title: Genetic programming outperformed multivariable logistic regression in diagnosing pulmonary embolism.
abstract: OBJECTIVE
  Genetic programming is a search method that can be used to solve complex associations between large numbers of variables. It has been used, for example, for myoelectrical signal recognition, but its value for medical prediction as in diagnostic and prognostic settings, has not been documented.
  
  
  METHODS
  We compared genetic programming and the commonly used logistic regression technique in the development of a prediction model using empirical data from a study on diagnosis of pulmonary embolism. Using part (67%) of the data, we developed and internally validated (using bootstrapping techniques) a diagnostic prediction model by genetic programming and by logistic regression, and compared both on their predictive ability in the remaining data (validation set).
  
  
  RESULTS
  In the validation set, the area under the ROC curve of the genetic programming model was significantly larger (0.73; 95%CI: 0.64-0.82) than that of the logistic regression model (0.68; 0.59-0.77). The calibration of both models was similar, indicating a similar amount of overoptimism.
  
  
  CONCLUSIONS
  Although the interpretation of a genetic programming model is less intuitive and this is the first empirical study quantifying its value for medical prediction, genetic programming seems a promising technique to develop prediction rules for diagnostic and prognostic purposes.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center, P.O. Box 85500, GA Utrecht 3508, The Netherlands. cbiesheu@umcutrecht.nl
authors.forename: Cornelis J
authors.initials: CJ
authors.lastname: Biesheuvel
authors.forename: Ivar
authors.initials: I
authors.lastname: Siccama
authors.forename: Diederick E
authors.initials: DE
authors.lastname: Grobbee
authors.forename: Karel G M
authors.initials: KG
authors.lastname: Moons
mesh_terms: D000328:Adult; D000465:Algorithms; D003937:Diagnosis, Differential; D006801:Humans; D016015:Logistic Models; D008957:Models, Genetic; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011336:Probability; D011655:Pulmonary Embolism / Q000175:diagnosis*; D012372:ROC Curve