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Does decision tree analysis predict oral ulcer activity-related factors in patients with Behçet's syndrome?

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45

 

  1. Department of Health Management, Institute of Health Sciences, Marmara University, Istanbul, and Department of Health Management, Faculty of Economics and Administrative Sciences, Izmir Kâtip Celebi University, Izmir, Turkey.
  2. Department of Health Management, Institute of Health Sciences, Marmara University, Istanbul, Turkey.
  3. Department of Statistics, Faculty of Science and Literature, Mimar Sinan Fine Arts Faculty, Istanbul, Turkey.
  4. Department of Statistics, Faculty of Science and Literature, Mimar Sinan Fine Arts Faculty, Istanbul, Turkey.
  5. Department of Oral and Maxillofacial Surgery, Gulhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey.
  6. Department of Health Management, Faculty of Health Sciences, Marmara University, Istanbul, Turkey.
  7. Barts and The London School of Medicine and Dentistry, Centre Immunobiology and Regenerative Medicine, Queen Mary University of London, UK.
  8. Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey.
  9. Division of Rheumatology, Medical School, Universidade Federal de São Paulo, Brazil.
  10. Division of Rheumatology, Medical School, Ege University, Izmir, Turkey.
  11. Division of Rheumatology, Medical School, Universidade Federal de São Paulo, Brazil.
  12. Barts and The London School of Medicine and Dentistry, Centre Immunobiology and Regenerative Medicine, Queen Mary University of London, UK.
  13. Barts and The London School of Medicine and Dentistry, Centre Immunobiology and Regenerative Medicine, Queen Mary University of London, UK.
  14. Division of Rheumatology, Medical School, Hacettepe University, Ankara, Turkey.
  15. Division of Rheumatology, Medical School, Hacettepe University, Ankara, Turkey.
  16. Dermatology Department, Medical School, Akdeniz University, Antalya, Turkey.
  17. Division of Rheumatology, Gulhane Medical School, University of Health Sciences, Ankara, Turkey.
  18. Barts and The London School of Medicine and Dentistry, Centre Immunobiology and Regenerative Medicine, Queen Mary University of London, UK.
  19. Division of Rheumatology, Medical School, Kocaeli University, Turkey.
  20. Division of Rheumatology, Medical School, Cukurova University, Adana, Turkey.
  21. Division of Rheumatology, Sanliurfa Mehmet Akif Inan Education and Research Hospital, Sanliurfa, Turkey.
  22. Barts and The London School of Medicine and Dentistry, Centre Immunobiology and Regenerative Medicine, Queen Mary University of London, UK.
  23. Division of Rheumatology, Medical School, Erciyes University, Kayseri, Turkey.
  24. Rheumatology Clinic, Istanbul Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey.
  25. Division of Rheumatology, Medical School, Cumhuriyet University, Sivas, Turkey.
  26. Division of Rheumatology, Medical School, Cukurova University, Adana, Turkey.
  27. Division of Rheumatology, Medical School, Kocaeli University, Turkey.
  28. Division of Rheumatology, Gulhane Medical School, University of Health Sciences, Ankara, Turkey.
  29. Division of Rheumatology, Gulhane Medical School, University of Health Sciences, Ankara, Turkey.
  30. Dermatology Department, Medical School, Akdeniz University, Antalya, Turkey
  31. Department of Dermatology, Medical School, Ankara University, Ankara, Turkey.
  32. Division of Rheumatology, Medical School, Erciyes University, Kayseri, Turkey.
  33. Division of Rheumatology, Medical School, Osmangazi University, Eskisehir, Turkey.
  34. Division of Rheumatology, Medical School, Osmangazi University, Eskisehir, Turkey.
  35. Division of Rheumatology, Medical School, Hacettepe University, Ankara, Turkey.
  36. Division of Rheumatology, Medical School, Ege University, Izmir, Turkey.
  37. Division of Rheumatology, Medical School, Ege University, Izmir, Turkey.
  38. Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey.
  39. Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey.
  40. Dermatology Department, Medical School, Marmara University, Istanbul, Turkey.
  41. Medical Department, Jordan’s Friends of Behçet’s Disease Patients Society, Amman, Jordan.
  42. Division of Rheumatology, Medical School, Universidade Federal de São Paulo, Brazil.
  43. Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey.
  44. Barts and The London School of Medicine and Dentistry, Centre Immunobiology and Regenerative Medicine, Queen Mary University of London, UK.
  45. Department of Health Management, Faculty of Health Sciences, Marmara University, Istanbul, Turkey. gonca.mumcu@gmail.com

CER16792
2023 Vol.41, N°10
PI 2078, PF 2086
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PMID: 37902270 [PubMed]

Received: 28/04/2023
Accepted : 11/09/2023
In Press: 30/10/2023
Published: 30/10/2023

Abstract

OBJECTIVES:
The study aimed to identify the interactions among treatment protocols and oral ulcer activity related factors in patients with Behçet’s syndrome (BS) using the Classification and Regression Tree (CART) algorithm.
METHODS:
In this cross-sectional study, 979 patients with BS were included from16 centres in Turkey, Jordan, Brazil and the United Kingdom. In the CART algorithm, activities of oral ulcer (active vs. inactive), genital ulcer (active vs. inactive), cutaneous involvement (active vs. inactive), musculoskeletal involvement (active vs. inactive), gender (male vs. female), disease severity (mucocutaneous and musculoskeletal involvement vs. major organ involvement), smoking habits (current smoker vs. non-smoker), tooth brushing habits (irregular vs. regular), were input variables. The treatment protocols regarding immunosuppressive (IS) or non-IS medications were the target variable used to split from parent nodes to purer child nodes in the study.
RESULTS:
In mucocutaneous and musculoskeletal involvement (n=538), the ratio of IS use was higher in patients with irregular toothbrushing (ITB) habits (27.1%) than in patients with regular toothbrushing (RTB) habits (14.2%) in oral ulcer activity. In major organ involvement (n=441), male patients with ITB habits were more likely treated with IS medications compared to those with RTB habits (91.6% vs. 77.6%, respectively).
CONCLUSIONS:
Male BS patients on IS who have major organ involvement and oral ulcer activity with mucocutaneous and musculoskeletal involvement have irregular toothbrushing habits. Improved oral hygiene practices should be considered to be an integral part for implementing patient empowerment strategies for BS.

DOI: https://doi.org/10.55563/clinexprheumatol/5kr2b1

Rheumatology Article