<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE root>
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="other" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Oncohematology</journal-id><journal-title-group><journal-title xml:lang="en">Oncohematology</journal-title><trans-title-group xml:lang="ru"><trans-title>Онкогематология</trans-title></trans-title-group></journal-title-group><issn publication-format="print">1818-8346</issn><issn publication-format="electronic">2413-4023</issn><publisher><publisher-name xml:lang="en">Publishing House ABV Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">1017</article-id><article-id pub-id-type="doi">10.17650/1818-8346-2025-20-1-171-181</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>SUPPORTIVE THERAPY ASPECTS</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>АСПЕКТЫ ПОДДЕРЖИВАЮЩЕЙ ТЕРАПИИ</subject></subj-group><subj-group subj-group-type="article-type"><subject></subject></subj-group></article-categories><title-group><article-title xml:lang="en">Development of a method for differential diagnosis of iron deficiency anemia and anemia of chronic disease based on demographic data and routine laboratory tests using machine learning technologies</article-title><trans-title-group xml:lang="ru"><trans-title>Разработка метода дифференциальной диагностики железодефицитной анемии и анемии хронических болезней на основе демографических данных и результатов рутинных лабораторных исследований с использованием технологий машинного обучения</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0004-0969-6144</contrib-id><name-alternatives><name xml:lang="en"><surname>Varekha</surname><given-names>N. V.</given-names></name><name xml:lang="ru"><surname>Вареха</surname><given-names>Н. В.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Nikolay Vyacheslavovich Varekha</p><p>117198; 6 Miklukho-Maklaya St.; Moscow</p></bio><bio xml:lang="ru"><p>Николай Вячеславович Вареха</p><p>117198; ул. Миклухо-Маклая, 6; Москва</p></bio><email>niki2187@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4546-1578</contrib-id><name-alternatives><name xml:lang="en"><surname>Stuklov</surname><given-names>N. I.</given-names></name><name xml:lang="ru"><surname>Стуклов</surname><given-names>Н. И.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>117198; 6 Miklukho-Maklaya St.; Moscow</p></bio><bio xml:lang="ru"><p>117198; ул. Миклухо-Маклая, 6; Москва</p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5381-1013</contrib-id><name-alternatives><name xml:lang="en"><surname>Gordienko</surname><given-names>K. V.</given-names></name><name xml:lang="ru"><surname>Гордиенко</surname><given-names>К. В.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>123007; 76A Khoroshevskoe Shosse; Moscow</p></bio><bio xml:lang="ru"><p>123007; Хорошевское шоссе, 76А; Москва</p></bio><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9567-3317</contrib-id><name-alternatives><name xml:lang="en"><surname>Gimadiev</surname><given-names>R. R.</given-names></name><name xml:lang="ru"><surname>Гимадиев</surname><given-names>Р. Р.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>117198; 6 Miklukho-Maklaya St.; 123007; 76A Khoroshevskoe Shosse; 119002; Build. 1, 14 Bolshoy Vlasyevsky Pereulok; Moscow</p></bio><bio xml:lang="ru"><p>117198; ул. Миклухо-Маклая, 6; 123007; Хорошевское шоссе, 76А; 119002; Большой Власьевский пер., 14, стр. 1; Москва</p></bio><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3493-1415</contrib-id><name-alternatives><name xml:lang="en"><surname>Shchegolev</surname><given-names>O. B.</given-names></name><name xml:lang="ru"><surname>Щеголев</surname><given-names>О. Б.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>119002; Build. 1, 14 Bolshoy Vlasyevsky Pereulok; Moscow</p></bio><bio xml:lang="ru"><p>119002; Большой Власьевский пер., 14, стр. 1; Москва</p></bio><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2523-5944</contrib-id><name-alternatives><name xml:lang="en"><surname>Kislaya</surname><given-names>S. N.</given-names></name><name xml:lang="ru"><surname>Кислая</surname><given-names>С. Н.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>117198; 6 Miklukho-Maklaya St.; Moscow</p></bio><bio xml:lang="ru"><p>117198; ул. Миклухо-Маклая, 6; Москва</p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0004-7507-8205</contrib-id><name-alternatives><name xml:lang="en"><surname>Gubina</surname><given-names>E. V.</given-names></name><name xml:lang="ru"><surname>Губина</surname><given-names>Е. В.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>119002; Build. 1, 14 Bolshoy Vlasyevsky Pereulok; Moscow</p></bio><bio xml:lang="ru"><p>119002; Большой Власьевский пер., 14, стр. 1; Москва</p></bio><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4164-0058</contrib-id><name-alternatives><name xml:lang="en"><surname>Gurkina</surname><given-names>A. A.</given-names></name><name xml:lang="ru"><surname>Гуркина</surname><given-names>А. А.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>117198; 6 Miklukho-Maklaya St.; Moscow</p></bio><bio xml:lang="ru"><p>117198; ул. Миклухо-Маклая, 6; Москва</p></bio><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Рeoples’ Friendship University of Russia named after Patrice Lumumba</institution></aff><aff><institution xml:lang="ru">ФГАОУ ВО «Российский университет дружбы народов им. Патриса Лумумбы»</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Institute of Biomedical Problems, Russian Academy of Sciences</institution></aff><aff><institution xml:lang="ru">ФГБУН «Государственный научный центр Российской Федерации – Институт медико-биологических проблем РАН»</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">LabHub LLC</institution></aff><aff><institution xml:lang="ru">ООО «ЛабХаб»</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2025-03-19" publication-format="electronic"><day>19</day><month>03</month><year>2025</year></pub-date><volume>20</volume><issue>1</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>171</fpage><lpage>181</lpage><history><date date-type="received" iso-8601-date="2025-03-22"><day>22</day><month>03</month><year>2025</year></date><date date-type="accepted" iso-8601-date="2025-03-22"><day>22</day><month>03</month><year>2025</year></date></history><permissions><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/></permissions><self-uri xlink:href="https://oncohematology.abvpress.ru/ongm/article/view/1017">https://oncohematology.abvpress.ru/ongm/article/view/1017</self-uri><abstract xml:lang="en"><p><bold>   Background. </bold>The study of machine learning methods, a branch of artificial intelligence science, is relevant for the development of optimal screening strategies, identification of risk groups, and application of less expensive and more accessible laboratory tests to assess the body iron status.</p><p><bold>   Aim.</bold> To select an appropriate artificial intelligence algorithm for predicting serum ferritin (SF) levels and to evaluate its applicability for differential diagnosis of iron deficiency anemia and anemia of chronic diseases.</p><p><bold>   Materials and methods. </bold>A dataset of 9771 patients with micro‑normocytic anemia was used to create the model. On the basis of demographic data (gender and age), clinical blood count, C‑reactive protein level and known SF level, a regression model was developed to calculate the expected SF concentration in a particular patient and, using the same parameters, a classification model to determine the SF level group to which the patient belongs: I – &lt; 15 μg / L; II – 15–100 μg / L; III – 100–300 μg / L; Iv – ≥ 300 μg / L.</p><p><bold>   Results.</bold> As a result, the regression model has moderate predictive ability (R<sup>2</sup> = 0.70; median absolute error was 10.7 μg / L), the correlation coefficient between known and predicted SF level was r = 0.854 (p &lt; 0.05). The obtained classification model has high diagnostic accuracy for different clinical groups according to the SF level (AuC ROC was 0.91; 0.79; 0.84; 0.90 and 0.96; 0.76; 0.71; 0.82 for patients with reduced hemoglobin levels in women (&lt; 120 g / L) and men (&lt; 130 g / L) in groups I, II, III, Iv, respectively).</p><p><bold>   Conclusion. </bold>Prediction of SF level using the developed models can be used as an accurate and clinically relevant tool for differential diagnosis of iron deficiency anemia (predicted SF is decreased (&lt; 100 μg / L), C‑reactive protein is normal) and anemia of chronic diseases (predicted SF is normal or increased (&gt;100 μg / L), C‑reactive protein is increased) in real medical practice.</p></abstract><trans-abstract xml:lang="ru"><p><bold>   Введение. </bold>Изучение возможностей методов машинного обучения – раздела науки об искусственном интеллекте –  актуально для разработки оптимальной скрининг‑стратегии, определения групп риска, применения менее дорогостоящих и более доступных лабораторных тестов для оценки статуса железа в организме.</p><p><bold>   Цель исследования</bold> – подобрать подходящий алгоритм машинного обучения для прогнозирования уровня ферритина сыворотки (ФС) и оценить его применимость для дифференциальной диагностики железодефицитной анемии и анемии хронических болезней.</p><p><bold>   Материалы и методы.</bold> Для создания модели использовали набор данных 9771 пациента c микро‑ и нормоцитарными анемиями. На основе демографических данных (пол и возраст), клинического анализа крови, содержания С‑реактивного белка и известного уровня ФС разработаны регрессионная модель для расчета предполагаемой концентрации ФС у конкретного пациента и с использованием тех же параметров классификационная модель для определения группы уровня ФС, к которой относится пациент: I – &lt; 15 мкг / л; II – 15–100 мкг / л; III – 100–300 мкг / л; Iv – ≥ 300 мкг / л.</p><p><bold>   Результаты. </bold>Полученная регрессионная модель обладает умеренной предиктивной способностью (R<sup>2</sup> = 0,70; медианная абсолютная ошибка 10,7 мкг / л), коэффициент корреляции между известным и прогнозируемым уровнем ФС составил r = 0,85 (p &lt; 0,05). Классификационная модель обладает высокой диагностической точностью для разных клинических групп по уровню ФС (площадь под кривой ошибок составила 0,91; 0,79; 0,84; 0,90 и 0,96; 0,76; 0,71; 0,82 для пациентов со сниженным уровнем гемоглобина женского (&lt; 120 г / л) и мужского пола (&lt; 130 г / л) в группах I, II, III, Iv соответственно).</p><p><bold>   Заключение. </bold>Прогнозирование содержания ФС с помощью разработанных моделей может использоваться в качестве точного и клинически значимого инструмента для дифференциальной диагностики железодефицитной анемии (прогнозируемый ФС понижен (&lt; 100 мкг / л), содержание С‑реактивного белка в норме) и анемии хронических болезней (прогнозируемый ФС в норме или повышен (&gt; 100 мкг / л), содержание С‑реактивного белка повышено) в реальной врачебной практике.</p></trans-abstract><kwd-group xml:lang="en"><kwd>iron deficiency</kwd><kwd>iron‑deficiency anemia</kwd><kwd>anemia of chronic diseases</kwd><kwd>artificial intelligence</kwd><kwd>machine learning</kwd><kwd>ferritin</kwd><kwd>C‑reactive protein</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>дефицит железа</kwd><kwd>железодефицитная анемия</kwd><kwd>анемия хронических болезней</kwd><kwd>искусственный интеллект</kwd><kwd>машинное обучение</kwd><kwd>ферритин</kwd><kwd>C‑реактивный белок</kwd></kwd-group><funding-group><funding-statement xml:lang="en">The study was performed without external funding</funding-statement><funding-statement xml:lang="ru">Исследование проведено без спонсорской поддержки</funding-statement></funding-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and mineral nutrition information system. Geneva: World Health Organization, 2011. 6 p.</mixed-citation></ref><ref id="B2"><label>2.</label><citation-alternatives><mixed-citation xml:lang="en">Ministry of Health of Russia. Iron deficiency anemia. Clinical guidelines. 2024. Available at: https://cr.minzdrav.gov.ru/view-cr/669_2 (In Russ.).</mixed-citation><mixed-citation xml:lang="ru">Министерство здравоохранения Российской Федерации. Железодефицитная анемия. Клинические рекомендации. 2024. Доступно по: https://cr.minzdrav.gov.ru/view­cr/669_2</mixed-citation></citation-alternatives></ref><ref id="B3"><label>3.</label><citation-alternatives><mixed-citation xml:lang="en">Sakhin V.T., Kryukov E.V., Rukavitsyn O.A. Anemia of chronic diseases – the key mechanisms of pathogenesis and the attempt of the classification. Tikhookeanskiy meditsinskiy zhurnal = Pacific Medical Journal 2019;(1):33–7. (In Russ.). DOI: 10.17238/PmJ1609­1175.2019.1.33–37</mixed-citation><mixed-citation xml:lang="ru">Сахин В.Т., Крюков Е.В., Рукавицын О.А. Анемия хрони­ческих заболеваний – особенности патогенеза и попытка классификации. Тихоокеанский медицинский журнал 2019;(1):33–7. DOI: 10.17238/PmJ1609­1175.2019.1.33–37</mixed-citation></citation-alternatives></ref><ref id="B4"><label>4.</label><mixed-citation>Hoofnagle A.N. Harmonization of blood­based indicators of iron status: making the hard work matter. Am J Clin Nutr 2017;106(Suppl 6):1615S–9. DOI: 10.3945/ajcn.117.155895</mixed-citation></ref><ref id="B5"><label>5.</label><mixed-citation>Dogan S., Turkoglu I. Iron­deficiency anemia detection from hematology parameters by using decision trees. Int J Sci Technol 2008;3(1):85–92.</mixed-citation></ref><ref id="B6"><label>6.</label><mixed-citation>Azarkhish I., Raoufy M.R., Gharibzadeh S. Artificial intelligence models for predicting iron deficiency anemia and iron serum level based on accessible laboratory data. J Med Syst 2012;36(3):2057–61. DOI: 10.1007/s10916­011­9668­3</mixed-citation></ref><ref id="B7"><label>7.</label><mixed-citation>Luo Y., Szolovits P., Dighe A.S., Baron J.M. Using machine learning to predict laboratory test results. Am J Clin Pathol 2016;145(6):778–88. DOI: 10.1093/ajcp/aqw064</mixed-citation></ref><ref id="B8"><label>8.</label><mixed-citation>Pullakhandam S., McRoy S. Classification and explanation of iron deficiency anemia from complete blood count data using machine learning. BioMedInformatics 2024;4(1):661–72. DOI: 10.3390/biomedinformatics4010036</mixed-citation></ref><ref id="B9"><label>9.</label><mixed-citation>Yılmaz Z., Bozkurt M.R. Determination of women iron deficiency anemia using neural networks. J Med Syst 2012;36(5):2941–5. DOI: 10.1007/s10916­011­9772­4</mixed-citation></ref><ref id="B10"><label>10.</label><mixed-citation>Kurstjens S., de Bel T., van der Horst A. et al. Automated prediction of low ferritin concentrations using a machine learning algorithm. Clin Chem Lab Med 2022;60(12):1921–8. DOI: 10.1515/cclm­2021­1194</mixed-citation></ref><ref id="B11"><label>11.</label><mixed-citation>Terzi E., Sarıbacak B., Sağlam F., Cengiz M.A. A novel expert system for diagnosis of iron deficiency anemia. Comput Math Methods Med 2022;2022:7352096. DOI: 10.1155/2022/7352096</mixed-citation></ref><ref id="B12"><label>12.</label><mixed-citation>McDermott M., Dighe A.S., Szolovits P. et al. Using machine learning to develop smart reflex testing protocols. J Am Med Inform Assoc 2023;31(2):416–25. DOI: 10.1093/jamia/ocad187</mixed-citation></ref><ref id="B13"><label>13.</label><mixed-citation>WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations. Geneva: World Health Organization, 2020.</mixed-citation></ref><ref id="B14"><label>14.</label><mixed-citation>Schop A., Stouten K., van Houten R. et al. Diagnostics in anaemia of chronic disease in general practice: a real­world retrospective cohort study. BJGP Open 2018;2(3):bjgpopen18X101597. DOI: 10.3399/bjgpopen18x101597</mixed-citation></ref><ref id="B15"><label>15.</label><mixed-citation>Weiss G., Goodnough L. Anemia of chronic disease. N Engl J Med 2005;352(10):1011–23. DOI: 10.1056/NEJMra041809</mixed-citation></ref><ref id="B16"><label>16.</label><mixed-citation>Vakhrushev A., Ryzhkov A., Savchenko M. et al. LightAutoML: AutoML solution for a large financial services ecosystem. arXiv 2021;2109.01528. DOI: 10.48550/arXiv.2109.01528</mixed-citation></ref><ref id="B17"><label>17.</label><mixed-citation>Nick T.G., Campbell K.M. Logistic regression. Methods Mol Biol 2007;404:273–301. DOI: 10.1007/978­1­59745­530­5_14</mixed-citation></ref><ref id="B18"><label>18.</label><mixed-citation>Ke G., Meng Q., Finley T. et al. LightGBM: a highly efficient gradient boosting decision tree. Advances in neural information processing systems 2017;30:3149–57.</mixed-citation></ref><ref id="B19"><label>19.</label><mixed-citation>Moritz P., Nishihara R., Jordan M. A linearly­convergent stochastic L­BFGS algorithm. Artificial Intelligence and Statistics 2016;249–58.</mixed-citation></ref><ref id="B20"><label>20.</label><mixed-citation>Fushiki T. Estimation of prediction error by using K­fold cross-validation. Statistics and Computing 2011;21:137–46. DOI: 10.1007/s11222­009­9153­8</mixed-citation></ref><ref id="B21"><label>21.</label><mixed-citation>Swets J.A., Dawes R.M., Monahan J. Better decisions through science. Sci Am 2000;283(4):82–7. DOI: 10.1038/scientificamerican1000­82</mixed-citation></ref><ref id="B22"><label>22.</label><mixed-citation>Das K.R., Imon A. A brief review of tests for normality. Am J Theor Appl Stat 2016;5(1):5–12. DOI: 10.11648/j.ajtas.20160501.12</mixed-citation></ref><ref id="B23"><label>23.</label><mixed-citation>Meissel K., Yao E.S. Using Cliff’s delta as a non­parametric effect size measure: an accessible web app and R tutorial. Practical Assessment, Research, and Evaluation 2024;29(1). DOI: 10.7275/pare.1977</mixed-citation></ref><ref id="B24"><label>24.</label><citation-alternatives><mixed-citation xml:lang="en">Federal State Statistics Service. Population of the Russian Federation by gender and age by January 1, 2021. 2021. Available at: https://rosstat.gov.ru/storage/mediabank/Bul_chislen_nasel-pv_01­01­2021.pdf (accessed 23. 04. 2022).</mixed-citation><mixed-citation xml:lang="ru">Федеральная служба государственной статистики. Численность населения Российской Федерации по полу и возрасту на 1 января 2021 года. 2021. Доступно по: https://rosstat.gov.ru/storage/mediabank/Bul_chislen_nasel­-pv_01­01­2021.pdf (дата обращения 23. 04. 2022).</mixed-citation></citation-alternatives></ref></ref-list></back></article>
