Machine-learning Approach for the Development of a Novel Predictive Model for the Diagnosis of Hepatocellular Carcinoma.

Because of its multifactorial nature, predicting the presence of cancer using a single biomarker is difficult. We aimed to establish a novel machine-learning model for predicting hepatocellular carcinoma (HCC) using real-world data obtained during clinical practice. To establish a predictive model, we developed a machine-learning framework which developed optimized classifiers and their respective hyperparameter, depending on the nature of the data, using a grid-search method. We applied the current framework to 539 and 1043 patients with and without HCC to develop a predictive model for the diagnosis of HCC. Using the optimal hyperparameter, gradient boosting provided the highest predictive accuracy for the presence of HCC (87.34%) and produced an area under the curve (AUC) of 0.940. Using cut-offs of 200 ng/mL for AFP, 40 mAu/mL for DCP, and 15% for AFP-L3, the accuracies of AFP, DCP, and AFP-L3 for predicting HCC were 70.67% (AUC, 0.766), 74.91% (AUC, 0.644), and 71.05% (AUC, 0.683), respectively. A novel predictive model using a machine-learning approach reduced the misclassification rate by about half compared with a single tumor marker. The framework used in the current study can be applied to various kinds of data, thus potentially become a translational mechanism between academic research and clinical practice.