Computer-assisted detection of monoclonal components: results from the multicenter study for the evaluation of CASPER (Computer Assisted Serum Protein Electrophoresis Recognizer) algorithm.
BACKGROUND
To investigate the potential use of Artificial Neural Network (ANN) in the evaluation of serum protein electrophoresis, we set up a multicenter study involving six Italian laboratories. For this purpose, we developed an algorithm named CASPER (Computer Assisted Serum Protein Electrophoresis Recognizer).


METHODS
A total of 59,516 samples from the six centers were divided into three groups. Training and validation sets were used to develop the neural network, whereas evaluation set was used to test the performance of CASPER in recognizing abnormal electrophoretic profiles.


RESULTS
CASPER showed 93.0% sensitivity and 47.4% specificity. CASPER sensitivity and specificity ranged in the six sites from 88% (site 3) to 97% (site 5) and from 36% (site 6) to 53% (site 3), respectively. Sensitivity for gamma zone was 94.6%, for beta zone 89.7% and for oligoclonal patterns 92.0%.


CONCLUSIONS
The sensitivity of the CASPER algorithm does not allow us to recommend its use as a replacement for the visual inspection, but it could be helpful in avoiding accidental misclassifications by the operator. Moreover, the CASPER algorithm may be a useful tool for training operators and students. This study evidenced a high inter-observer variability, which should be addressed in a dedicated study. Data set to train and validate ANNs should contain a huge range and an adequate number of different abnormalities.
Ognibene
Agostino
A
Laboratorio Generale, Dipartimento di Diagnostica di Laboratorio, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy. ognibenea@aou-careggi.toscana.it
Graziani
Maria S
MS
Caldini
Anna
A
Terreni
Alessandro
A
Righetti
Gabriella
G
Varagnolo
Maria C
MC
Campanella
Ada
A
Martelli
Marinella
M
Mancini
Rita
R
Rizzotti
Paolo
P
Plebani
Mario
M
Mori
Marco
M
Gaspari
Giovanni
G
Motta
Roberto
R
Galli
Gianni
G
Fabris
Massimiliano
M
Messeri
Gianni
G
D000465:Algorithms; D000911:Antibodies, Monoclonal / Q000097:blood*; D001797:Blood Protein Electrophoresis; D003201:Computers; D016571:Neural Networks, Computer; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D000911:Antibodies, Monoclonal