title: The assessment of data mining for the prediction of therapeutic outcome in 3719 Egyptian patients with chronic hepatitis C.
abstract: BACKGROUND
  Decision-tree analysis; a core component of data mining analysis can build predictive models for the therapeutic outcome to antiviral therapy in chronic hepatitis C virus (HCV) patients.
  
  
  OBJECTIVE
  To develop a prediction model for the end virological response (ETR) to pegylated interferon PEG-IFN plus ribavirin (RBV) therapy in chronic HCV patients using routine clinical, laboratory, and histopathological data.
  
  
  METHODS
  Retrospective initial data (19 attributes) from 3719 Egyptian patients with chronic HCV presumably genotype-4 was assigned to model building using the J48 decision tree-inducing algorithm (Weka implementation of C4.5). All patients received PEG-IFN plus RBV at Cairo-Fatemia Hospital, Cairo, Egypt in the context of the national treatment program. Factors predictive of ETR were explored and patients were classified into seven subgroups according to the different rates of ETR. The universality of the decision-tree model was subjected to a 10-fold cross-internal validation in addition to external validation using an independent dataset collected of 200 chronic HCV patients.
  
  
  RESULTS
  At week 48, overall ETR was 54% according to intention to treat protocol. The decision-tree model included AFP level (<8.08 ng/ml) which was associated with high probability of ETR (73%) followed by stages of fibrosis and Hb levels according to the patients' gender followed by the age of patients.
  
  
  CONCLUSIONS
  In a decision-tree model for the prediction for antiviral therapy in chronic HCV patients, AFP level was the initial split variable at a cutoff of 8.08 ng/ml. This model could represent a potential tool to identify patients' likelihood of response among difficult-to-treat presumably genotype-4 chronic HCV patients and could support clinical decisions regarding the proper selection of patients for therapy without imposing any additional costs.
authors.affiliation: Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt. naglaazayed@yahoo.com
authors.forename: Naglaa
authors.initials: N
authors.lastname: Zayed
authors.forename: Abu Bakr
authors.initials: AB
authors.lastname: Awad
authors.forename: Wafaa
authors.initials: W
authors.lastname: El-Akel
authors.forename: Wahid
authors.initials: W
authors.lastname: Doss
authors.forename: Tahany
authors.initials: T
authors.lastname: Awad
authors.forename: Amr
authors.initials: A
authors.lastname: Radwan
authors.forename: Mahasen
authors.initials: M
authors.lastname: Mabrouk
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D003663:Decision Trees; D004359:Drug Therapy, Combination; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000473:pathology / Q000821:virology; D008297:Male; D015999:Multivariate Analysis; D011092:Polyethylene Glycols / Q000627:therapeutic use; D012367:RNA, Viral / Q000032:analysis; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D012737:Sex Factors; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D000509:alpha-Fetoproteins; D011092:Polyethylene Glycols; D012254:Ribavirin; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a