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Evaluation of a machine learning tool to screen for hypoadrenocorticism in dogs presenting to a teaching hospital
BACKGROUND: Dogs with hypoadrenocorticism (HA) have clinical signs and clinicopathologic abnormalities that can be mistaken as other diseases. In dogs with a differential diagnosis of HA, a machine learning model (MLM) has been validated to discriminate between HA and other diseases. This MLM has no...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley & Sons, Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9708410/ https://www.ncbi.nlm.nih.gov/pubmed/36259689 http://dx.doi.org/10.1111/jvim.16566 |
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author | Reagan, Krystle L. Pires, Jully Quach, Nina Gilor, Chen |
author_facet | Reagan, Krystle L. Pires, Jully Quach, Nina Gilor, Chen |
author_sort | Reagan, Krystle L. |
collection | PubMed |
description | BACKGROUND: Dogs with hypoadrenocorticism (HA) have clinical signs and clinicopathologic abnormalities that can be mistaken as other diseases. In dogs with a differential diagnosis of HA, a machine learning model (MLM) has been validated to discriminate between HA and other diseases. This MLM has not been evaluated as a screening tool for a broader group of dogs. HYPOTHESIS: An MLM can accurately screen dogs for HA. ANIMALS: Dogs (n = 1025) examined at a veterinary hospital. METHODS: Dogs that presented to a tertiary referral hospital that had a CBC and serum chemistry panel were enrolled. A trained MLM was applied to clinicopathologic data and in dogs that were MLM positive for HA, diagnosis was confirmed by measurement of serum cortisol. RESULTS: Twelve dogs were MLM positive for HA and had further cortisol testing. Five had HA confirmed (true positive), 4 of which were treated for mineralocorticoid and glucocorticoid deficiency, and 1 was treated for glucocorticoid deficiency alone. Three MLM positive dogs had baseline cortisol ≤2 μg/dL but were euthanized or administered glucocorticoid treatment without confirming the diagnosis with an ACTH‐stimulation test (classified as “undetermined”), and in 4, HA was ruled out (false positives). The positive likelihood ratio of the MLM was 145 to 254. All dogs diagnosed with HA by attending clinicians tested positive by the MLM. CONCLUSIONS AND CLINICAL IMPORTANCE: This MLM can robustly predict HA status when indiscriminately screening all dogs with blood work. In this group of dogs with a low prevalence of HA, the false positive rates were clinically acceptable. |
format | Online Article Text |
id | pubmed-9708410 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley & Sons, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-97084102022-12-02 Evaluation of a machine learning tool to screen for hypoadrenocorticism in dogs presenting to a teaching hospital Reagan, Krystle L. Pires, Jully Quach, Nina Gilor, Chen J Vet Intern Med SMALL ANIMAL BACKGROUND: Dogs with hypoadrenocorticism (HA) have clinical signs and clinicopathologic abnormalities that can be mistaken as other diseases. In dogs with a differential diagnosis of HA, a machine learning model (MLM) has been validated to discriminate between HA and other diseases. This MLM has not been evaluated as a screening tool for a broader group of dogs. HYPOTHESIS: An MLM can accurately screen dogs for HA. ANIMALS: Dogs (n = 1025) examined at a veterinary hospital. METHODS: Dogs that presented to a tertiary referral hospital that had a CBC and serum chemistry panel were enrolled. A trained MLM was applied to clinicopathologic data and in dogs that were MLM positive for HA, diagnosis was confirmed by measurement of serum cortisol. RESULTS: Twelve dogs were MLM positive for HA and had further cortisol testing. Five had HA confirmed (true positive), 4 of which were treated for mineralocorticoid and glucocorticoid deficiency, and 1 was treated for glucocorticoid deficiency alone. Three MLM positive dogs had baseline cortisol ≤2 μg/dL but were euthanized or administered glucocorticoid treatment without confirming the diagnosis with an ACTH‐stimulation test (classified as “undetermined”), and in 4, HA was ruled out (false positives). The positive likelihood ratio of the MLM was 145 to 254. All dogs diagnosed with HA by attending clinicians tested positive by the MLM. CONCLUSIONS AND CLINICAL IMPORTANCE: This MLM can robustly predict HA status when indiscriminately screening all dogs with blood work. In this group of dogs with a low prevalence of HA, the false positive rates were clinically acceptable. John Wiley & Sons, Inc. 2022-10-19 2022 /pmc/articles/PMC9708410/ /pubmed/36259689 http://dx.doi.org/10.1111/jvim.16566 Text en © 2022 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | SMALL ANIMAL Reagan, Krystle L. Pires, Jully Quach, Nina Gilor, Chen Evaluation of a machine learning tool to screen for hypoadrenocorticism in dogs presenting to a teaching hospital |
title | Evaluation of a machine learning tool to screen for hypoadrenocorticism in dogs presenting to a teaching hospital |
title_full | Evaluation of a machine learning tool to screen for hypoadrenocorticism in dogs presenting to a teaching hospital |
title_fullStr | Evaluation of a machine learning tool to screen for hypoadrenocorticism in dogs presenting to a teaching hospital |
title_full_unstemmed | Evaluation of a machine learning tool to screen for hypoadrenocorticism in dogs presenting to a teaching hospital |
title_short | Evaluation of a machine learning tool to screen for hypoadrenocorticism in dogs presenting to a teaching hospital |
title_sort | evaluation of a machine learning tool to screen for hypoadrenocorticism in dogs presenting to a teaching hospital |
topic | SMALL ANIMAL |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9708410/ https://www.ncbi.nlm.nih.gov/pubmed/36259689 http://dx.doi.org/10.1111/jvim.16566 |
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