Diagnosis of neurosyphilis in HIV-negative patients with syphilis: development, validation, and clinical utility of a suite of machine learning models

作者：Huachun Zou, Zhen Lu, Wenjia Weng, Ligang Yang, Luoyao Yang, Xinying Leng, Junfeng Wang, Yi‐Fan Lin, Jiaxin Wu, Leiwen Fu, Xiaohui Zhang, Yuwei Li, Liuyuan Wang, Xinsheng Wu, Xinyi Zhou, Tian Tian, Lixia Huang, Christina M. Marra, Bin Yang, Tian‐Ci Yang, Wujian Ke · 发表于：EClinicalMedicine · 年份：2023 · DOI：10.1016/j.eclinm.2023.102080 · 被引用次数：30 · 研究领域：Syphilis Diagnosis and Treatment、Reproductive tract infections research、Autoimmune and Inflammatory Disorders

Background: The ability to accurately identify the absolute risk of neurosyphilis diagnosis for patients with syphilis would allow preventative and therapeutic interventions to be delivered to patients at high-risk, sparing patients at low-risk from unnecessary care. We aimed to develop, validate, and evaluate the clinical utility of simplified clinical diagnostic models for neurosyphilis diagnosis in HIV-negative patients with syphilis. Methods: We searched PubMed, China National Knowledge Infrastructure and UpToDate for publications about neurosyphilis diagnostic guidelines in English or Chinese from database inception until March 15, 2023. We developed and validated machine learning models with a uniform set of predictors based on six authoritative diagnostic guidelines across four continents to predict neurosyphilis using routinely collected data from real-world clinical practice in China and the United States (through the Dermatology Hospital of Southern Medical University in Guangzhou [659 recruited between August 2012 and March 2022, treated as Development cohort], the Beijing Youan Hospital of Capital Medical University in Beijng [480 recruited between December 2013 and April 2021, treated as External cohort 1], the Zhongshan Hospital of Xiamen University in Xiamen [493 recruited between November 2005 and November 2021, treated as External cohort 2] from China, and University of Washington School of Medicine in Seattle [16 recruited between September 2002 and April 20...