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Prediction of oral food challenge outcomes via ensemble learning

Informatics in Medicine Unlocked 2023年 36卷

作者： Zhang, Justin Lee, Deborah Jungles, Kylie Shaltis, Diane Najarian, Kayvan Ravikumar, Rajan Sanders, Georgiana Gryak, Jonathan Department of Electrical and Computer Engineering University of Michigan Ann Arbor MI United States Department of Internal Medicine University of Michigan Ann Arbor MI United States Department of Pediatrics University of Michigan Ann Arbor MI United States Department of Computational Medicine and Bioinformatics University of Michigan Ann Arbor MI United States Michigan Institute for Data Science University of Michigan Ann Arbor MI United States Department of Emergency Medicine University of Michigan Ann Arbor MI United States Department of Computer Science and Engineering University of Michigan Ann Arbor MI United States Max Harry Weil Institute for Critical Care Research and Innovation University of Michigan Ann Arbor MI United States Mary H. Weiser Food Allergy Center University of Michigan Ann Arbor MI United States Department of Computer Science Queens College City University of New York New York NY United States

Oral Food Challenges (OFCs) are essential to accurately diagnosing food allergy due to the limitations of existing clinical testing. However, some patients are hesitant to undergo OFCs, while those willing suffer from limited access to allergists in rural/community healthcare settings. Despite its success in predicting patient outcomes in other clinical settings, few applications of machine learning to food allergy have been developed. Thus, in this study, we seek to leverage machine learning methodologies for OFC outcome prediction. Retrospective data was gathered from 1,112 patients who collectively underwent a total of 1,284 OFCs, and consisted of clinical factors including serum-specific Immunoglobulin E (IgE), total IgE, skin prick tests (SPTs), comorbidities, sex, and age. using these features, multiple machine learning models were constructed to predict OFC outcomes for three common allergens: peanut, egg, and milk. The best performing model for each allergen was an ensemble of random forest (egg) or learning using concave and convex kernels (LUCCK) (peanut, milk) models, which achieved an Area under the Curve (AUC) of 0.91, 0.96, and 0.94, in predicting OFC outcomes for peanut, egg, and milk, respectively. Moreover, all such models had sensitivity and specificity values ≥89%. Model interpretation via SHapley Additive exPlanations (SHAP) indicates that specific IgE, along with wheal and flare values from SPTs, are highly predictive of OFC outcomes. The results of this analysis suggest that ensemble learning has the potential to predict OFC outcomes and reveal relevant clinical factors for further study. © 2022 The Author(s)

关键词： Ensemble learning learning using concave and convex kernels Machine learning Oral food challenges SHAP

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