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

BioMed Research International
Abraham PouliakisPetros Karakitsos

Abstract

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. 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. 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 CA...Continue Reading

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Citations

Apr 7, 2018·Journal of Health Organization and Management·Francisco GonzalezFelix Rubial
May 22, 2018·NPJ Science of Food·Claire M McDonaldSteve C Hathaway
Dec 11, 2020·Journal of Thyroid Research·Christos FragopoulosEvangelos P Misiakos
Aug 26, 2021·International Journal for Numerical Methods in Biomedical Engineering·S PadmakalaAdlin Sheeba

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Methods Mentioned

BETA
biopsies
PCR
flow cytometry

Software Mentioned

SPSS Statistics
CART

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