Machine Learning (ML) based-method applied in recurrent pregnancy loss (RPL) patients diagnostic work-up: a potential innovation in common clinical practice

Author:

Bruno V.,D’Orazio M.,Ticconi C.,Abundo P.,Riccio S.,Martinelli E.,Rosato N.,Piccione E.,Zupi E.,Pietropolli A.

Abstract

AbstractRPL is a very debated condition, in which many issues concerning definition, etiological factors to investigate or therapies to apply are still controversial. ML could help clinicians to reach an objectiveness in RPL classification and access to care. Our aim was to stratify RPL patients in different risk classes by applying an ML algorithm, through a diagnostic work-up to validate it for the appropriate prognosis and potential therapeutic approach. 734 patients were enrolled and divided into 4 risk classes, according to the numbers of miscarriages. ML method, called Support Vector Machine (SVM), was used to analyze data. Using the whole set of 43 features and the set of the most informative 18 features we obtained comparable results: respectively 81.86 ± 0.35% and 81.71 ± 0.37% Unbalanced Accuracy. Applying the same method, introducing the only features recommended by ESHRE, a correct classification was obtained only in 58.52 ± 0.58%. ML approach could provide a Support Decision System tool to stratify RPL patients and address them objectively to the proper clinical management.

Publisher

Springer Science and Business Media LLC

Subject

Multidisciplinary

Reference30 articles.

1. Bruno, V., Ticconi, C., Sarta, S., Piccione, E. & Pietropolli, A. What has to be pointed out in unexplained recurrent pregnancy loss research in the unsolved fields: lessons from clinic. An Italian RPL Unit experience. Ital J Gynaecol Obstet 2019;31(N. 2) (accepted article, in press).

2. RECURRENT PREGNANCY LOSS Guideline of the European Society of Human Reproduction and Embryology. ESHRE Early Pregnancy Guid Dev Gr (2017).

3. Jaslow, C. R., Carney, J. L. & Kutteh, W. H. Diagnostic factors identified in 1020 women with two versus three or more recurrent pregnancy losses. Fertil Steril (2010).

4. Jauniaux, E., Farquharson, R. G., Christiansen, O. B. & Exalto N. Evidence-based guidelines for the investigation and medical treatment of recurrent miscarriage. Hum Reprod (2006).

5. RCOG. The Investigation and Treatment of Couples with Recurrent First- trimester and Second-trimester Miscarriage. R Coll Obstet Gynaecol Green-top Guidel No 17 (2013).

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