{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:21:01Z","timestamp":1791566461150,"version":"4.3.4"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2021YFS0142"],"award-info":[{"award-number":["2021YFS0142"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81601462"],"award-info":[{"award-number":["81601462"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anti\u2010MDA5+ dermatomyositis (DM) represents a heterogeneous group of patients as diverse individuals display different clinical characteristics, disease progression and complications development. The heterogeneity makes it difficult to classify interstitial lung disease in anti\u2010MDA5 antibodies positive dermatomyositis (anti\u2010MDA5+ DM\u2010ILD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To distinguish and characterize phenotypic subgroups for anti\u2010MDA5+ DM\u2010ILD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From August 2014 to March 2022, 188 anti\u2010MDA5+ DM\u2010ILD patients were retrospectively enrolled. 21 HRCT\u2010derived quantitative features were reduced to four principal components through principal component analysis. The missForest algorithm was employed for missing data imputation. Clusters were determined by partitioning around medoids. The classification and regression tree (CART) algorithm was utilized to distinguish between three clusters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The Silhouette Coefficient and Dunn index indicated an optimal cluster number of 3. Patients in cluster 2 (high\u2010risk cluster) have the highest RP\u2010ILD incidence rate (84.9% vs. 18.1% vs. 17.1%, cluster 2 vs. 1 vs. 3,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), extremely high early mortality (88.7% vs. 4.3% vs. 2.4%, cluster 2 vs. 1 vs. 3,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and moderate dermato\u2010rheumatologic pattern. Patients in cluster 1 correspond to a pure dermato\u2010rheumatologic pattern (dermato\u2010rheumatologic cluster). Cluster 3 (low\u2010risk cluster) was characterized by not obvious dermato\u2010rheumatologic and the lowest RP\u2010ILD incidence (17.1%) as well as the lowest early mortality (2.4%). The accuracy of the CART algorithm in differentiating clusters was 67.7% in the validation cohort with 56 patients. Principal component 1 was a key feature in the CART algorithm. Sensitivity analyses employing multiple clustering approaches confirmed the robustness of the three\u2010cluster solution by partitioning around medoids.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clustering analysis offers valuable insights into the heterogeneity and clinical implications of anti\u2010MDA5+ DM\u2010ILD. HRCT\u2010derived quantitative features demonstrate significant value for early risk stratification in anti\u2010MDA5+ DM\u2010ILD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdv.20850","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T11:18:56Z","timestamp":1752837536000},"page":"446-454","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Risk stratification in anti\u2010\n                    <scp>MDA5<\/scp>\n                    + dermatomyositis\u2010related interstitial lung disease by using cluster analysis"],"prefix":"10.1111","volume":"40","author":[{"given":"Wenzhang","family":"He","sequence":"first","affiliation":[{"name":"Department of Radiology West China Hospital of Sichuan University  Chengdu China"},{"name":"Department of Radiology Chongqing General Hospital, Chongqing University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5870-2369","authenticated-orcid":false,"given":"Beibei","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology West China Hospital of Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhigang","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Radiology The First Affiliated Hospital of Chongqing Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Huang","sequence":"additional","affiliation":[{"name":"Biomedical Big Data Center West China Hospital\/West China School of Medicine, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiology West China Hospital of Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology West China Hospital of Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinqiu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology West China Hospital of Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueting","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Radiology West China Hospital of Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology West China Hospital of Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2376-3268","authenticated-orcid":false,"given":"Liqing","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Radiology West China Hospital of Sichuan University  Chengdu China"},{"name":"Medical Imaging Center West China Lecheng Hospital, Sichuan University  Qionghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,18]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000009727"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/2024869"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.768052"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ane.13331"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-007-0562-9"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kes102"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kead263"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keac094"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.1121-18"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000010436"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.42308"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(24)00267-4"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.240016"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2017.09.016"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2004.02.006"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2009.323"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-020-08822-5"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina55030070"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-96292-w"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00371-2019"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2011.05.006"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201910-741OC"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20221160"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/tomography8020082"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keab371"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-025-03485-z"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-024-03415-5"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaa123"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/ctm2.70226"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12969-023-00933-5"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-017-0527-8"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-019-04398-2"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-021-04897-1"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.220139"}],"container-title":["Journal of the European Academy of Dermatology and Venereology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdv.20850","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jdv.20850","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdv.20850","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:54:48Z","timestamp":1773032088000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdv.20850"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,18]]},"references-count":34,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1111\/jdv.20850"],"URL":"https:\/\/doi.org\/10.1111\/jdv.20850","archive":["Portico"],"relation":{},"ISSN":["0926-9959","1468-3083"],"issn-type":[{"value":"0926-9959","type":"print"},{"value":"1468-3083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,18]]},"assertion":[{"value":"2024-11-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}