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      Liver cirrhosis prediction for patients with Wilson disease based on machine learning: a case–control study from southwest China

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          Objectives

          Wilson disease (WD) is a rare autosomal recessive disease caused by an ATP7B gene mutation. Liver cirrhosis is an important issue that affects the clinical management and prognosis of WD patients. Blood routine examination is a potential biomarker for predicting the occurrence of liver cirrhosis in WD. We aim to construct a predictive model for the occurrence of liver cirrhosis using general clinical information, blood routine examination, urine copper, and serum ceruloplasmin through a machine learning approach.

          Methods

          Case–control study of WD patients admitted to West China Fourth Hospital between 2005 and 2020. Patients with a score of at least four in scoring system of WD were enrolled. A machine learning model was constructed by EmpowerStats software according to the general clinical data, blood routine examination, 24 h urinary copper, and serum ceruloplasmin.

          Results

          This study analyzed 346 WD patients, of which 246 were without liver cirrhosis. And we found platelet large cell count (P-LCC), red cell distribution width CV (RDW-CV), serum ceruloplasmin, age at diagnosis, and mean corpuscular volume (MCV) were the top five important predictors. Moreover, the model was of high accuracy, with an area under the receiver operating characteristic curve of 0.9998 in the training set and 0.7873 in the testing set.

          Conclusions

          In conclusion, the predictive model for predicting liver cirrhosis in WD, constructed by machine learning, had a higher accuracy. And the most important indices in the predictive model were P-LCC, RDW-CV, serum ceruloplasmin, age at diagnosis, and MCV.

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          Most cited references27

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          An overview of statistical learning theory.

          Statistical learning theory was introduced in the late 1960's. Until the 1990's it was a purely theoretical analysis of the problem of function estimation from a given collection of data. In the middle of the 1990's new types of learning algorithms (called support vector machines) based on the developed theory were proposed. This made statistical learning theory not only a tool for the theoretical analysis but also a tool for creating practical algorithms for estimating multidimensional functions. This article presents a very general overview of statistical learning theory including both theoretical and algorithmic aspects of the theory. The goal of this overview is to demonstrate how the abstract learning theory established conditions for generalization which are more general than those discussed in classical statistical paradigms and how the understanding of these conditions inspired new algorithmic approaches to function estimation problems. A more detailed overview of the theory (without proofs) can be found in Vapnik (1995). In Vapnik (1998) one can find detailed description of the theory (including proofs).
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            EASL Clinical Practice Guidelines: Wilson's disease.

            (2012)
            This Clinical Practice Guideline (CPG) has been developed to assist physicians and other healthcare providers in the diagnosis and management of patients with Wilson's disease. The goal is to describe a number of generally accepted approaches for diagnosis, prevention, and treatment of Wilson's disease. Recommendations are based on a systematic literature review in the Medline (PubMed version), Embase (Dialog version), and the Cochrane Library databases using entries from 1966 to 2011. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system used in other EASL CPGs was used and set against the somewhat different grading system used in the AASLD guidelines (Table 1A and B). Unfortunately, there is not a single randomized controlled trial conducted in Wilson's disease which has an optimal design. Thus, it is impossible to assign a high or even a moderate quality of evidence to any of the questions dealt with in these guidelines. The evaluation is mostly based on large case series which have been reported within the last decades. Copyright © 2011 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
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              Multicenter Comparison of Machine Learning Methods and Conventional Regression for Predicting Clinical Deterioration on the Wards.

              Machine learning methods are flexible prediction algorithms that may be more accurate than conventional regression. We compared the accuracy of different techniques for detecting clinical deterioration on the wards in a large, multicenter database.
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                Author and article information

                Journal
                Eur J Gastroenterol Hepatol
                Eur J Gastroenterol Hepatol
                EJGH
                European Journal of Gastroenterology & Hepatology
                Lippincott Williams And Wilkins
                0954-691X
                1473-5687
                25 July 2022
                October 2022
                : 34
                : 10
                : 1067-1073
                Affiliations
                [a ]Department of Geriatric Medicine and Neurology, West China School of Public Health and West China Fourth Hospital
                [b ]West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, People’s Republic of China
                Author notes
                Correspondence to Peiwei Hong, MD, Department of Geriatric Medicine and Neurology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China, E-mail: hongpeiwei1988@ 123456qq.com
                Article
                00012
                10.1097/MEG.0000000000002424
                9439697
                35895997
                a78ac190-24c8-46dd-8a95-538b7c020b16
                Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

                History
                : 18 May 2022
                : 29 June 2022
                Categories
                Original Articles: Hepatology
                Custom metadata
                TRUE

                blood routine examination,hepatolenticular degeneration,liver cirrhosis,machine learning,wilson disease

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