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Table 6 The sensitivity, specificity, and positive likelihood ratio of predicting the index MDT decisions using the best machine learning model versus using ESMO and NCCN guidelines

From: Computational prediction of multidisciplinary team decision-making for adjuvant breast cancer drug therapies: a machine learning approach

MDT recommendation

Accuracy of prediction by

Modality

Recommended

Best ML modela

ESMO Guidelines

NCCN Guidelines

Strategy

N (%)

Sens/Spec

LR+

Sens/Spec

LR+

Pb

Sens/Spec

LR+

Pb

Chemotherapy

 Aggressive

582 (60)

0.93/0.89

8.8

0.55 c /0.78 c

2.5

<0.01

0.97/0.12c

1.1

<0.01

 Conservative

342 (35)

0.86/0.95

16.7

0.60 c /0.82 c

3.3

<0.01

0.82/0.71c

2.9

<0.01

Endocrine

 Aggressive

916 (91)

0.98/0.85

6.5

0.98/0.81

5.2

0.68

0.97/0.75

3.9

0.25

 Conservative

794 (79)

0.97/0.65

2.8

0.99/0.36c

1.5

0.30

0.96/0.50

1.9

0.37

Trastuzumab

 Aggressive

93 (20)

0.98/0.99

77.9

0.97/0.97

33.3

0.60

0.97/0.98

45.2

0.73

 Conservative

86 (19)

0.95/0.99

122.9

0.97/0.96

24.0

0.24

0.92/0.98

37.7

0.28

  1. The sensitivity (sens), specificity (spec), and the positive likelihood ratio (LR+) when using the best machine learning models or guideline to predict MDT recommendations
  2. Note: aThe best models were ripple down rules for the chemotherapy decisions, polynomial SVM for the aggressive endocrine decisions, and ADTree for the remaining groups
  3. bpairwise comparisons of likelihood ratios using two-sided z-test (i.ebest model vs. guideline)
  4. cthe best model performed better than the guideline