Moderate-High Disease Activity in Patients with Recent-Onset Psoriatic Arthritis-Multivariable Prediction Model Based on Machine Learning

新发银屑病关节炎患者的中高疾病活动度——基于机器学习的多变量预测模型

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作者:Rubén Queiro, Daniel Seoane-Mato, Ana Laiz, Eva Galindez Agirregoikoa, Carlos Montilla, Hye S Park, Jose A Pinto Tasende, Juan J Bethencourt Baute, Beatriz Joven Ibáñez, Elide Toniolo, Julio Ramírez, Nuria Montero, Cristina Pruenza García-Hinojosa, Ana Serrano García, On Behalf Of The Proyecto Reaps

Abstract

The aim was to identify patient- and disease-related characteristics predicting moderate-to-high disease activity in recent-onset psoriatic arthritis (PsA). We performed a multicenter observational prospective study (2-year follow-up, regular annual visits) in patients aged ≥18 years who fulfilled the CASPAR criteria and had less than 2 years since the onset of symptoms. The moderate-to-high activity of PsA was defined as DAPSA > 14. We trained a logistic regression model and random forest-type and XGBoost machine learning algorithms to analyze the association between the outcome measure and the variables selected in the bivariate analysis. The sample comprised 158 patients. At the first follow-up visit, 20.8% of the patients who attended the clinic had a moderate-to-severe disease. This percentage rose to 21.2% on the second visit. The variables predicting moderate-high activity were the PsAID score, tender joint count, level of physical activity, and sex. The mean values of the measures of validity of the machine learning algorithms were all high, especially sensitivity (98%; 95% CI: 86.89-100.00). PsAID was the most important variable in the prediction algorithms, reinforcing the convenience of its inclusion in daily clinical practice. Strategies that focus on the needs of women with PsA should be considered.

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