Development of a Prediction Model and Corresponding Scoring Table for Postherpetic Neuralgia Using Six Machine Learning Algorithms: A Retrospective Study.

IF 4.1 2区 医学 Q1 CLINICAL NEUROLOGY
Pain and Therapy Pub Date : 2024-08-01 Epub Date: 2024-06-04 DOI:10.1007/s40122-024-00612-7
Zheng Lin, Lu-Yan Yu, Si-Yi Pan, Yi Cao, Ping Lin
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引用次数: 0

Abstract

Introduction: Postherpetic neuralgia (PHN), a complication of herpes zoster, significantly impacts the quality of life of affected patients. Research indicates that early intervention for pain can reduce the occurrence or severity of PHN. This study aims to develop a predictive model and scoring table to identify patients at risk of developing PHN following acute herpetic neuralgia, facilitating informed clinical decision-making.

Methods: We conducted a retrospective review of 524 hospitalized patients with herpes zoster at The First Affiliated Hospital of Zhejiang Chinese Medical University from December 2020 to December 2023 and classified them according to whether they had PHN, collecting a comprehensive set of 30 patient characteristics and disease-related indicators, 5 comorbidity indicators, 2 disease score values, and 10 serological indicators. Relevant features associated with PHN were identified using the least absolute shrinkage and selection operator (LASSO). Then, the patients were divided into a training set and a test set in a 4:1 ratio, with comparability tested using univariate analysis. Six models were established in the training set using machine learning methods: support vector machines, logistic regression, random forest, k-nearest neighbor, gradient boosting, and neural network. The performance of these models was evaluated in the test set, and a nomogram based on logistic regression was used to create a PHN prediction score table.

Results: Eight non-zero characteristic variables selected from the LASSO regression results were included in the model, including age [area under the curve (AUC) = 0.812, p < 0.001], Numerical Rating Scale (NRS) (AUC = 0.792, p < 0.001), receiving treatment time (AUC = 0.612, p < 0.001), rash recovery time (AUC = 0.680, p < 0.001), history of malignant tumor (AUC = 0.539, p < 0.001), history of diabetes (AUC = 0.638, p < 0.001), varicella-zoster virus immunoglobulin M (AUC = 0.620, p < 0.001), and serum nerve-specific enolase (AUC = 0.659, p < 0,001). The gradient boosting model outperformed other classifier models on the test set with an AUC of 0.931, 95% confidence interval (CI) (0.882-0.980), accuracy of 0.886 (95% CI 0.809-0.940). In the test set, our predictive scoring table achieved an AUC of 0.820 (95% CI 0.869-0.970) with accuracy of 0.790 (95% CI 0.700-0.864).

Conclusion: This study presents a methodology for predicting the development of postherpetic neuralgia in shingles patients by analyzing historical case data, employing various machine learning techniques, and selecting the optimal model through comparative analysis. In addition, a logistic regression model has been used to create a scoring table for predicting the postherpetic neuralgia.

Abstract Image

使用六种机器学习算法开发带状疱疹后神经痛的预测模型和相应评分表:回顾性研究
简介:带状疱疹后遗神经痛(PHN)是带状疱疹的一种并发症,严重影响患者的生活质量。研究表明,对疼痛进行早期干预可降低 PHN 的发生率或严重程度。本研究旨在开发一种预测模型和评分表,以识别急性带状疱疹神经痛后有可能发展为 PHN 的患者,从而帮助患者做出明智的临床决策:我们对浙江中医药大学附属第一医院 2020 年 12 月至 2023 年 12 月的 524 例带状疱疹住院患者进行了回顾性研究,并根据是否患有 PHN 对患者进行了分类,收集了 30 项患者特征和疾病相关指标、5 项合并症指标、2 项疾病评分值和 10 项血清学指标。使用最小绝对缩小和选择算子(LASSO)确定了与 PHN 相关的特征。然后,按照 4:1 的比例将患者分为训练集和测试集,并使用单变量分析检验可比性。在训练集中使用机器学习方法建立了六个模型:支持向量机、逻辑回归、随机森林、k-近邻、梯度提升和神经网络。在测试集中评估了这些模型的性能,并使用基于逻辑回归的提名图创建了 PHN 预测评分表:结果:从 LASSO 回归结果中选出的 8 个非零特征变量被纳入了模型,包括年龄[曲线下面积(AUC)= 0.812,P 结论:该研究提出了一种预测 PHN 的方法:本研究通过分析带状疱疹患者的历史病例数据,采用各种机器学习技术,并通过比较分析选择最佳模型,提出了一种预测带状疱疹患者发生带状疱疹后遗神经痛的方法。此外,研究还利用逻辑回归模型创建了带状疱疹后遗神经痛预测评分表。
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来源期刊
Pain and Therapy
Pain and Therapy CLINICAL NEUROLOGY-
CiteScore
6.60
自引率
5.00%
发文量
110
审稿时长
6 weeks
期刊介绍: Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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