Prediction model of ocular metastasis from primary liver cancer: Machine learning‐based development and interpretation study

Abstract

BackgroundOcular metastasis (OM) is a rare metastatic site of primary liver cancer (PLC). The purpose of this study was to establish a clinical predictive model of OM in PLC patients based on machine learning (ML).MethodsWe retrospectively collected the clinical data of 1540 PLC patients and divided it into a training set and an internal test set in a 7:3 proportion. PLC patients were divided into OM and non‐ocular metastasis (NOM) groups, and univariate logistic regression analysis was performed between the two groups. The variables with univariate logistic analysis p < 0.05 were selected for the ML model. We constructed six ML models, which were internally verified by 10‐fold cross‐validation. The prediction performance of each ML model was evaluated by receiver operating characteristic curves (ROCs). We also constructed a web calculator based on the optimal performance ML model to personalize the risk probability for OM.ResultsSix variables were selected for the ML model. The extreme gradient boost (XGB) ML model achieved the optimal differential diagnosis ability, with an area under the curve (AUC) = 0.993, accuracy = 0.992, sensitivity = 0.998, and specificity = 0.984. Based on these results, an online web calculator was constructed by using the XGB ML model to help clinicians diagnose and treat the risk probability of OM in PLC patients. Finally, the Shapley additive explanations (SHAP) library was used to obtain the six most important risk factors for OM in PLC patients: CA125, ALP, AFP, TG, CA199, and CEA.ConclusionWe used the XGB model to establish a risk prediction model of OM in PLC patients. The predictive model can help identify PLC patients with a high risk of OM, provide early and personalized diagnosis and treatment, reduce the poor prognosis of OM patients, and improve the quality of life of PLC patients.

Approaching Personalized Medicine: The Use of Machine Learning to Determine Predictors of Mortality in a Population with SARS-CoV-2 Infection

“…The ML model based on extreme gradient boosting (XGB) was selected in our study because of its generalizability, low risk of overfitting, high interpretability [25], and high scalability [34]. XGB has been confirmed to be a reliable method for recognizing patterns in other diseases such as lupus erythematosus [16], traumatic brain injury-induced coagulopathy [35], epilepsy [36], diabetes [37], Alzheimer's disease [38,39], HIV [40,41], or different types of cancer [42][43][44][45][46]. We, therefore, used the aforementioned ML technique to determine which factors were most predictive of disease severity in a closed group of patients hospitalized for COVID-19 during the first two months of the pandemic, a time when the population did not yet have herd immunity and had not yet been vaccinated.…”