Construction of a predictive model for relapse of primary autoimmune hemolytic anemia: a retrospective cohort study

Objectives To develop a machine learning-based model to predict the relapse risk of Primary Autoimmune Haemolytic Anaemia (AIHA) after the last remission.Methods A retrospective study was conducted on primary AIHA cases who visited the Affiliated Hospital of Southwest Medical University and Xuyong C...

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Main Authors: Pan Li, Chuanqi Zhong, Xianjun Huang, Zhi Cai, Tianhong Guo
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Annals of Medicine
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Online Access:https://www.tandfonline.com/doi/10.1080/07853890.2025.2506482
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author Pan Li
Chuanqi Zhong
Xianjun Huang
Zhi Cai
Tianhong Guo
author_facet Pan Li
Chuanqi Zhong
Xianjun Huang
Zhi Cai
Tianhong Guo
author_sort Pan Li
collection DOAJ
description Objectives To develop a machine learning-based model to predict the relapse risk of Primary Autoimmune Haemolytic Anaemia (AIHA) after the last remission.Methods A retrospective study was conducted on primary AIHA cases who visited the Affiliated Hospital of Southwest Medical University and Xuyong County People’s Hospital from May 2017 to May 2022. Cases were categorized as relapsed or non-relapsed based on the 1-year outcomes. Twenty-two features were analyzed to identify relapse risk factors. The least absolute shrinkage and selection operator (LASSO) regression model and multivariate logistic regression analysis were used to establish a predictive model. The C-index, Calibration curves, ROC, and Decision curve analysis (DCA) were used to evaluate the discriminatory, corrective, accurate, and clinical effectiveness of the predictive model.Results A total of 232 cases of primary AIHA were included, and five potential variables including ‘DAT results’, ‘Hb’, ‘Multiline therapy’, ‘Complicating ITP’, and ‘Complicating infection’, have been screened for constructing a 1-year relapse risk prediction nomogram for primary AIHA. The nomogram has a C-index of 0.852 (95% CI: 0.797–0.907), confirmed by bootstrapping validation as 0.829. The area under the ROC was 0.846. The DCA shows that when the threshold probability is in the range of 1 ∼ 91%.Conclusions By following the current diagnostic and treatment criteria for AIHA in China, we retrospectively collect a multitude of medical records and analyze several relevant variables of AIHA, construct a predictive model by machine learning. Using this 1-year relapse risk nomogram can effectively predict the risk of relapse within 1 year after remission of primary AIHA.
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spelling doaj-art-026b7bed4e124891a31610b99d6f13e82025-08-20T01:55:38ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2506482Construction of a predictive model for relapse of primary autoimmune hemolytic anemia: a retrospective cohort studyPan Li0Chuanqi Zhong1Xianjun Huang2Zhi Cai3Tianhong Guo4Department of Oncology, Xuyong County People’s Hospital, Luzhou, Sichuan, ChinaClinical Laboratory, Luzhou Second People’s Hospital, Luzhou, Sichuan, ChinaDepartment of Transfusion, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, ChinaClinical Laboratory Diagnostics, the Southwest Medical University, Luzhou, Sichuan, ChinaDepartment of Transfusion, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, ChinaObjectives To develop a machine learning-based model to predict the relapse risk of Primary Autoimmune Haemolytic Anaemia (AIHA) after the last remission.Methods A retrospective study was conducted on primary AIHA cases who visited the Affiliated Hospital of Southwest Medical University and Xuyong County People’s Hospital from May 2017 to May 2022. Cases were categorized as relapsed or non-relapsed based on the 1-year outcomes. Twenty-two features were analyzed to identify relapse risk factors. The least absolute shrinkage and selection operator (LASSO) regression model and multivariate logistic regression analysis were used to establish a predictive model. The C-index, Calibration curves, ROC, and Decision curve analysis (DCA) were used to evaluate the discriminatory, corrective, accurate, and clinical effectiveness of the predictive model.Results A total of 232 cases of primary AIHA were included, and five potential variables including ‘DAT results’, ‘Hb’, ‘Multiline therapy’, ‘Complicating ITP’, and ‘Complicating infection’, have been screened for constructing a 1-year relapse risk prediction nomogram for primary AIHA. The nomogram has a C-index of 0.852 (95% CI: 0.797–0.907), confirmed by bootstrapping validation as 0.829. The area under the ROC was 0.846. The DCA shows that when the threshold probability is in the range of 1 ∼ 91%.Conclusions By following the current diagnostic and treatment criteria for AIHA in China, we retrospectively collect a multitude of medical records and analyze several relevant variables of AIHA, construct a predictive model by machine learning. Using this 1-year relapse risk nomogram can effectively predict the risk of relapse within 1 year after remission of primary AIHA.https://www.tandfonline.com/doi/10.1080/07853890.2025.2506482Autoimmune haemolytic anemiarelapsemachine learningnomograms
spellingShingle Pan Li
Chuanqi Zhong
Xianjun Huang
Zhi Cai
Tianhong Guo
Construction of a predictive model for relapse of primary autoimmune hemolytic anemia: a retrospective cohort study
Annals of Medicine
Autoimmune haemolytic anemia
relapse
machine learning
nomograms
title Construction of a predictive model for relapse of primary autoimmune hemolytic anemia: a retrospective cohort study
title_full Construction of a predictive model for relapse of primary autoimmune hemolytic anemia: a retrospective cohort study
title_fullStr Construction of a predictive model for relapse of primary autoimmune hemolytic anemia: a retrospective cohort study
title_full_unstemmed Construction of a predictive model for relapse of primary autoimmune hemolytic anemia: a retrospective cohort study
title_short Construction of a predictive model for relapse of primary autoimmune hemolytic anemia: a retrospective cohort study
title_sort construction of a predictive model for relapse of primary autoimmune hemolytic anemia a retrospective cohort study
topic Autoimmune haemolytic anemia
relapse
machine learning
nomograms
url https://www.tandfonline.com/doi/10.1080/07853890.2025.2506482
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