1
|
Donaldson K, Cardamone D, Genovese M, Garbely J, Demers L. Clinical Performance of a Gene-Based Machine Learning Classifier in Assessing Risk of Developing OUD in Subjects Taking Oral Opioids: A Prospective Observational Study. Ann Clin Lab Sci 2021; 51:451-460. [PMID: 34452883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To reduce the incidence of Opioid Use Disorder (OUD), multiple guidelines recommend assessing the risk of OUD prior to prescribing oral opioids. Although subjective risk assessments are available to help classify subjects at risk for OUD, we are aware of no clinically validated objective risk assessment tools. An objective risk assessment based on genetics may help inform shared decision-making prior to prescribing short-duration oral opioids. METHODS A multicenter, observational cohort of adults exposed to prescription oral opioids for 4-30 days was conducted to determine the performance of an OUD classifier derived from machine learning (ML). From this cohort, the demographics of the U.S. adult opioid-prescribed population were used to create a blinded, random, representative group of subjects (n=385) for analysis to accurately estimate the performance characteristics in the intended use population. Genotyping was performed via a qualitative SNP microarray on DNA extracted from buccal samples. RESULTS In the study subjects, the classifier demonstrated 82.5% sensitivity (95% confidence intervals: 76.1%-87.8%) and 79.9% specificity (73.7-85.2%), with no statistically significant differences in clinical performance observed based on gender, age, length of follow-up from opioid exposure, race, or ethnicity. CONCLUSION This study demonstrates an ML classifier may provide additional objective information regarding a patient's risk of developing OUD. This information may enable subjects and healthcare providers to make more informed decisions when considering the use of oral opioids.
Collapse
|
2
|
Donaldson K, Buchanich JM, Grigson PS, Deneke E, Donaldson K, Vrana KE, Sacks DB, Kuehn GJ, Cardamone D, Pesce A, Smiley S, Nickley J, Krock K, Thomas R, Wilkerson ML, Farag HA, Challa SR, Tice AM, Wolk DM, Prichard J, Grant ML, Regmi S, Kerbacher B, Quinton LE, Farag HA, Tice AM, Wolk DM, Olson J, Haynes A, Yu E, McCully KS, Assi J, Wong M, Zarrin-Khameh N, Nifong TP, Hawker CD, Carlton GT, Rivera JM, Foulis PR, Zuraw A, Morlote D, Peker D, Reddy V, Harada S, Crutchfield C, Zander D, Barbhuiya MA, Pederson EC, Straub ML, Scott SC, Neibauer TL, Salter WF, Creer MH, Zhu Y, Bornhorst JA, Theobald JP, Algeciras-Schimnich A, Cao L, Knox J, Hardy R, Texas HJ, McGuire MF, Hunter RL, Brown RE, Hicks J, Hicks J, Cai Z, Brown RE, Ali Y, Cheng KC, Katz SR, Ding Y, Vanselow DJ, Yakovlev MA, Lin AY, Clark DP, Vargas P, Xin X, Copper JE, Canfield VA, Ang KC, Wang Y, Xiao X, De Carlo F, van Rossum DB, La Rivière PJ, Newell J, Hossler C, Roche M, Warrick J, Phaeton R, Kesterson J, Donaldson K, Myers C, Barrios R, Mintz P, Robyak K, Hamilton C, McGhee P, Pederson C, Straub M, Scott S, Neibauer T, Salter W, Creer M, Zhu Y, Hamilton C, Robyak K, McGhee P, Pederson C, Straub M, Scott S, Neibauer T, Salter W, Creer M, Zhu Y, Singh N, Morlote D, Vnencak-Jones C, Yemelyanova A, Harada S, Shah M, Moghadamtousi SZ, Lan C, Duose D, Hu P, Esquenazi Y, Luthra R, Ballester LY, Koenig AN, Liu CG, Zhang J, Kalia A, Al-Habib A, Van Arsdall M, Dhingra S, Patel K, Tatevian N. Abstracts of Presentations at the Association of Clinical Scientists 139 th Meeting Hershey, PA, May 15-18, 2019. Ann Clin Lab Sci 2019; 49:403-416. [PMID: 31308044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Robert E Brown
- UT Health McGovern Medical School at Houston, Houston, TX
| | | | | | | | | | | | - Keith C Cheng
- Department of Pathology, Penn State College of Medicine
| | | | - Yifu Ding
- Department of Pathology, Penn State College of Medicine
| | | | | | - Alex Y Lin
- Department of Pathology, Penn State College of Medicine
| | | | | | - Xuying Xin
- Department of Pathology, Penn State College of Medicine
| | - Jean E Copper
- Department of Pathology, Penn State College of Medicine
| | | | - Khai C Ang
- Department of Pathology, Penn State College of Medicine
| | - Yuxin Wang
- Omnivision Technologies, Santa Clara, CA
| | - Xianghui Xiao
- Advanced Photon Source, Argonne National Laboratory, University of Chicago
- Brookhaven National Laboratory, University of Chicago
| | - Francesco De Carlo
- Advanced Photon Source, Argonne National Laboratory, University of Chicago
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Mauli Shah
- Graduate Program in Diagnostic Genetics, School of Health Professions, UT MD Anderson Cancer Center, Houston, TX
| | | | - Chieh Lan
- Department of Translational Molecular Pathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Dzifa Duose
- Department of Translational Molecular Pathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Peter Hu
- Graduate Program in Diagnostic Genetics, School of Health Professions, UT MD Anderson Cancer Center, Houston, TX
| | - Yoshua Esquenazi
- Department of Neurosurgery, McGovern Medical School, University of Texas Health Science Center, Houston, TX
| | - Rajyalakshmi Luthra
- Department of Hematopathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Leomar Y Ballester
- Department of Neurosurgery, McGovern Medical School, University of Texas Health Science Center, Houston, TX
| | | | | | | | | | - Ali Al-Habib
- The University of Texas Health Science Center, Houston, TX
| | | | | | | | - Nina Tatevian
- The University of Texas Health Science Center, Houston, TX
| |
Collapse
|
4
|
Babushok DV, Cardamone D, Rulander N, Master SR, Hexner EO. A common, under-recognized cause of elevated serum erythropoietin. Am J Med 2014; 127:e7-8. [PMID: 25149545 PMCID: PMC5621041 DOI: 10.1016/j.amjmed.2014.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 08/02/2014] [Accepted: 08/04/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Daria V Babushok
- Abramson Cancer Center and Department of Medicine, University of Pennsylvania, Philadelphia
| | - David Cardamone
- William Pepper Laboratories, Hospital of the University of Pennsylvania, Philadelphia
| | - Nichole Rulander
- William Pepper Laboratories, Hospital of the University of Pennsylvania, Philadelphia
| | - Stephen R Master
- William Pepper Laboratories, Hospital of the University of Pennsylvania, Philadelphia; Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Elizabeth O Hexner
- Abramson Cancer Center and Department of Medicine, University of Pennsylvania, Philadelphia.
| |
Collapse
|
6
|
Abstract
Immunoassays are commonly used for clinical diagnosis, although interferences have been well documented. The streptavidin-biotin interaction provides an efficient and convenient method to manipulate assay components and is currently used in several immunoassay platforms. To date, there has been no report in the literature of interference from endogenous anti-streptavidin antibodies; however, such antibodies would potentially affect multiple diagnostic platforms. We report results from a patient being treated for thyroid dysfunction who demonstrated a T-uptake result of less than 0.2 and a nonlinear thyroid stimulating hormone dilution that suggested an immunoassay interference. Protein-A sepharose pretreatment corrected the nonlinear dilution and revealed an interference trend of falsely decreased results, as measured by sandwich assay, and falsely elevated results, as measured by competitive assay. The results of streptavidin-agarose adsorption were comparable to adsorption with protein-A sepharose. To our knowledge, this is the first published description of an endogenous anti-streptavidin antibody interfering with clinical laboratory assays.
Collapse
Affiliation(s)
- Nichole Johnson Rulander
- From the William Pepper Laboratories, Hospital of the University of Pennsylvania, Philadelphia (Drs Senior and Master, Ms Rulander, and Mr Cardamone); and the Division of Endocrinology, Diabetes, and Metabolism (Dr Snyder) and the Department of Pathology and Laboratory Medicine (Dr Master), Perelman School of Medicine, University of Pennsylvania
| | - David Cardamone
- From the William Pepper Laboratories, Hospital of the University of Pennsylvania, Philadelphia (Drs Senior and Master, Ms Rulander, and Mr Cardamone); and the Division of Endocrinology, Diabetes, and Metabolism (Dr Snyder) and the Department of Pathology and Laboratory Medicine (Dr Master), Perelman School of Medicine, University of Pennsylvania
| | - Marilyn Senior
- From the William Pepper Laboratories, Hospital of the University of Pennsylvania, Philadelphia (Drs Senior and Master, Ms Rulander, and Mr Cardamone); and the Division of Endocrinology, Diabetes, and Metabolism (Dr Snyder) and the Department of Pathology and Laboratory Medicine (Dr Master), Perelman School of Medicine, University of Pennsylvania
| | - Peter J. Snyder
- From the William Pepper Laboratories, Hospital of the University of Pennsylvania, Philadelphia (Drs Senior and Master, Ms Rulander, and Mr Cardamone); and the Division of Endocrinology, Diabetes, and Metabolism (Dr Snyder) and the Department of Pathology and Laboratory Medicine (Dr Master), Perelman School of Medicine, University of Pennsylvania
| | - Stephen R. Master
- From the William Pepper Laboratories, Hospital of the University of Pennsylvania, Philadelphia (Drs Senior and Master, Ms Rulander, and Mr Cardamone); and the Division of Endocrinology, Diabetes, and Metabolism (Dr Snyder) and the Department of Pathology and Laboratory Medicine (Dr Master), Perelman School of Medicine, University of Pennsylvania
| |
Collapse
|
7
|
Kricka LJ, Milone M, Master SR, Shaw LM, Young DS, Fontanilla R, Smith T, Gardiner J, Cardamone D, Fleming M, Rhoads DG. Effect of a Variable Magnetic Field on Clinical Laboratory Testing. Clin Chem 2009; 55:1249-50. [DOI: 10.1373/clinchem.2009.123679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Larry J Kricka
- Department of Pathology & Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, PA
| | - Michael Milone
- Department of Pathology & Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, PA
| | - Stephen R Master
- Department of Pathology & Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, PA
| | - Leslie M Shaw
- Department of Pathology & Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, PA
| | - Donald S Young
- Department of Pathology & Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, PA
| | - Rodellia Fontanilla
- Department of Pathology & Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, PA
| | - Treasa Smith
- Department of Pathology & Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, PA
| | - JoAnn Gardiner
- Department of Pathology & Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, PA
| | - David Cardamone
- Department of Pathology & Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, PA
| | | | | |
Collapse
|