Unfortunately, a substantial portion of pregnancies in lupus patients are complicated by an adverse pregnancy outcome (APO). This can include preterm delivery, intrauterine growth restriction and foetal mortality. Given the high prevalence of APOs in this group, there has been considerable interest in predicting those at the greatest risk of negative outcomes, to permit enhanced observation and intervention in these patients. The EUREKA algorithm was developed to predict obstetric risk in patients with different subsets of antiphospholipid antibodies and generated significant discourse.1 More recently, machine learning (ML) methodology has been applied by Fazzari et al to a large observational cohort (PROMISSE) to identify additional predictors of APO.2
The PROMISSE cohort enrolled 385 pregnant women with mild to moderate SLE both with and without antiphospholipid antibody positivity. They collected data on pregnancy outcomes between 2003 and 2013 from 9 North American sites. Exclusion criteria included a daily prednisone dose >20mg, a urinary PCR >1000, serum creatinine >1.2mg/dL, type 1 or 2 diabetes mellitus, or systemic hypertension.
Previous work in this cohort has linked increased levels of the complement activation productsBb and sC5b-9 to higher rates of APOs.3 More recently, Fazzari et al have applied several ML approaches to the PROMISSE cohort and compared these to logistic regression modelling to identify predictors of APO in SLE patients.2
Approaches were trialled including least absolute shrinkage and selection operator (LASSO), random forest, neural network, support vector machines (SVM-RBF) gradient boosting, and SuperLearner. These were compared via area under the receiver operating characteristic(AUROC). Forty-one predictors assessed during routine care of patients with SLE were used to build these models.
Fazzari et al identified several risk factors for APO including high disease activity, lupus anticoagulant positivity, thrombocytopenia, and antihypertensive use. When comparing AUROC, the SuperLearner package had the numerically superior area under the curve (AUC) (0.78). However, this was not significantly different to LASSO, SVM-RBF, or random forest (AUC 0.77 in all cases).
Weaknesses of the PROMISSE cohort are its exclusion of high disease activity SLE patients and those with a systemic blood pressure of > 140/90mmHg. Additionally, the proportion of patients with APOs within the cohort was low (18.4%), likely in part related to the stringent exclusion criteria. A recent retrospective Portuguese study of which did not exclude high disease activity of lupus nephritis patients identified a far higher rate of APO (41.4%) in their SLE cohort.4 Indeed, Ntali et al recently demonstrated reduced APOs in SLE patients with low disease activity in a prospective observational study.5 Application of these models in a higher disease burden cohort would therefore be desirable.
This work demonstrates the utility of ML in aiding clinical risk stratification within a complex patient cohort. The utilization of standard clinical variables and comparison of several ML techniques are substantial strengths of this work. However, further validation in external cohorts is desirable. The application of ML methodology in risk stratification within SLE may provide better clarity in a heterogeneous patient cohort. Additionally, in the future, similar methodological approaches could be trialled across the autoimmune connective tissue disease spectrum to provide better prognostic information to patients at diagnosis, irrespective of their diagnostic label.
References:
- What Is Machine Learning? | How It Works, Techniques ... [Last Updated On: September 5th, 2019] [Originally Added On: September 5th, 2019]
- Start Here with Machine Learning [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- What is Machine Learning? | Emerj [Last Updated On: October 1st, 2019] [Originally Added On: October 1st, 2019]
- Microsoft Azure Machine Learning Studio [Last Updated On: October 1st, 2019] [Originally Added On: October 1st, 2019]
- Machine Learning Basics | What Is Machine Learning? | Introduction To Machine Learning | Simplilearn [Last Updated On: October 1st, 2019] [Originally Added On: October 1st, 2019]
- What is Machine Learning? A definition - Expert System [Last Updated On: October 2nd, 2019] [Originally Added On: October 2nd, 2019]
- Machine Learning | Stanford Online [Last Updated On: October 2nd, 2019] [Originally Added On: October 2nd, 2019]
- How to Learn Machine Learning, The Self-Starter Way [Last Updated On: October 17th, 2019] [Originally Added On: October 17th, 2019]
- definition - What is machine learning? - Stack Overflow [Last Updated On: November 3rd, 2019] [Originally Added On: November 3rd, 2019]
- Artificial Intelligence vs. Machine Learning vs. Deep ... [Last Updated On: November 3rd, 2019] [Originally Added On: November 3rd, 2019]
- Machine Learning in R for beginners (article) - DataCamp [Last Updated On: November 3rd, 2019] [Originally Added On: November 3rd, 2019]
- Machine Learning | Udacity [Last Updated On: November 3rd, 2019] [Originally Added On: November 3rd, 2019]
- Machine Learning Artificial Intelligence | McAfee [Last Updated On: November 3rd, 2019] [Originally Added On: November 3rd, 2019]
- Machine Learning [Last Updated On: November 3rd, 2019] [Originally Added On: November 3rd, 2019]
- AI-based ML algorithms could increase detection of undiagnosed AF - Cardiac Rhythm News [Last Updated On: November 19th, 2019] [Originally Added On: November 19th, 2019]
- The Cerebras CS-1 computes deep learning AI problems by being bigger, bigger, and bigger than any other chip - TechCrunch [Last Updated On: November 19th, 2019] [Originally Added On: November 19th, 2019]
- Can the planet really afford the exorbitant power demands of machine learning? - The Guardian [Last Updated On: November 19th, 2019] [Originally Added On: November 19th, 2019]
- New InfiniteIO Platform Reduces Latency and Accelerates Performance for Machine Learning, AI and Analytics - Business Wire [Last Updated On: November 19th, 2019] [Originally Added On: November 19th, 2019]
- How to Use Machine Learning to Drive Real Value - eWeek [Last Updated On: November 19th, 2019] [Originally Added On: November 19th, 2019]
- Machine Learning As A Service Market to Soar from End-use Industries and Push Revenues in the 2025 - Downey Magazine [Last Updated On: November 26th, 2019] [Originally Added On: November 26th, 2019]
- Rad AI Raises $4M to Automate Repetitive Tasks for Radiologists Through Machine Learning - - HIT Consultant [Last Updated On: November 26th, 2019] [Originally Added On: November 26th, 2019]
- Machine Learning Improves Performance of the Advanced Light Source - Machine Design [Last Updated On: November 26th, 2019] [Originally Added On: November 26th, 2019]
- Synthetic Data: The Diamonds of Machine Learning - TDWI [Last Updated On: November 26th, 2019] [Originally Added On: November 26th, 2019]
- The transformation of healthcare with AI and machine learning - ITProPortal [Last Updated On: November 26th, 2019] [Originally Added On: November 26th, 2019]
- Workday talks machine learning and the future of human capital management - ZDNet [Last Updated On: November 26th, 2019] [Originally Added On: November 26th, 2019]
- Machine Learning with R, Third Edition - Free Sample Chapters - Neowin [Last Updated On: November 26th, 2019] [Originally Added On: November 26th, 2019]
- Verification In The Era Of Autonomous Driving, Artificial Intelligence And Machine Learning - SemiEngineering [Last Updated On: November 26th, 2019] [Originally Added On: November 26th, 2019]
- Podcast: How artificial intelligence, machine learning can help us realize the value of all that genetic data we're collecting - Genetic Literacy... [Last Updated On: November 28th, 2019] [Originally Added On: November 28th, 2019]
- The Real Reason Your School Avoids Machine Learning - The Tech Edvocate [Last Updated On: November 28th, 2019] [Originally Added On: November 28th, 2019]
- Siri, Tell Fido To Stop Barking: What's Machine Learning, And What's The Future Of It? - 90.5 WESA [Last Updated On: November 28th, 2019] [Originally Added On: November 28th, 2019]
- Microsoft reveals how it caught mutating Monero mining malware with machine learning - The Next Web [Last Updated On: November 28th, 2019] [Originally Added On: November 28th, 2019]
- The role of machine learning in IT service management - ITProPortal [Last Updated On: November 28th, 2019] [Originally Added On: November 28th, 2019]
- Global Director of Tech Exploration Discusses Artificial Intelligence and Machine Learning at Anheuser-Busch InBev - Seton Hall University News &... [Last Updated On: November 28th, 2019] [Originally Added On: November 28th, 2019]
- The 10 Hottest AI And Machine Learning Startups Of 2019 - CRN: The Biggest Tech News For Partners And The IT Channel [Last Updated On: November 28th, 2019] [Originally Added On: November 28th, 2019]
- Startup jobs of the week: Marketing Communications Specialist, Oracle Architect, Machine Learning Scientist - BetaKit [Last Updated On: November 30th, 2019] [Originally Added On: November 30th, 2019]
- Here's why machine learning is critical to success for banks of the future - Tech Wire Asia [Last Updated On: December 2nd, 2019] [Originally Added On: December 2nd, 2019]
- 3 questions to ask before investing in machine learning for pop health - Healthcare IT News [Last Updated On: December 8th, 2019] [Originally Added On: December 8th, 2019]
- Machine Learning Answers: If Caterpillar Stock Drops 10% A Week, Whats The Chance Itll Recoup Its Losses In A Month? - Forbes [Last Updated On: December 8th, 2019] [Originally Added On: December 8th, 2019]
- Measuring Employee Engagement with A.I. and Machine Learning - Dice Insights [Last Updated On: December 8th, 2019] [Originally Added On: December 8th, 2019]
- Amazon Wants to Teach You Machine Learning Through Music? - Dice Insights [Last Updated On: December 8th, 2019] [Originally Added On: December 8th, 2019]
- Machine Learning Answers: If Nvidia Stock Drops 10% A Week, Whats The Chance Itll Recoup Its Losses In A Month? - Forbes [Last Updated On: December 8th, 2019] [Originally Added On: December 8th, 2019]
- AI and machine learning platforms will start to challenge conventional thinking - CRN.in [Last Updated On: December 23rd, 2019] [Originally Added On: December 23rd, 2019]
- Machine Learning Answers: If Twitter Stock Drops 10% A Week, Whats The Chance Itll Recoup Its Losses In A Month? - Forbes [Last Updated On: December 23rd, 2019] [Originally Added On: December 23rd, 2019]
- Machine Learning Answers: If Seagate Stock Drops 10% A Week, Whats The Chance Itll Recoup Its Losses In A Month? - Forbes [Last Updated On: December 23rd, 2019] [Originally Added On: December 23rd, 2019]
- Machine Learning Answers: If BlackBerry Stock Drops 10% A Week, Whats The Chance Itll Recoup Its Losses In A Month? - Forbes [Last Updated On: December 23rd, 2019] [Originally Added On: December 23rd, 2019]
- Amazon Releases A New Tool To Improve Machine Learning Processes - Forbes [Last Updated On: December 23rd, 2019] [Originally Added On: December 23rd, 2019]
- Another free web course to gain machine-learning skills (thanks, Finland), NIST probes 'racist' face-recog and more - The Register [Last Updated On: December 23rd, 2019] [Originally Added On: December 23rd, 2019]
- Kubernetes and containers are the perfect fit for machine learning - JAXenter [Last Updated On: December 23rd, 2019] [Originally Added On: December 23rd, 2019]
- TinyML as a Service and machine learning at the edge - Ericsson [Last Updated On: December 23rd, 2019] [Originally Added On: December 23rd, 2019]
- AI and machine learning products - Cloud AI | Google Cloud [Last Updated On: December 23rd, 2019] [Originally Added On: December 23rd, 2019]
- Machine Learning | Blog | Microsoft Azure [Last Updated On: December 23rd, 2019] [Originally Added On: December 23rd, 2019]
- Machine Learning in 2019 Was About Balancing Privacy and Progress - ITPro Today [Last Updated On: December 25th, 2019] [Originally Added On: December 25th, 2019]
- CMSWire's Top 10 AI and Machine Learning Articles of 2019 - CMSWire [Last Updated On: December 25th, 2019] [Originally Added On: December 25th, 2019]
- Here's why digital marketing is as lucrative a career as data science and machine learning - Business Insider India [Last Updated On: January 13th, 2020] [Originally Added On: January 13th, 2020]
- Dell's Latitude 9510 shakes up corporate laptops with 5G, machine learning, and thin bezels - PCWorld [Last Updated On: January 13th, 2020] [Originally Added On: January 13th, 2020]
- Finally, a good use for AI: Machine-learning tool guesstimates how well your code will run on a CPU core - The Register [Last Updated On: January 13th, 2020] [Originally Added On: January 13th, 2020]
- Cloud as the enabler of AI's competitive advantage - Finextra [Last Updated On: January 13th, 2020] [Originally Added On: January 13th, 2020]
- Forget Machine Learning, Constraint Solvers are What the Enterprise Needs - - RTInsights [Last Updated On: January 13th, 2020] [Originally Added On: January 13th, 2020]
- Informed decisions through machine learning will keep it afloat & going - Sea News [Last Updated On: January 13th, 2020] [Originally Added On: January 13th, 2020]
- The Problem with Hiring Algorithms - Machine Learning Times - machine learning & data science news - The Predictive Analytics Times [Last Updated On: January 13th, 2020] [Originally Added On: January 13th, 2020]
- New Program Supports Machine Learning in the Chemical Sciences and Engineering - Newswise [Last Updated On: January 13th, 2020] [Originally Added On: January 13th, 2020]
- AI-System Flags the Under-Vaccinated in Israel - PrecisionVaccinations [Last Updated On: January 22nd, 2020] [Originally Added On: January 22nd, 2020]
- New Contest: Train All The Things - Hackaday [Last Updated On: January 22nd, 2020] [Originally Added On: January 22nd, 2020]
- AFTAs 2019: Best New Technology Introduced Over the Last 12 MonthsAI, Machine Learning and AnalyticsActiveViam - www.waterstechnology.com [Last Updated On: January 22nd, 2020] [Originally Added On: January 22nd, 2020]
- Educate Yourself on Machine Learning at this Las Vegas Event - Small Business Trends [Last Updated On: January 22nd, 2020] [Originally Added On: January 22nd, 2020]
- Seton Hall Announces New Courses in Text Mining and Machine Learning - Seton Hall University News & Events [Last Updated On: January 22nd, 2020] [Originally Added On: January 22nd, 2020]
- Looking at the most significant benefits of machine learning for software testing - The Burn-In [Last Updated On: January 22nd, 2020] [Originally Added On: January 22nd, 2020]
- Leveraging AI and Machine Learning to Advance Interoperability in Healthcare - - HIT Consultant [Last Updated On: January 22nd, 2020] [Originally Added On: January 22nd, 2020]
- Adventures With Artificial Intelligence and Machine Learning - Toolbox [Last Updated On: January 22nd, 2020] [Originally Added On: January 22nd, 2020]
- Five Reasons to Go to Machine Learning Week 2020 - Machine Learning Times - machine learning & data science news - The Predictive Analytics Times [Last Updated On: January 22nd, 2020] [Originally Added On: January 22nd, 2020]
- Uncover the Possibilities of AI and Machine Learning With This Bundle - Interesting Engineering [Last Updated On: January 22nd, 2020] [Originally Added On: January 22nd, 2020]
- Learning that Targets Millennial and Generation Z - HR Exchange Network [Last Updated On: January 23rd, 2020] [Originally Added On: January 23rd, 2020]
- Red Hat Survey Shows Hybrid Cloud, AI and Machine Learning are the Focus of Enterprises - Computer Business Review [Last Updated On: January 23rd, 2020] [Originally Added On: January 23rd, 2020]
- Vectorspace AI Datasets are Now Available to Power Machine Learning (ML) and Artificial Intelligence (AI) Systems in Collaboration with Elastic -... [Last Updated On: January 23rd, 2020] [Originally Added On: January 23rd, 2020]
- What is Machine Learning? | Types of Machine Learning ... [Last Updated On: January 23rd, 2020] [Originally Added On: January 23rd, 2020]
- How Machine Learning Will Lead to Better Maps - Popular Mechanics [Last Updated On: January 30th, 2020] [Originally Added On: January 30th, 2020]
- Jenkins Creator Launches Startup To Speed Software Testing with Machine Learning -- ADTmag - ADT Magazine [Last Updated On: January 30th, 2020] [Originally Added On: January 30th, 2020]
- An Open Source Alternative to AWS SageMaker - Datanami [Last Updated On: January 30th, 2020] [Originally Added On: January 30th, 2020]
- Machine Learning Could Aid Diagnosis of Barrett's Esophagus, Avoid Invasive Testing - Medical Bag [Last Updated On: January 30th, 2020] [Originally Added On: January 30th, 2020]
- OReilly and Formulatedby Unveil the Smart Cities & Mobility Ecosystems Conference - Yahoo Finance [Last Updated On: January 30th, 2020] [Originally Added On: January 30th, 2020]