Evidence map›Paper›PMID 38937388›Full record

ArticleClinical rheumatology2024

Prediction of prognosis in patients with systemic sclerosis based on a machine-learning model.

Yan Zheng, Wei Jin, Zhaohui Zheng, Kui Zhang, Junfeng Jia, Cong Lei, Weitao Wang, Ping Zhu

Abstract read
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In one paragraph

Article in Clinical rheumatology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Yan Zheng *Department of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, No. 15 Changle West Road, Xi'an, 710032, People's Republic of China.
Wei Jin *Department of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, No. 15 Changle West Road, Xi'an, 710032, People's Republic of China.
Zhaohui Zheng *Department of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, No. 15 Changle West Road, Xi'an, 710032, People's Republic of China.
Kui ZhangDepartment of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, No. 15 Changle West Road, Xi'an, 710032, People's Republic of China.
Junfeng JiaDepartment of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, No. 15 Changle West Road, Xi'an, 710032, People's Republic of China.
Cong LeiDepartment of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, No. 15 Changle West Road, Xi'an, 710032, People's Republic of China.
Weitao WangDepartment of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, No. 15 Changle West Road, Xi'an, 710032, People's Republic of China.
Ping ZhuDepartment of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, No. 15 Changle West Road, Xi'an, 710032, People's Republic of China. zhuping@fmmu.edu.cn.ORCID http://orcid.org/0000-0002-8391-4945

Funding

National Natural Science Foundation of China 62272468National Natural Science Foundation of China 92169211
6 · The paper itself

Abstract

objectiveThe clinical manifestations of systemic sclerosis (SSc) are highly variable, resulting in varied outcomes and complications. Diverse fibrosis of the skin and internal organs, vasculopathy, and dysregulated immune system lead to poor and varied prognoses in patients with SSc subtypes. Therefore, this study aimed to develop a personalized tool for predicting the prognosis of patients with SSc.

methodsA cohort of 517 patients with SSc were recruited between January 2009 and November 2021 at Xijing Hospital in China, and 266 patients completed the follow-up and performed in the survival analysis. Risk factors for death were identified using Cox survival analysis and random survival forest-based machine-learning methods separately. The consistency index, area under the curve (AUC), and integrated Brier scores were used to compare the predictive performance of the different prognostic models.

resultsThe results of Cox-based multivariate regression analysis suggested that pulmonary arterial hypertension, digital ulcer, and Modified Rodnan Skin Score (mRSS) were independent risk factors for poor prognosis in patients with SSc and significant risk factors in random survival forest (RSF) surveys. A nomogram was plotted to evaluate the prognostic risk to facilitate clinical assessment; the RSF model had better predictive performance than the Cox model, with 3- and 5-year AUCs of 0.74 and 0.78, respectively.

conclusionMachine-learning models can help us better understand the prognosis of patients with SSc and comprehensively evaluate the clinical characteristics of each individual. The early identification of the characteristics of high-risk patients can improve the prognosis of those with SSc. Key Points • Regarding predictive performance, the random survival forest model was more effective than the Cox model and had unique advantages in analyzing nonlinear effects and variable importance. • Machine learning using the simple clinical features of patients with systemic sclerosis (SSc) to predict mortality can guide attending physicians, and the early identification of high-risk patients with SSc and referral to experts will assist rheumatologists in monitoring and management planning.

Indexed as

Machine LearningScleroderma, SystemicAdultAgedChinaFemaleHumansMaleMiddle AgedNomogramsPrognosisProportional Hazards ModelsRisk FactorsSurvival AnalysisMachine-learning modelPrognosisRisk factorsSystemic sclerosis

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