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Purpose To develop and validate neural network (NN) vs logistic regression (LR) diagnostic prediction models in patients with suspected giant cell arteritis (GCA). Design: Multicenter retrospective chart review. Methods An audit of consecutive patients undergoing temporal artery biopsy (TABx) for suspected GCA was conducted at 14 international medical centers. The outcome variable was biopsy-proven GCA. The predictor variables were age, gender, headache, clinical temporal artery abnormality, jaw claudication, vision loss, diplopia, erythrocyte sedimentation rate, C-reactive protein, and platelet level. The data were divided into three groups to train, validate, and test the models. The NN model with the lowest false-negative rate was chosen. Internal and external validations were performed. Results Of 1,833 patients who underwent TABx, there was complete information on 1,201 patients, 300 (25%) of whom had a positive TABx. On multivariable LR age, platelets, jaw claudication, vision loss, log C-reactive protein, log erythrocyte sedimentation rate, headache, and clinical temporal artery abnormality were statistically significant predictors of a positive TABx ( P ≤0.05). The area under the receiver operating characteristic curve/Hosmer–Lemeshow P for LR was 0.867 (95% CI, 0.794, 0.917)/0.119 vs NN 0.860 (95% CI, 0.786, 0.911)/0.805, with no statistically significant difference of the area under the curves ( P =0.316). The misclassification rate/false-negative rate of LR was 20.6%/47.5% vs 18.1%/30.5% for NN. Missing data analysis did not change the results. Conclusion Statistical models can aid in the triage of patients with suspected GCA. Misclassification remains a concern, but cutoff values for 95% and 99% sensitivities are provided ( https://goo.gl/THCnuU ).

Blepharoptosis is a common complaint of eyelid malposition in which the upper eyelid is lower than normal. There are multiple types of blepharoptosis based on cause, and important studies have recently been published on one type, myogenic blepharoptosis. There have classically been three methods for correcting blepharoptosis. For the most severe cases, frontalis slings are often performed. New materials, such as polyester mesh, have shown promise as alternatives in forming frontalis slings. A recent paper has suggested a new algorithm for another method of blepharoptosis correction, the conjunctiva-Müller muscle resection. The effectiveness of the third type of procedure for blepharoptosis correction, the external levator advancement, has been reinforced in a study examining the procedure in cases of congenital blepharoptosis.