Phenotype Algorithms to Identify Hidradenitis Suppurativa Using Real-World Data: Development and Validation Study

Machine Learning for Early Detection of Hidradenitis Suppurativa: A Feasibility Study Using Medical Insurance Claims Data

Patients with hidradenitis suppurativa (HS) are often misdiagnosed and may wait up to 10 years to receive a diagnosis of HS. This study aimed to predict HS diagnosis prior to actual diagnosis on the basis of previous medical history using models developed with insurance claims data. Three machine learning models were compared with a model using features selected by a dermatologist (clinical baseline model). The study analyzed 5,900,000 United States individuals' insurance records over 13.5 years. The population included 13,886 patients with HS with at least 1 claim in each of the 2 years prior to their first HS diagnosis and 69,428 control patients with no HS diagnosis. The models aimed to classify HS diagnosis status on the basis of clinical features observed over 2 years. Model performance was assessed by area under the receiver operating characterisitic curve, F1-score, and precision and recall rates. The machine learning models (logistic regression, random forest, and XGBoost) showed a higher area under the receiver operating characterisitic curve than the clinical baseline model (logistic regression = 0.75, random forest = 0.79, XGBoost = 0.80, clinical = 0.71). In the clinical model and the best-performing XGBoost model, the top features associated with diagnosis were patient age at prediction and sex. The XGBoost model top features also included the use of sulfamethoxazole/trimethoprim and clindamycin phosphate and obesity.

Characteristics and treatment pathways in pediatric and adult hidradenitis suppurativa: An examination using real world data

Background

Hidradenitis suppurativa (HS) is a chronic, debilitating, inflammatory disease. Contemporaneous real-world data can be used to elucidate the clinical treatment of pediatric patients and how treatment strategies compare with adult hidradenitis suppurativa patients.

Objective

The objective of this study is to evaluate clinical and treatment characteristics of pediatric and adult HS patients.

Methods

HS adult and pediatric patients were identified in 3 the United States administrative claims databases during the study period between 2016 to 2021. Patients were required to have 2 diagnostic codes for HS and have at least 365 days of prior observation time to the first HS diagnosis.

Results

Pediatric and adult HS treatments were similar. The proportions of subjects treated with topical and oral antibiotic or oral antibiotic alone or topical medication alone or surgery alone covered 90% of the treated pediatric subjects and 91% of treated adult subjects. The remaining proportion of subjects received other treatment combinations.

Limitations

The databases represent subjects with commercial or government insurance coverage and thus do not necessarily represent the broader US population. The databases do not capture information about medications obtained without insurance.

Conclusions

Although subtle differences exist, this study confirms that topical and systemic therapeutic treatment of HS in adults and adolescents is very similar.