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The Application of Classification and Regression Trees for the Triage of Women for Referral to Colposcopy and the Estimation of Risk for Cervical Intraepithelial Neoplasia: A Study Based on 1625 Cases with Incomplete Data from Molecular Tests.

Pouliakis A, Karakitsou E, Chrelias C, Pappas A, Panayiotides I, Valasoulis G, Kyrgiou M, Paraskevaidis E, Karakitsos P - Biomed Res Int (2015)

Bottom Line: Algorithms useful for the triage of women were produced; gynecologists could apply these in conjunction with available examination results and conclude to an estimation of the risk for a woman to harbor CIN expressed as a probability.The most important test was the cytological examination; however the CART handled cases with inadequate cytological outcome and increased the diagnostic accuracy by exploiting the results of ancillary techniques even if there were inadequate missing data.The CART performance was better than any other single test involved in this study.

View Article: PubMed Central - PubMed

Affiliation: Department of Cytopathology, University of Athens Medical School, Attikon University Hospital, Rimini 1, Haidari, 12462 Athens, Greece.

ABSTRACT

Objective: Nowadays numerous ancillary techniques detecting HPV DNA and mRNA compete with cytology; however no perfect test exists; in this study we evaluated classification and regression trees (CARTs) for the production of triage rules and estimate the risk for cervical intraepithelial neoplasia (CIN) in cases with ASCUS+ in cytology.

Study design: We used 1625 cases. In contrast to other approaches we used missing data to increase the data volume, obtain more accurate results, and simulate real conditions in the everyday practice of gynecologic clinics and laboratories. The proposed CART was based on the cytological result, HPV DNA typing, HPV mRNA detection based on NASBA and flow cytometry, p16 immunocytochemical expression, and finally age and parous status.

Results: Algorithms useful for the triage of women were produced; gynecologists could apply these in conjunction with available examination results and conclude to an estimation of the risk for a woman to harbor CIN expressed as a probability.

Conclusions: The most important test was the cytological examination; however the CART handled cases with inadequate cytological outcome and increased the diagnostic accuracy by exploiting the results of ancillary techniques even if there were inadequate missing data. The CART performance was better than any other single test involved in this study.

No MeSH data available.


Related in: MedlinePlus

Structure of the CART model.
© Copyright Policy - open-access
Related In: Results  -  Collection


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fig1: Structure of the CART model.

Mentions: The CART architecture appears in Figure 1. It is worth noting that the role of the cytological examination result is dominant and that characteristics, such as the woman's age and the majority of HPV subtypes as were identified by the HPV subtyping test, were not found significant to be included. An example of a method of tree usage in practice is as follows.


The Application of Classification and Regression Trees for the Triage of Women for Referral to Colposcopy and the Estimation of Risk for Cervical Intraepithelial Neoplasia: A Study Based on 1625 Cases with Incomplete Data from Molecular Tests.

Pouliakis A, Karakitsou E, Chrelias C, Pappas A, Panayiotides I, Valasoulis G, Kyrgiou M, Paraskevaidis E, Karakitsos P - Biomed Res Int (2015)

Structure of the CART model.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4538922&req=5

fig1: Structure of the CART model.
Mentions: The CART architecture appears in Figure 1. It is worth noting that the role of the cytological examination result is dominant and that characteristics, such as the woman's age and the majority of HPV subtypes as were identified by the HPV subtyping test, were not found significant to be included. An example of a method of tree usage in practice is as follows.

Bottom Line: Algorithms useful for the triage of women were produced; gynecologists could apply these in conjunction with available examination results and conclude to an estimation of the risk for a woman to harbor CIN expressed as a probability.The most important test was the cytological examination; however the CART handled cases with inadequate cytological outcome and increased the diagnostic accuracy by exploiting the results of ancillary techniques even if there were inadequate missing data.The CART performance was better than any other single test involved in this study.

View Article: PubMed Central - PubMed

Affiliation: Department of Cytopathology, University of Athens Medical School, Attikon University Hospital, Rimini 1, Haidari, 12462 Athens, Greece.

ABSTRACT

Objective: Nowadays numerous ancillary techniques detecting HPV DNA and mRNA compete with cytology; however no perfect test exists; in this study we evaluated classification and regression trees (CARTs) for the production of triage rules and estimate the risk for cervical intraepithelial neoplasia (CIN) in cases with ASCUS+ in cytology.

Study design: We used 1625 cases. In contrast to other approaches we used missing data to increase the data volume, obtain more accurate results, and simulate real conditions in the everyday practice of gynecologic clinics and laboratories. The proposed CART was based on the cytological result, HPV DNA typing, HPV mRNA detection based on NASBA and flow cytometry, p16 immunocytochemical expression, and finally age and parous status.

Results: Algorithms useful for the triage of women were produced; gynecologists could apply these in conjunction with available examination results and conclude to an estimation of the risk for a woman to harbor CIN expressed as a probability.

Conclusions: The most important test was the cytological examination; however the CART handled cases with inadequate cytological outcome and increased the diagnostic accuracy by exploiting the results of ancillary techniques even if there were inadequate missing data. The CART performance was better than any other single test involved in this study.

No MeSH data available.


Related in: MedlinePlus