The Improved-EFI Score: A Multi-Omics-Based Novel Efficacy Predictive Tool for Predicting the Natural Fertility of Endometriosis Patients

Qiumin He,1,* Chongyuan Zhang,2,* Yao Hu,1 Jinfang Deng,1 Shuirong Zhang1 1Department of Gynaecology,Jingzhou Central Hospital, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, People’s Republic of China; 2Department of Gynaecology,Jingzhou Maternal and Ch...

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Main Authors: He Q, Zhang C, Hu Y, Deng J, Zhang S
Format: Article
Language:English
Published: Dove Medical Press 2025-02-01
Series:International Journal of General Medicine
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Online Access:https://www.dovepress.com/the-improved-efi-score-a-multi-omics-based-novel-efficacy-predictive-t-peer-reviewed-fulltext-article-IJGM
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author He Q
Zhang C
Hu Y
Deng J
Zhang S
author_facet He Q
Zhang C
Hu Y
Deng J
Zhang S
author_sort He Q
collection DOAJ
description Qiumin He,1,* Chongyuan Zhang,2,* Yao Hu,1 Jinfang Deng,1 Shuirong Zhang1 1Department of Gynaecology,Jingzhou Central Hospital, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, People’s Republic of China; 2Department of Gynaecology,Jingzhou Maternal and Child Health Hospital, Jingzhou, Hubei, 434000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shuirong Zhang, Email zhangshuirong1024@163.comObjective: Infertility caused by endometriosis (EM) directly affects the possibility of pregnancy in women of gestational age. This study aims to establish a prediction model to accurately predict the natural pregnancy outcome of patients with EM, providing valuable information for clinical decision-making.Methods: We retrospectively selected a total of 496 patients who underwent their first laparoscopic surgery for infertility at the Obstetrics and Gynecology Department of Jingzhou Central Hospital from January 2016 to June 2023. An improved endometriosis fertility index (EFI) predictive model was created based on ultrasound radiomics and urinary proteomics gathered during the patient’s initial admission, using two machine learning algorithms. The predictive model was evaluated for C-index, calibration, and clinical applicability through receiver working characteristic curve, decision curve analysis.Results: The improved EFI prediction model nomogram, based on five ultrasound radiomics parameters and three urine proteomics, had AUC values of 0.921 (95% CI: 0.864– 0.978) and 0.909 (95% CI: 0.852– 0.966) in the training and validation sets, respectively, while the traditional EFI prediction model had AUC values of 0.889 (95% CI: 0.832– 0.946) and 0.873 (95% CI: 0.816– 0.930) in the training and validation sets, respectively. Additionally, the nomogram exhibited better discrimination ability and achieved an overall better benefit against threshold probability than the EFI model and decision tree in the decision curve analysis (DCA).Conclusion: The combined ultrasound radiomics–urine proteomics model was better able to predict natural pregnancy-associated patients with EM compared to the classical EFI score. This can help clinicians better predict an individual patient’s risk of natural pregnancy following a first-ever laparoscopic surgery and facilitate earlier diagnosis and treatment.Keywords: endometriosis, infertility, Endometriosis Fertility Index, radiomics, uromics, prediction
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spelling doaj-art-ebe6e84f241b4e028a2db437d987c4412025-08-20T02:14:31ZengDove Medical PressInternational Journal of General Medicine1178-70742025-02-01Volume 18881895100347The Improved-EFI Score: A Multi-Omics-Based Novel Efficacy Predictive Tool for Predicting the Natural Fertility of Endometriosis PatientsHe QZhang CHu YDeng JZhang SQiumin He,1,* Chongyuan Zhang,2,* Yao Hu,1 Jinfang Deng,1 Shuirong Zhang1 1Department of Gynaecology,Jingzhou Central Hospital, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, People’s Republic of China; 2Department of Gynaecology,Jingzhou Maternal and Child Health Hospital, Jingzhou, Hubei, 434000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shuirong Zhang, Email zhangshuirong1024@163.comObjective: Infertility caused by endometriosis (EM) directly affects the possibility of pregnancy in women of gestational age. This study aims to establish a prediction model to accurately predict the natural pregnancy outcome of patients with EM, providing valuable information for clinical decision-making.Methods: We retrospectively selected a total of 496 patients who underwent their first laparoscopic surgery for infertility at the Obstetrics and Gynecology Department of Jingzhou Central Hospital from January 2016 to June 2023. An improved endometriosis fertility index (EFI) predictive model was created based on ultrasound radiomics and urinary proteomics gathered during the patient’s initial admission, using two machine learning algorithms. The predictive model was evaluated for C-index, calibration, and clinical applicability through receiver working characteristic curve, decision curve analysis.Results: The improved EFI prediction model nomogram, based on five ultrasound radiomics parameters and three urine proteomics, had AUC values of 0.921 (95% CI: 0.864– 0.978) and 0.909 (95% CI: 0.852– 0.966) in the training and validation sets, respectively, while the traditional EFI prediction model had AUC values of 0.889 (95% CI: 0.832– 0.946) and 0.873 (95% CI: 0.816– 0.930) in the training and validation sets, respectively. Additionally, the nomogram exhibited better discrimination ability and achieved an overall better benefit against threshold probability than the EFI model and decision tree in the decision curve analysis (DCA).Conclusion: The combined ultrasound radiomics–urine proteomics model was better able to predict natural pregnancy-associated patients with EM compared to the classical EFI score. This can help clinicians better predict an individual patient’s risk of natural pregnancy following a first-ever laparoscopic surgery and facilitate earlier diagnosis and treatment.Keywords: endometriosis, infertility, Endometriosis Fertility Index, radiomics, uromics, predictionhttps://www.dovepress.com/the-improved-efi-score-a-multi-omics-based-novel-efficacy-predictive-t-peer-reviewed-fulltext-article-IJGMendometriosisinfertilityendometriosis fertility indexradiomicsuromicsprediction
spellingShingle He Q
Zhang C
Hu Y
Deng J
Zhang S
The Improved-EFI Score: A Multi-Omics-Based Novel Efficacy Predictive Tool for Predicting the Natural Fertility of Endometriosis Patients
International Journal of General Medicine
endometriosis
infertility
endometriosis fertility index
radiomics
uromics
prediction
title The Improved-EFI Score: A Multi-Omics-Based Novel Efficacy Predictive Tool for Predicting the Natural Fertility of Endometriosis Patients
title_full The Improved-EFI Score: A Multi-Omics-Based Novel Efficacy Predictive Tool for Predicting the Natural Fertility of Endometriosis Patients
title_fullStr The Improved-EFI Score: A Multi-Omics-Based Novel Efficacy Predictive Tool for Predicting the Natural Fertility of Endometriosis Patients
title_full_unstemmed The Improved-EFI Score: A Multi-Omics-Based Novel Efficacy Predictive Tool for Predicting the Natural Fertility of Endometriosis Patients
title_short The Improved-EFI Score: A Multi-Omics-Based Novel Efficacy Predictive Tool for Predicting the Natural Fertility of Endometriosis Patients
title_sort improved efi score a multi omics based novel efficacy predictive tool for predicting the natural fertility of endometriosis patients
topic endometriosis
infertility
endometriosis fertility index
radiomics
uromics
prediction
url https://www.dovepress.com/the-improved-efi-score-a-multi-omics-based-novel-efficacy-predictive-t-peer-reviewed-fulltext-article-IJGM
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