Evidence map›Paper›PMID 41462380›Full record

ArticleBMC rheumatology2025

Calibrated, explainable machine learning on routine laboratory data to characterize diagnostic assignment patterns in rheumatic diseases: a retrospective study of 12,085 patients.

Amal Mohamed Elmesiry, Amira Shahin Ibrahim, Hemmat A Elabd, Basma Mohamed El Naggar, Eman E Abd Elsalam, Mai Abd El Halim Moussa, Eman A Rageh, Mona Mokhtar, Muhammad M Harb, Aya H Elshazly and 2 more

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Article in BMC rheumatology, 2025. 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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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Amal Mohamed ElmesiryDepartment of Rheumatology and Rehabilitation, Faculty of Medicine for Girls, Al Azhar University, Cairo, Egypt.
Amira Shahin IbrahimDepartment of Rheumatology and Rehabilitation, Faculty of Medicine for Girls, Al Azhar University, Cairo, Egypt.
Hemmat A ElabdDepartment of Rheumatology and Rehabilitation, Faculty of Medicine for Girls, Al Azhar University, Cairo, Egypt.
Basma Mohamed El NaggarDepartment of Rheumatology and Rehabilitation, Faculty of Medicine for Girls, Al Azhar University, Cairo, Egypt.
Eman E Abd ElsalamDepartment of Rheumatology and Rehabilitation, Faculty of Medicine for Girls, Al Azhar University, Cairo, Egypt.
Mai Abd El Halim MoussaDepartment of Rheumatology and Rehabilitation, Faculty of Medicine for Girls, Al Azhar University, Cairo, Egypt.
Eman A RagehDepartment of Rheumatology and Rehabilitation, Faculty of Medicine for Girls, Al Azhar University, Cairo, Egypt.
Mona MokhtarDepartment of Rheumatology and Rehabilitation, Faculty of Medicine for Girls, Al Azhar University, Cairo, Egypt.
Muhammad M HarbDepartment of Rheumatology and Rehabilitation, Faculty of Medicine, Al Azhar University, Cairo, Egypt.
Aya H ElshazlyDepartment of Internal Medicine, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
Mohamed A KhalafallahFaculty of Medicine, Alexandria University, Alexandria, Egypt.
Atef A HassanFaculty of Medicine, Al-Azhar University, Cairo, Egypt. atefabdo26399@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOverlap in routine laboratory profiles complicates differential diagnosis of rheumatic diseases, particularly seronegative spondyloarthritis. We examined whether models trained on routine labs reproduce diagnostic assignment patterns and yield calibrated, explainable probabilities.

methodsWe analyzed a publicly available, fully de-identified dataset (n = 12,085). Adults (≥ 18 years) with confirmed diagnoses and ≤ 30% biomarker missingness were included. Nineteen routine variables (demographics, ESR/CRP, serology) plus four engineered features were used. Missingness (~ 14.5%) was imputed using MICE, variables were standardized, and the data were split 80/20 with stratification. Random Forest, LightGBM, XGBoost, CatBoost, and TabNet were trained with fixed, literature-informed hyperparameters. We assessed 5-fold CV, independent test performance, calibration (Brier/ECE), and SHAP; a predefined seronegative subgroup (RF/anti-CCP negative) was analyzed.

resultsXGBoost achieved the highest test accuracy (85.48%); Random Forest (83.78%) was selected for detailed interpretation due to superior calibration. Performance varied by disease: SLE recall was 97.9% compared to ankylosing spondylitis (AS), 57.6%. Among 2,417 test cases, 381 (15.76%) were misclassified; the most frequent error was AS misclassified as RA (109; 28.6%). SHAP ranked ESR/CRP, RF/anti-CCP, HLA-B27, and C3/C4 as dominant contributors. In seronegative patients (n = 390), the prevalence of HLA-B27 was higher (+ 6.5%; p = 0.024), and the prevalence of anti-La was lower (–11.6%; p = 0.001).

conclusionsRoutine laboratory data can be converted into calibrated, explainable probabilities that characterize diagnostic assignment patterns, rather than independent predictions. Given poor AS performance, the approach is not reliable for differentiating spondyloarthropathies from RA without additional clinical or imaging data. External/temporal validation, integration of clinical and imaging features, and prospective evaluation are needed.

trial registrationNot applicable.

Indexed as

CalibrationDifferential diagnosisExplainable AILaboratory biomarkersMachine learningMulticlass classificationRheumatologySeronegativeSHAPSpondyloarthritis

Identifiers

PMID41462380
PMCPMC12849087

What Socratic holds

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LicenceCC BY
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.