Development and validation of machine learning classifiers for predicting treatment-needed retinopathy of prematurity

Abstract Background This study aims to design and evaluate various supervised machine-learning models for identifying premature infants who require treatment based on demographic data and clinical findings from screening examinations. Methods We conducted a retrospective review of medical records fo...

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Main Authors: Nasser Shoeibi, Majid Abrishami, Seyedeh Maryam Hosseini, Mohammad-Reza Ansari-Astaneh, Razieh Farrahi, Bahareh Gharib, Fatemeh Neghabi, Mojtaba Abrishami, Mehdi Sakhaee, Mehrdad Motamed Shariati
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Medical Informatics and Decision Making
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Online Access:https://doi.org/10.1186/s12911-025-03057-w
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author Nasser Shoeibi
Majid Abrishami
Seyedeh Maryam Hosseini
Mohammad-Reza Ansari-Astaneh
Razieh Farrahi
Bahareh Gharib
Fatemeh Neghabi
Mojtaba Abrishami
Mehdi Sakhaee
Mehrdad Motamed Shariati
author_facet Nasser Shoeibi
Majid Abrishami
Seyedeh Maryam Hosseini
Mohammad-Reza Ansari-Astaneh
Razieh Farrahi
Bahareh Gharib
Fatemeh Neghabi
Mojtaba Abrishami
Mehdi Sakhaee
Mehrdad Motamed Shariati
author_sort Nasser Shoeibi
collection DOAJ
description Abstract Background This study aims to design and evaluate various supervised machine-learning models for identifying premature infants who require treatment based on demographic data and clinical findings from screening examinations. Methods We conducted a retrospective review of medical records for infants screened for retinopathy of prematurity (ROP) at our clinic over the past decade. We extracted demographic and clinical data, including eleven features: sex, maternal education, paternal education, birth weight, gestational age, ROP stage, zone of retinal involvement, age at examination, weight at examination, and CPR. We developed and assessed several classifiers: logistic regression (LR), decision tree (DT), support vector machine (SVM), naïve Bayes (NB), K-nearest neighbors (KNN), XGBoost, artificial neural networks (ANN), and random forest (RF). The target variable was defined as whether the neonate received any treatment during the follow-up period. Results Our analysis included data from 9,692 infants. Among the machine learning models evaluated, the XGBoost and ANN models achieved the highest accuracy at 96%. In terms of sensitivity (recall), the NB model exhibited the lowest false negative rate, indicating the highest sensitivity (0.99). In the context of premature neonates, accurately diagnosing those who require treatment is crucial. Therefore, from a clinical perspective, prioritizing a model with the lowest false negative rate may be more beneficial than selecting one based solely on the highest accuracy. Conclusion While AI can enhance decision-making processes by providing real-time risk assessments, these tools must be used to augment—not replace—clinical judgment. Clinicians must remain involved in interpreting model outputs and making final treatment decisions based on a holistic understanding of each patient’s unique circumstances. Clinical trial number Not applicable.
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spelling doaj-art-e75ab870dcf84b2c858eea9b1b99768e2025-08-20T03:03:41ZengBMCBMC Medical Informatics and Decision Making1472-69472025-07-0125111510.1186/s12911-025-03057-wDevelopment and validation of machine learning classifiers for predicting treatment-needed retinopathy of prematurityNasser Shoeibi0Majid Abrishami1Seyedeh Maryam Hosseini2Mohammad-Reza Ansari-Astaneh3Razieh Farrahi4Bahareh Gharib5Fatemeh Neghabi6Mojtaba Abrishami7Mehdi Sakhaee8Mehrdad Motamed Shariati9Eye Research Center, Mashhad University of Medical SciencesEye Research Center, Mashhad University of Medical SciencesEye Research Center, Mashhad University of Medical SciencesEye Research Center, Mashhad University of Medical SciencesDepartment of Health Information Technology, Ferdows Faculty of Medical SciencesEye Research Center, Mashhad University of Medical SciencesEye Research Center, Mashhad University of Medical SciencesEye Research Center, Mashhad University of Medical SciencesEye Research Center, Mashhad University of Medical SciencesEye Research Center, Mashhad University of Medical SciencesAbstract Background This study aims to design and evaluate various supervised machine-learning models for identifying premature infants who require treatment based on demographic data and clinical findings from screening examinations. Methods We conducted a retrospective review of medical records for infants screened for retinopathy of prematurity (ROP) at our clinic over the past decade. We extracted demographic and clinical data, including eleven features: sex, maternal education, paternal education, birth weight, gestational age, ROP stage, zone of retinal involvement, age at examination, weight at examination, and CPR. We developed and assessed several classifiers: logistic regression (LR), decision tree (DT), support vector machine (SVM), naïve Bayes (NB), K-nearest neighbors (KNN), XGBoost, artificial neural networks (ANN), and random forest (RF). The target variable was defined as whether the neonate received any treatment during the follow-up period. Results Our analysis included data from 9,692 infants. Among the machine learning models evaluated, the XGBoost and ANN models achieved the highest accuracy at 96%. In terms of sensitivity (recall), the NB model exhibited the lowest false negative rate, indicating the highest sensitivity (0.99). In the context of premature neonates, accurately diagnosing those who require treatment is crucial. Therefore, from a clinical perspective, prioritizing a model with the lowest false negative rate may be more beneficial than selecting one based solely on the highest accuracy. Conclusion While AI can enhance decision-making processes by providing real-time risk assessments, these tools must be used to augment—not replace—clinical judgment. Clinicians must remain involved in interpreting model outputs and making final treatment decisions based on a holistic understanding of each patient’s unique circumstances. Clinical trial number Not applicable.https://doi.org/10.1186/s12911-025-03057-wArtificial intelligenceMachine learningPrediction modelsRetinopathy of prematurityTreatment
spellingShingle Nasser Shoeibi
Majid Abrishami
Seyedeh Maryam Hosseini
Mohammad-Reza Ansari-Astaneh
Razieh Farrahi
Bahareh Gharib
Fatemeh Neghabi
Mojtaba Abrishami
Mehdi Sakhaee
Mehrdad Motamed Shariati
Development and validation of machine learning classifiers for predicting treatment-needed retinopathy of prematurity
BMC Medical Informatics and Decision Making
Artificial intelligence
Machine learning
Prediction models
Retinopathy of prematurity
Treatment
title Development and validation of machine learning classifiers for predicting treatment-needed retinopathy of prematurity
title_full Development and validation of machine learning classifiers for predicting treatment-needed retinopathy of prematurity
title_fullStr Development and validation of machine learning classifiers for predicting treatment-needed retinopathy of prematurity
title_full_unstemmed Development and validation of machine learning classifiers for predicting treatment-needed retinopathy of prematurity
title_short Development and validation of machine learning classifiers for predicting treatment-needed retinopathy of prematurity
title_sort development and validation of machine learning classifiers for predicting treatment needed retinopathy of prematurity
topic Artificial intelligence
Machine learning
Prediction models
Retinopathy of prematurity
Treatment
url https://doi.org/10.1186/s12911-025-03057-w
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