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Logistic regression was employed to examine the relationship between demographic and pathological characteristics and the occurrence of positive surgical margins. Various machine learning methods were then applied to construct and evaluate the performance of the risk prediction model.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The overall rate of positive surgical margins was 12.9%. Independent risk factors identified included glandular involvement (OR\u2009=\u20091.716, 95% CI: 1.345\u20132.189), transformation zone III (OR\u2009=\u20092.838, 95% CI: 2.258\u20133.568), HPV16\/18 infection (OR\u2009=\u20092.863, 95% CI: 2.247\u20133.648), multiple HR-HPV infections (OR\u2009=\u20091.930, 95% CI: 1.537\u20132.425), TCT\u2009\u2265\u2009ASC-H (OR\u2009=\u20093.251, 95% CI: 2.584\u20134.091), and lesions covering\u2009\u2265\u20093 quadrants (OR\u2009=\u20093.264, 95% CI: 2.593\u20134.110). Logistic regression demonstrated the best prediction performance, with an accuracy of 74.7%, sensitivity of 76.7%, specificity of 74.4%, and AUC of 0.826.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Independent risk factors for positive margins after CKC include HPV16\/18 infection, multiple HR-HPV infections, glandular involvement, extensive lesion coverage, high TCT grades, and involvement of transformation zone III. The logistic regression model provides a robust and clinically valuable tool for predicting the risk of positive margins, guiding clinical decisions and patient management post-CKC.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12905-024-03180-2","type":"journal-article","created":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T06:02:07Z","timestamp":1717740127000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Development of a machine learning-based model for predicting positive margins in high-grade squamous intraepithelial lesion (HSIL) treatment by Cold Knife Conization(CKC): a single-center retrospective study"],"prefix":"10.1186","volume":"24","author":[{"given":"Lin","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahong","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingyu","family":"Lei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xufeng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keming","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,7]]},"reference":[{"issue":"2","key":"3180_CR1","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1097\/00004347-199304000-00018","volume":"12","author":"AG Ost\u00f6r","year":"1993","unstructured":"Ost\u00f6r AG. 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Informed consent was obtained for all patients or family members. In addition to this, all methods in the study were performed in accordance with the relevant guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"332"}}