Machine learning to optimize cerebrospinal fluid dilution for analysis of MRZH reaction

Ana Turčić; Andrija Štajduhar; Željka Vogrinc; Ljiljana Zaninović; Dunja Rogić

doi:10.1515/cclm-2023-1013

Article

Machine learning to optimize cerebrospinal fluid dilution for analysis of MRZH reaction

Ana Turčić , Andrija Štajduhar , Željka Vogrinc , Ljiljana Zaninović and Dunja Rogić

Published/Copyright: October 4, 2023

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From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 62 Issue 3

Abstract

Objectives

To create a supervised machine learning algorithm aimed at predicting an optimal cerebrospinal fluid (CSF) dilution when determining virus specific antibody indices to reduce the need for repeated tests.

Methods

The CatBoost model was trained, optimized, and tested on a dataset with five input variables: albumin quotient, immunoglobulin G (IgG) in CSF, IgG quotient (QIgG), intrathecal synthesis (ITS) and limes quotient (LIM IgG). Albumin and IgG concentrations in CSF and serum were performed by immunonephelometry on Atellica NEPH 630 (Siemens Healthineers, Erlangen, Germany) and ITS and LIM IgG were calculated according to Reiber. Concentrations of IgG antibodies to measles, rubella, varicella zoster and herpes simplex 1/2 viruses were analysed in CSF and serum by ELISA (Euroimmun, Lübeck, Germany). Optimal CSF dilution was defined for each virus and used as a classification variable while the standard operating procedure was set to start at 2×-dilution of CSF.

Results

The dataset included 571 samples with the imbalanced distribution of the optimal CSF dilutions: 2× dilution n=440, 3× dilution n=109, 4× dilution n=22. The optimized CatBoost model achieved an area under the curve (AUC) score of 0.971, and a test accuracy of 0.900. The model falsely classified 14 (9.9 %) samples of the testing set but reduced the need for repeated testing compared to the standard protocol by 42 %. The output of the CatBoost model is mostly dependant on the QIgG, ITS and CSF IgG variables.

Conclusions

An accurate algorithm was achieved for predicting the optimal CSF dilution, which reduces the number of test repeats.

Keywords: cerebrospinal fluid; machine learning; MRZ reaction; model optimization

Corresponding author: Ana Turčić, Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia, E-mail: ana.turcic@kbc-zagreb.hr

Research ethics: Not applicable.
Informed consent: Not applicable.
Author contributions: Study concept and design: AT. Acquisition of data: AT, ZV, LJZ. Analysis and interpretation of data: AT, AŠ. Drafting the manuscript: AT, AŠ. Critical revision of the manuscript for important intellectual content: ZV, LJZ, DR. Administrative, technical, and material support: ZV, DR. The authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: The authors state no conflict of interest.
Research funding: None declared.
Data availability: The raw data can be obtained on request from the corresponding author.

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Received: 2023-07-06

Accepted: 2023-09-21

Published Online: 2023-10-04

Published in Print: 2024-02-26

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Articles in the same Issue

https://doi.org/10.1515/cclm-2023-1013

Keywords for this article

cerebrospinal fluid; machine learning; MRZ reaction; model optimization