ArticleJournal of veterinary internal medicine2026
Predicting the likelihood of hypoadrenocorticism in dogs using signalment and routine laboratory results with an ensemble machine learning predictive model.
Article in Journal of veterinary internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe adrenocorticotropic hormone stimulation test (ACTHst), required for diagnosing hypoadrenocorticism in dogs (canine hypoadrenocorticism, CHA), is limited by the cost and availability of synthetic adrenocorticotropic hormone, and results are subject to delays.
objectivesDevelop and validate a machine learning model that predicts the probability of CHA using signalment and routine laboratory test results. ANIMALS: Sixty-eight confirmed and untreated CHA dogs, and 504 control dogs (CHA suspected but ultimately excluded).
methodsCross-sectional multicenter study. Dogs in which CHA was confirmed or excluded by resting cortisol measurement or an ACTHst were identified from medical records of 5 veterinary referral hospitals. Data from 4/5 institutions were used to train a parallel random forest algorithm (parRF), the output of which was the predicted probability of CHA. Model performance was assessed on training set data (internal validation) and a different population (external validation from the fifth hospital).
resultsThe parRF accurately predicted CHA in internal validation (area under the receiver-operating characteristic curve [ROC AUC]: 0.998; 95% CI, 0.996-0.999, 50%-predicted-probability sensitivity: 97.3%; 95% CI, 93.6-98.6, and specificity: 98.6%; 95% CI, 95.9-99.5). Three decision thresholds were determined: predicted probabilities of 10%, 50%, and 80% to optimize sensitivity, accuracy, and specificity, respectively. The model accuracy was confirmed using external data: ROC AUC: 0.942 (95% CI, 0.853-1.0); sensitivity: 94.1% (95% CI, 71.3-99.9), 58.8% (95% CI, 32.9-81.6), 41.2% (95% CI, 18.4-67.1); specificity: 93.9% (95% CI, 85.2-98.3), 100% (95% CI, 94.6-100), 100% (95% CI, 94.6-100), at 10%, 50%, and 80% decision thresholds, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: Although the parRF should be further externally validated, it shows promise to help veterinarians diagnose CHA.
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