Development of a five-year mortality model in systemic sclerosis patients by different analytical approaches

Lorenzo Beretta, Alessandro Santaniello, Francesco Cappiello, Nitesh V. Chawla, Madelon C. Vonk, Patricia E. Carreira, Yannick Allanore, Delia A. Popa-Diaconu, Marta Cossu, Francesco Bertolotti, Gianfranco Ferraccioli, Antonino Mazzone, Raffaella Scorza

Research output: Contribution to journalArticlepeer-review

Abstract

Objective. Systemic sclerosis (SSc) is a multiorgan disease with high mortality rates. Several clinical feature s have been associated with poor survival in different populations of SSc patients, but no clear and reproducible prognostic model to assess individual survival prediction in scleroderma patients has ever been developed. Methods. We used Cox regression and three data mining-based classifiers (Naïve Bayes Classifier [NBC], Random Forests [RND-F] and logistic regression [Log-Reg]) to develop a robust and reproducible 5-year prognostic model. All the models were built and internally validated by means of 5-fold cross-validation on a population of 558 Italian SSc patients. Their predictive ability and capability of generalisation was then tested on an independent population of 356 patients recruited from 5 external centres and finally compared to the predictions made by two SSc domain experts on the same population. Results. The NBC outperformed the Cox-based classifier and the other data mining algorithms after internal cross-validation (area under receiving operator characteristic curve, AUROC: NBC=0.759; RND-F=0.736; Log-Reg=0.754 and Cox= 0.724). The NBC had also a remarkable and better trade-off between sensitivity and specificity (e.g. Balanced accuracy, BA) than the Cox-based classifier, when tested on an independent population of SSc patients (BA: NBC=0.769, Cox=0.622). The NBC was also superior to domain experts in predicting 5-year survival in this population (AUROC=0.829 vs. AUROC=0.788 and BA=0.769 vs. BA=0.67). Conclusion. We provide a model to make consistent 5-year prognostic predictions in SSc patients. Its internal validity, as well as capability of generalisation and reduced uncertainty compared to human experts support its use at bedside. Available at: http://www.nd.edu/~nchawla/survival. xls.

Original languageEnglish
JournalClinical and Experimental Rheumatology
Volume28
Issue number2 SUPPL. 58
Publication statusPublished - 2010

Keywords

  • Cox regression
  • Data mining
  • Naïve bayes
  • Survival
  • Systemic sclerosis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy

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