MEETING ABSTRACT Open Access

Evaluation of biomarkers for diagnosnosticdecision making in patients with gout usingnovel mathematical model. Complex PPPMapproachRostyslav V Bubnov1*, Ivan M Melnyk2†

From EPMA-World Congress 2013Brussels, Belgium. 20-21 September 2013

IntroductionGout is a common metabolic disorder, involving liver,kidney and joints, it is met more often in men. Recentlywe described specific ultrasound (US) signs of goutnephropathy [1]. We suggest novel mathematical modelaccording to which the medical process is percepted as acomplex system like “black box” [2,3]. This process (dis-ease progression) is described by some of the primaryindicators (US and laboratory biomarkers). So primaryindicators and output rate are stochastic in nature andpresented as statistical information. The “best” mathema-tical model of the medical process is studied using a spe-cial algorithm for processing statistical data [2].

The aimwas to assess the complex multiparameter evaluation ofbiomarkers for diagnostic decision making in patientswith gout using novel mathematical model.

Materials and methodsWe considered 42 patients (35 men, 7 women) to thefirst group, mean age was 58 ± 4.5, whom gout wasdiagnosed, according to disease history, or increasedlevels of uric acid in blood. The average level of uricacid in patients in group was 465 μmol/L. The controlgroup included 34 patients (16 men, 18 women), meanage 54 ± 6 years without clinical, laboratory signs ofnephropathy and liver pathology. All patients underwent

ultrasound examination, gray scale, Doppler and sonoe-lastography parameters of liver and kidneys wererecorded and evaluated statistically and assessed withown model [3]. Integrated index (Y) rated ranged 0/1for disease description and staging was calculated.

ResultsIn all patients of the first group were US signs of fattyliver, in 38 patients (90%) ultrasonography signs ofnephropathy were registered, significantly more frequent(P < 0.01) than in second group. The diffuse fatty liver(P < 0.01) and portal hypertension (P < 0.1) were pre-vailed in the first group. Transaminase increase wasregistered only in 7 patients (17%) of the first group.Nephropathy signs included thinning, increasing echo-genicity of kidney parenchyma (P < 0.05), detection offibrotic changes and small hyperechoic inclusions, hillymargins, anaechoic strips under the capsule, RI increas-ing in segmental arteries over 0.7. The revealing ofnephropathy (r > 0.85) was correlated with creatininelevel increase and with liver fibrosis (r > 0.8). Additionalattributes were joint lesions (P < 0.01). Integrated indexY was 0.73 in first group and 0.28 in second (P < 0.01).

ConclusionsUltrasound can be an effective method for early detec-tion of liver and kidneys involvement in gout patientsfor performing their personalized treatment. The sensi-tivity, specificity, positive and negative predictive valueand accuracy the gout involvement of liver and kidneysusing complex ultrasonography diagnostic criteriawere 92.6%, 84.4%, 80%, 95%, and 91.9% respectively.Nephropathy appearance correlates with diffuse liver

* Correspondence: rostbubnov@gmail.com† Contributed equally1Clinical Hospital Pheophania, Center for ultrasound diagnosis andinterventional sonography, Kyiv, UkraineFull list of author information is available at the end of the article

Bubnov and Melnyk EPMA Journal 2014, 5(Suppl 1):A58http://www.epmajournal.com/content/5/S1/A58

© 2014 Bubnov and Melnyk; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the CreativeCommons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, andreproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

involvement. Integrated index Y could be reliable fordisease staging and control treatment follow up.

RecommendationsIt is recommended to create the system for complexevaluation of biomarkers using suggested mathematicalmodel, based of patient medical records for prediction,personalized treatment and prevention gout that may beapplicable in still existing closed medical system, obtain-ing relevant extensive data.

Authors’ details1Clinical Hospital Pheophania, Center for ultrasound diagnosis andinterventional sonography, Kyiv, Ukraine. 2International Research and TrainingCenter for Information Technology and Systems NAS of Ukraine, Kyiv,Ukraine.

Published: 11 February 2014

References1. Bubnov RV, Abdullaiev RYa: Ultrasonography capabilities for gouty

nephropathy. EUROSON 2012, Annual meeting, Madrid 2012, 35, AbstractsBook.

2. Melnyk IM, Bubnov RV: Choice of diagnostic decision making in medicineand intervention mistake prediction using mathematical models. Int J InfModels Anal 2012, 1(1):78-83.

3. Melnik IM: Genetic Algorithm for Solving the Problem of an OptimumRegression Model Construction as a Discrete Optimization Problem. JAutom Inf Sci 2008, 40(6):60-71.

doi:10.1186/1878-5085-5-S1-A58Cite this article as: Bubnov and Melnyk: Evaluation of biomarkers fordiagnosnostic decision making in patients with gout using novelmathematical model. Complex PPPM approach. EPMA Journal 2014 5(Suppl 1):A58.

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Bubnov and Melnyk EPMA Journal 2014, 5(Suppl 1):A58http://www.epmajournal.com/content/5/S1/A58

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