Abstract

IntroductionDiagnosing Kashin-Beck disease (KBD) involves damages to multiple joints and carries variable clinical symptoms, posing great challenge to the diagnosis of KBD for clinical practitioners. However, it is still unclear which clinical features of KBD are more informative for the diagnosis of Kashin-Beck disease among adolescent.MethodsWe first manually extracted 26 possible features including clinical manifestations, and pathological changes of X-ray images from 400 KBD and 400 non-KBD adolescents. With such features, we performed four classification methods, i.e., random forest algorithms (RFA), artificial neural networks (ANNs), support vector machines (SVMs) and linear regression (LR) with four feature selection methods, i.e., RFA, minimum redundancy maximum relevance (mRMR), support vector machine recursive feature elimination (SVM—RFE) and Relief. The performance of diagnosis of KBD with respect to different classification models were evaluated by sensitivity, specificity, accuracy, and the area under the receiver operating characteristic (ROC) curve (AUC).ResultsOur results demonstrated that the 10 out of 26 discriminative features were displayed more powerful performance, regardless of the chosen of classification models and feature selection methods. These ten discriminative features were distal end of phalanges alterations, metaphysis alterations and carpals alterations and clinical manifestations of ankle joint movement limitation, enlarged finger joints, flexion of the distal part of fingers, elbow joint movement limitation, squatting limitation, deformed finger joints, wrist joint movement limitation.ConclusionsThe selected ten discriminative features could provide a fast, effective diagnostic standard for KBD adolescents.

Highlights

  • Diagnosing Kashin-Beck disease (KBD) involves damages to multiple joints and carries variable clinical symptoms, posing great challenge to the diagnosis of KBD for clinical practitioners

  • The classification models were trained with default parameter settings companying with four feature selection methods (i.e., Random forest algorithm (RFA), minimum redundancy maximum relevance (mRMR) [21], support vector machine (SVM)-RFE [22] and Relief [23]), which are falling into three categories, i.e., wrappers, embedded methods, and filters [24,25,26]

  • Significant differences between KBD and non-KBD group were observed in clinical grading of KBD, joint pain, short fingers, flexion of the distal part of fingers, wrist joint movement limitation, elbow joint movement limitation, ankle joint movement limitation, knee joint movement limitation, squatting limitation, enlarged finger joint, enlarged elbow joint, enlarged ankle joint, and deformed joints

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Summary

Introduction

Diagnosing Kashin-Beck disease (KBD) involves damages to multiple joints and carries variable clinical symptoms, posing great challenge to the diagnosis of KBD for clinical practitioners. It is still unclear which clinical features of KBD are more informative for the diagnosis of Kashin-Beck disease among adolescent. The available evidences indicate that even though single clinical manifestations, and X-ray pathological changes are strongly correlated with KBD diagnosis, they do not show effective, strong diagnostic performance on their own [7]. A standard diagnostic method, contains a group of highly specific features with high sensitivity and specificity is warranted in order to KBD diagnosis among adolescents

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