Identifying predictors of clinical outcomes using the projection-predictive feature selection—a proof of concept on the example of Crohn’s disease

ObjectivesSeveral clinical disease activity indices (DAIs) have been developed to noninvasively assess mucosal healing in pediatric Crohn’s disease (CD). However, their clinical application can be complex. Therefore, we present a new way to identify the most informative biomarkers for mucosal inflam...

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Main Authors: Elisa Wirthgen, Frank Weber, Laura Kubickova-Weber, Benjamin Schiller, Sarah Schiller, Michael Radke, Jan Däbritz
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-07-01
Series:Frontiers in Pediatrics
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fped.2023.1170563/full
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author Elisa Wirthgen
Frank Weber
Laura Kubickova-Weber
Benjamin Schiller
Sarah Schiller
Michael Radke
Jan Däbritz
Jan Däbritz
Jan Däbritz
author_facet Elisa Wirthgen
Frank Weber
Laura Kubickova-Weber
Benjamin Schiller
Sarah Schiller
Michael Radke
Jan Däbritz
Jan Däbritz
Jan Däbritz
author_sort Elisa Wirthgen
collection DOAJ
description ObjectivesSeveral clinical disease activity indices (DAIs) have been developed to noninvasively assess mucosal healing in pediatric Crohn’s disease (CD). However, their clinical application can be complex. Therefore, we present a new way to identify the most informative biomarkers for mucosal inflammation from current markers in use and, based on this, how to obtain an easy-to-use DAI for clinical practice. A further aim of our proof-of-concept study is to demonstrate how the performance of such a new DAI can be compared to that of existing DAIs.MethodsThe data of two independent study cohorts, with 167 visits from 109 children and adolescents with CD, were evaluated retrospectively. A variable selection based on a Bayesian ordinal regression model was applied to select clinical or standard laboratory parameters as predictors, using an endoscopic outcome. The predictive performance of the resulting model was compared to that of existing pediatric DAIs.ResultsWith our proof-of-concept dataset, the resulting model included C-reactive protein (CRP) and fecal calprotectin (FC) as predictors. In general, our model performed better than the existing DAIs. To show how our Bayesian approach can be applied in practice, we developed a web application for predicting disease activity for a new CD patient or visit.ConclusionsOur work serves as a proof-of-concept, showing that the statistical methods used here can identify biomarkers relevant for the prediction of a clinical outcome. In our case, a small number of biomarkers is sufficient, which, together with the web interface, facilitates the clinical application. However, the retrospective nature of our study, the rather small amount of data, and the lack of an external validation cohort do not allow us to consider our results as the establishment of a novel DAI for pediatric CD. This needs to be done with the help of a prospective study with more data and an external validation cohort in the future.
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spelling doaj.art-5e5104d35b914cf5a0b668f08b6e97562024-05-08T04:49:47ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-07-011110.3389/fped.2023.11705631170563Identifying predictors of clinical outcomes using the projection-predictive feature selection—a proof of concept on the example of Crohn’s diseaseElisa Wirthgen0Frank Weber1Laura Kubickova-Weber2Benjamin Schiller3Sarah Schiller4Michael Radke5Jan Däbritz6Jan Däbritz7Jan Däbritz8Department of Pediatrics, Rostock University Medical Center, Rostock, GermanyInstitute for Biostatistics and Informatics in Medicine and Ageing Research, Rostock University Medical Center, Rostock, GermanyMedical School, University of Rostock, Rostock, GermanyDepartment of Pediatrics, Pediatric Gastroenterology, Rostock University Medical Center, Rostock, GermanyDepartment of Pediatrics, Pediatric Gastroenterology, Rostock University Medical Center, Rostock, GermanyDepartment of Pediatrics, Pediatric Gastroenterology, Rostock University Medical Center, Rostock, GermanyDepartment of Pediatrics, Rostock University Medical Center, Rostock, GermanyDepartment of Pediatrics, Pediatric Gastroenterology, Rostock University Medical Center, Rostock, GermanyDepartment of Pediatrics, Greifswald University Medical Center, Greifswald, GermanyObjectivesSeveral clinical disease activity indices (DAIs) have been developed to noninvasively assess mucosal healing in pediatric Crohn’s disease (CD). However, their clinical application can be complex. Therefore, we present a new way to identify the most informative biomarkers for mucosal inflammation from current markers in use and, based on this, how to obtain an easy-to-use DAI for clinical practice. A further aim of our proof-of-concept study is to demonstrate how the performance of such a new DAI can be compared to that of existing DAIs.MethodsThe data of two independent study cohorts, with 167 visits from 109 children and adolescents with CD, were evaluated retrospectively. A variable selection based on a Bayesian ordinal regression model was applied to select clinical or standard laboratory parameters as predictors, using an endoscopic outcome. The predictive performance of the resulting model was compared to that of existing pediatric DAIs.ResultsWith our proof-of-concept dataset, the resulting model included C-reactive protein (CRP) and fecal calprotectin (FC) as predictors. In general, our model performed better than the existing DAIs. To show how our Bayesian approach can be applied in practice, we developed a web application for predicting disease activity for a new CD patient or visit.ConclusionsOur work serves as a proof-of-concept, showing that the statistical methods used here can identify biomarkers relevant for the prediction of a clinical outcome. In our case, a small number of biomarkers is sufficient, which, together with the web interface, facilitates the clinical application. However, the retrospective nature of our study, the rather small amount of data, and the lack of an external validation cohort do not allow us to consider our results as the establishment of a novel DAI for pediatric CD. This needs to be done with the help of a prospective study with more data and an external validation cohort in the future.https://www.frontiersin.org/articles/10.3389/fped.2023.1170563/fullinflammatory bowel diseaseendoscopycalprotectinC-reactive proteinmonitoringBayesian
spellingShingle Elisa Wirthgen
Frank Weber
Laura Kubickova-Weber
Benjamin Schiller
Sarah Schiller
Michael Radke
Jan Däbritz
Jan Däbritz
Jan Däbritz
Identifying predictors of clinical outcomes using the projection-predictive feature selection—a proof of concept on the example of Crohn’s disease
Frontiers in Pediatrics
inflammatory bowel disease
endoscopy
calprotectin
C-reactive protein
monitoring
Bayesian
title Identifying predictors of clinical outcomes using the projection-predictive feature selection—a proof of concept on the example of Crohn’s disease
title_full Identifying predictors of clinical outcomes using the projection-predictive feature selection—a proof of concept on the example of Crohn’s disease
title_fullStr Identifying predictors of clinical outcomes using the projection-predictive feature selection—a proof of concept on the example of Crohn’s disease
title_full_unstemmed Identifying predictors of clinical outcomes using the projection-predictive feature selection—a proof of concept on the example of Crohn’s disease
title_short Identifying predictors of clinical outcomes using the projection-predictive feature selection—a proof of concept on the example of Crohn’s disease
title_sort identifying predictors of clinical outcomes using the projection predictive feature selection a proof of concept on the example of crohn s disease
topic inflammatory bowel disease
endoscopy
calprotectin
C-reactive protein
monitoring
Bayesian
url https://www.frontiersin.org/articles/10.3389/fped.2023.1170563/full
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