{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T08:24:16Z","timestamp":1782980656365,"version":"3.54.5"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T00:00:00Z","timestamp":1727913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Andrology"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Varicocoele is a correctable cause of male infertility. Although physical examination is still being used in diagnosis and grading, it gives conflicting results when compared to ultrasonography\u2010based varicocoele grading.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aimed to develop a multi\u2010class machine learning model for the grading of varicocoeles based on ultrasonographic measurements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Between January and May 2024, we enrolled unilateral varicocoele patients at an infertility clinic, assessing their varicocoele stages using the Dubin and Amelar system. We measured vascular diameter and reflux time at the testicular apex and the subinguinal region ultrasonography in both the supine and standing positions. Using these measurements, we developed four multi\u2010class machine learning models, evaluating their performance metrics and determining which patient position and projection were most influential in varicocoele grading.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 248 patients with unilateral varicocoele in the study, their average age was 26.61\u00a0\u00b1\u00a04.95 years old. Of these, 212 had left\u2010sided and 36 had right\u2010sided varicocoeles. According to the Dubin and Amelar system, there were 66 grade I, 96 grade II, and 86 grade III varicocoeles. Among the models we created, the random forest (RF) model performed best, with an overall accuracy of 0.81\u00a0\u00b1\u00a00.06, an F1 score of 0.79\u00a0\u00b1\u00a00.02, a sensitivity of 0.69\u00a0\u00b1\u00a00.02, and a specificity of 0.8\u00a0\u00b1\u00a00.03.<\/jats:p><jats:p>Vascular diameter measurement at the testicular apex in the supine position had the most impact on grading across all models. In support vector machine and multi\u2010layer perceptron models, reflux time measurements from the subinguinal projection in the standing position contributed the most, while in RF and <jats:italic>k<\/jats:italic>\u2010nearest neighbors models, measurements from the subinguinal projection in the supine position were the most influential.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Machine learning methods have demonstrated superior accuracy in predicting disease compared to traditional statistical regressions and nomograms. These advancements hold promise for clinically automated prediction of varicocoele grades in patients. Tailored varicocoele grading for individuals has the potential to enhance treatment effectiveness and overall quality of life.<\/jats:p><\/jats:sec>","DOI":"10.1111\/andr.13776","type":"journal-article","created":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T03:28:50Z","timestamp":1727926130000},"page":"1451-1461","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Machine learning\u2010based classification of varicocoele grading: A promising approach for diagnosis and treatment optimization"],"prefix":"10.1111","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7349-9952","authenticated-orcid":false,"given":"Mehmet Vehbi","family":"Kayra","sequence":"first","affiliation":[{"name":"Department of Urology, Adana Dr. Turgut Noyan Application and Research Center Baskent University  Adana Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3139-8205","authenticated-orcid":false,"given":"Ali","family":"\u015eahin","sequence":"additional","affiliation":[{"name":"Department of Emergency Service Konya Dr. Vefa Tan\u0131r State Hospital  Konya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2649-1157","authenticated-orcid":false,"given":"Serdar","family":"Toks\u00f6z","sequence":"additional","affiliation":[{"name":"Department of Urology Sincan Education and Research Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1166-2467","authenticated-orcid":false,"given":"Mehmet","family":"Serindere","sequence":"additional","affiliation":[{"name":"Department of Radiology Hatay Education and Research Hospital  Hatay Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6797-3937","authenticated-orcid":false,"given":"Emre","family":"Alt\u0131nta\u015f","sequence":"additional","affiliation":[{"name":"Department of Urology Selcuk University School of Medicine  Konya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1141-1094","authenticated-orcid":false,"given":"Halil","family":"\u00d6zer","sequence":"additional","affiliation":[{"name":"Department of Radiology Selcuk University School of Medicine  Konya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6657-6227","authenticated-orcid":false,"given":"Murat","family":"G\u00fcl","sequence":"additional","affiliation":[{"name":"Department of Urology Selcuk University School of Medicine  Konya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2010.12.008"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2021.08.014"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrurol.2017.98"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.5534\/wjmh.230034"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/ju.0000000000001521"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0015\u20100282(16)37684\u20101"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345\u2010004\u20100421\u20100"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/andr.12797"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.humrep.a019362"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40477\u2010020\u201000509\u2010z"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/aja202438"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2021.07.004"},{"key":"e_1_2_8_14_1","first-page":"1015","volume-title":"Beyond Accuracy, F\u2010Score and ROC: A Family of Discriminant Measures for Performance Evaluation","author":"Sokolova M","year":"2006"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874\u2010019\u20100681\u20104"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.2174\/1389202922666210705124359"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330\u2010018\u20105698\u20102"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.5534\/wjmh.230050"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.compbiomed.2015.05.015"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.14477"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467\u2010022\u201034405\u20103"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.5534\/wjmh.210159"},{"key":"e_1_2_8_23_1","first-page":"1","article-title":"Varicocele detection in ultrasound images using deep learning","author":"AlZoubi O","year":"2024","journal-title":"Multimed Tools Appl"}],"container-title":["Andrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/andr.13776","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T11:03:50Z","timestamp":1755774230000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/andr.13776"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,3]]},"references-count":22,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1111\/andr.13776"],"URL":"https:\/\/doi.org\/10.1111\/andr.13776","archive":["Portico"],"relation":{},"ISSN":["2047-2919","2047-2927"],"issn-type":[{"value":"2047-2919","type":"print"},{"value":"2047-2927","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,3]]},"assertion":[{"value":"2024-03-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}