RESUMO
Identifying patients with rare diseases associated with common symptoms is challenging. Hunter syndrome, or Mucopolysaccharidosis type II is a progressive rare disease caused by a deficiency in the activity of the lysosomal enzyme, iduronate 2-sulphatase. It is inherited in an X-linked manner resulting in males being significantly affected. Expression in females varies with the majority being unaffected although symptoms may emerge over time. We developed a Naïve Bayes classification (NBC) algorithm utilizing the clinical diagnosis and symptoms of patients contained within their de-identified and unstructured electronic medical records (EMR) extracted by the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). To do so, we created a training dataset using published results in the scientific literature and from all MPS II symptoms and applied the training dataset and its independent features to compute the conditional posterior probabilities of having MPS II disease as a categorical dependent variable for 506497 male patients. The classifier identified 125 patients with the highest likelihood for having the disease and 18 features were selected to be necessary for forecasting. Next, a Recursive Backward Feature Elimination algorithm was employed, for optimal input features of the NBC model, using a k-fold Cross-Validation with 3 replicates. The accuracy of the final model was estimated by the Validation Set Approach technique and the bootstrap resampling. We also investigated that whether the NBC is as accurate as three other Bayesian networks. The Naïve Bayes Classifier appears to be an efficient algorithm in assisting physicians with the diagnosis of Hunter syndrome allowing optimal patient management.
Assuntos
Diagnóstico por Computador/métodos , Mucopolissacaridose II/classificação , Doenças Raras/classificação , Algoritmos , Teorema de Bayes , Canadá , Mineração de Dados , Registros Eletrônicos de Saúde , Humanos , Masculino , Mucopolissacaridose II/diagnóstico , Reconhecimento Automatizado de Padrão , Atenção Primária à Saúde , Doenças Raras/diagnóstico , Vigilância de Evento Sentinela , Adulto JovemRESUMO
Review of the literature on Hunter's syndrome and oral manifestations in pediatric dental patients including the primary and secondary systemic manifestations are presented. Numerous oral manifestations are presented as well. Based on the cases presented in the reviewed studies, little information is available on oral considerations and treatment of these children. Early restoration of the oral cavity is important prior to treatment of the disease itself.