algorithm using clinical and laboratory parameters may assist in ruling out and in diagnosing MDS
© 2021 by The American Society of Hematology..
We present a noninvasive Web-based app to help exclude or diagnose myelodysplastic syndrome (MDS), a bone marrow (BM) disorder with cytopenias and leukemic risk, diagnosed by BM examination. A sample of 502 MDS patients from the European MDS (EUMDS) registry (n > 2600) was combined with 502 controls (all BM proven). Gradient-boosted models (GBMs) were used to predict/exclude MDS using demographic, clinical, and laboratory variables. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were used to evaluate the models, and performance was validated using 100 times fivefold cross-validation. Model stability was assessed by repeating its fit using different randomly chosen groups of 502 EUMDS cases. AUC was 0.96 (95% confidence interval, 0.95-0.97). MDS is predicted/excluded accurately in 86% of patients with unexplained anemia. A GBM score (range, 0-1) of less than 0.68 (GBM < 0.68) resulted in a negative predictive value of 0.94, that is, MDS was excluded. GBM ≥ 0.82 provided a positive predictive value of 0.88, that is, MDS. The diagnosis of the remaining patients (0.68 ≤ GBM < 0.82) is indeterminate. The discriminating variables: age, sex, hemoglobin, white blood cells, platelets, mean corpuscular volume, neutrophils, monocytes, glucose, and creatinine. A Web-based app was developed; physicians could use it to exclude or predict MDS noninvasively in most patients without a BM examination. Future work will add peripheral blood cytogenetics/genetics, EUMDS-based prospective validation, and prognostication.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:5 |
|---|---|
| Enthalten in: |
Blood advances - 5(2021), 16 vom: 24. Aug., Seite 3066-3075 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Oster, Howard S [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 13.09.2021 Date Revised 25.09.2021 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1182/bloodadvances.2020004055 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM329314238 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM329314238 | ||
| 003 | DE-627 | ||
| 005 | 20231225204839.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1182/bloodadvances.2020004055 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1097.xml |
| 035 | |a (DE-627)NLM329314238 | ||
| 035 | |a (NLM)34387647 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Oster, Howard S |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A predictive algorithm using clinical and laboratory parameters may assist in ruling out and in diagnosing MDS |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 13.09.2021 | ||
| 500 | |a Date Revised 25.09.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021 by The American Society of Hematology. | ||
| 520 | |a We present a noninvasive Web-based app to help exclude or diagnose myelodysplastic syndrome (MDS), a bone marrow (BM) disorder with cytopenias and leukemic risk, diagnosed by BM examination. A sample of 502 MDS patients from the European MDS (EUMDS) registry (n > 2600) was combined with 502 controls (all BM proven). Gradient-boosted models (GBMs) were used to predict/exclude MDS using demographic, clinical, and laboratory variables. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were used to evaluate the models, and performance was validated using 100 times fivefold cross-validation. Model stability was assessed by repeating its fit using different randomly chosen groups of 502 EUMDS cases. AUC was 0.96 (95% confidence interval, 0.95-0.97). MDS is predicted/excluded accurately in 86% of patients with unexplained anemia. A GBM score (range, 0-1) of less than 0.68 (GBM < 0.68) resulted in a negative predictive value of 0.94, that is, MDS was excluded. GBM ≥ 0.82 provided a positive predictive value of 0.88, that is, MDS. The diagnosis of the remaining patients (0.68 ≤ GBM < 0.82) is indeterminate. The discriminating variables: age, sex, hemoglobin, white blood cells, platelets, mean corpuscular volume, neutrophils, monocytes, glucose, and creatinine. A Web-based app was developed; physicians could use it to exclude or predict MDS noninvasively in most patients without a BM examination. Future work will add peripheral blood cytogenetics/genetics, EUMDS-based prospective validation, and prognostication | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Crouch, Simon |e verfasserin |4 aut | |
| 700 | 1 | |a Smith, Alexandra |e verfasserin |4 aut | |
| 700 | 1 | |a Yu, Ge |e verfasserin |4 aut | |
| 700 | 1 | |a Abu Shrkihe, Bander |e verfasserin |4 aut | |
| 700 | 1 | |a Baruch, Shoham |e verfasserin |4 aut | |
| 700 | 1 | |a Kolomansky, Albert |e verfasserin |4 aut | |
| 700 | 1 | |a Ben-Ezra, Jonathan |e verfasserin |4 aut | |
| 700 | 1 | |a Naor, Shachar |e verfasserin |4 aut | |
| 700 | 1 | |a Fenaux, Pierre |e verfasserin |4 aut | |
| 700 | 1 | |a Symeonidis, Argiris |e verfasserin |4 aut | |
| 700 | 1 | |a Stauder, Reinhard |e verfasserin |4 aut | |
| 700 | 1 | |a Cermak, Jaroslav |e verfasserin |4 aut | |
| 700 | 1 | |a Sanz, Guillermo |e verfasserin |4 aut | |
| 700 | 1 | |a Hellström-Lindberg, Eva |e verfasserin |4 aut | |
| 700 | 1 | |a Malcovati, Luca |e verfasserin |4 aut | |
| 700 | 1 | |a Langemeijer, Saskia |e verfasserin |4 aut | |
| 700 | 1 | |a Germing, Ulrich |e verfasserin |4 aut | |
| 700 | 1 | |a Holm, Mette Skov |e verfasserin |4 aut | |
| 700 | 1 | |a Madry, Krzysztof |e verfasserin |4 aut | |
| 700 | 1 | |a Guerci-Bresler, Agnes |e verfasserin |4 aut | |
| 700 | 1 | |a Culligan, Dominic |e verfasserin |4 aut | |
| 700 | 1 | |a Sanhes, Laurence |e verfasserin |4 aut | |
| 700 | 1 | |a Mills, Juliet |e verfasserin |4 aut | |
| 700 | 1 | |a Kotsianidis, Ioannis |e verfasserin |4 aut | |
| 700 | 1 | |a van Marrewijk, Corine |e verfasserin |4 aut | |
| 700 | 1 | |a Bowen, David |e verfasserin |4 aut | |
| 700 | 1 | |a de Witte, Theo |e verfasserin |4 aut | |
| 700 | 1 | |a Mittelman, Moshe |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Blood advances |d 2016 |g 5(2021), 16 vom: 24. Aug., Seite 3066-3075 |w (DE-627)NLM268683263 |x 2473-9537 |7 nnns |
| 773 | 1 | 8 | |g volume:5 |g year:2021 |g number:16 |g day:24 |g month:08 |g pages:3066-3075 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1182/bloodadvances.2020004055 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 5 |j 2021 |e 16 |b 24 |c 08 |h 3066-3075 | ||