{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T23:57:24Z","timestamp":1793318244365,"version":"4.5.0"},"reference-count":43,"publisher":"Walter de Gruyter GmbH","issue":"11","funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["314061271-TRR\/CRC 205-1\/2"],"award-info":[{"award-number":["314061271-TRR\/CRC 205-1\/2"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_cclm-2025-0200_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Use of machine learning (ML) in diagnostics offers promise to optimise interpretation of laboratory data and guide clinical decision-making. For this, ML-based outputs should provide robustly reproducible results at least as good as the underlying laboratory data. The objective of this study was to assess robustness of ML-based steroid-probability-scores for diagnosis of primary aldosteronism (PA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-0200_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Reproducibility of ML-based steroid-probability-scores was assessed from coefficients of variation (CVs) for pools of quality control plasma from selected groups of patients with and without PA. Intra-patient measurement variability was assessed from CVs of three consecutive plasma specimens obtained on different days from 77 patients. Inter-laboratory reproducibility was assessed from 47 duplicate plasma specimens analysed in two different laboratories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-0200_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Support vector machine-derived steroid-probability-scores for diagnosis of PA for seven sets of quality control plasma pools yielded an averaged CV (2.5\u202f% CI 0.4\u20134.4\u202f%) that was lower (p=0.0078) than the averaged CV for seven steroids employed in that model (12.0\u202f% CI 7.4\u201316.6). Using three sets of plasma samples from 77 patients, CVs for intra-patient measurement variability of steroid-probability-scores were 7\u202f% (CI 5\u20139\u202f%) and lower (p&lt;0.0001) than CVs for measurements of aldosterone (38\u202f% CI 32\u201342\u202f%), 18-oxocortisol (36\u202f% CI 29\u201343\u202f%), 18-hydroxycortisol (25\u202f% CI 21\u201328\u202f%) and the aldosterone:renin ratio (46\u202f% CI 38\u201355\u202f%). ML-derived probability scores for 47 duplicate plasma samples analysed at two separate laboratories displayed excellent agreement and negligible bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-0200_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ML-based steroid-probability-scores for diagnosis of PA display remarkably high robustness according to reproducibility of measurements within and between laboratories as well as within patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/cclm-2025-0200","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T12:56:21Z","timestamp":1753361781000},"page":"2236-2246","source":"Crossref","is-referenced-by-count":7,"title":["Robustness of steroidomics-based machine learning for diagnosis of primary aldosteronism: a laboratory medicine perspective"],"prefix":"10.1515","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8601-9903","authenticated-orcid":false,"given":"Graeme","family":"Eisenhofer","sequence":"first","affiliation":[{"name":"Department of Medicine III , Technische Universit\u00e4t Dresden , Dresden , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirko","family":"Peitzsch","sequence":"additional","affiliation":[{"name":"Institute of Clinical Chemistry and Laboratory Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden , Dresden , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Mantik","sequence":"additional","affiliation":[{"name":"New South Wales Health Pathology, Department of Chemical Pathology , Prince of Wales Hospital , Sydney , New South Wales , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Schulze","sequence":"additional","affiliation":[{"name":"Center for Interdisciplinary Digital Sciences, Department of Information Services and High Performance Computing , Technische Universit\u00e4t Dresden , Dresden , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgiana","family":"Constantinescu","sequence":"additional","affiliation":[{"name":"Department of Medicine III , Technische Universit\u00e4t Dresden , Dresden , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhong","family":"Lu","sequence":"additional","affiliation":[{"name":"Monash Health Pathology and Department of Medicine , Monash University , Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Remde","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Endocrinology and Diabetes , University Hospital, University of W\u00fcrzburg , W\u00fcrzburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmina T.","family":"Fuss","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Endocrinology and Diabetes , University Hospital, University of W\u00fcrzburg , W\u00fcrzburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy Ann","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Medicine IV , University Hospital, Ludwig Maximilian University Munich , Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Gruber","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology and Clinical Nutrition , University Hospital Zurich and the LOOP Zurich Medical Research Center , Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques W.M.","family":"Lenders","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine , Radboud University Medical Center , Nijmegen , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Horvath","sequence":"additional","affiliation":[{"name":"New South Wales Health Pathology, Department of Chemical Pathology , Prince of Wales Hospital , Sydney , New South Wales , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Pamporaki","sequence":"additional","affiliation":[{"name":"Department of Medicine III , Technische Universit\u00e4t Dresden , Dresden , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,7,25]]},"reference":[{"key":"2025103114402239735_j_cclm-2025-0200_ref_001","doi-asserted-by":"crossref","unstructured":"Gopal, G, Suter-Crazzolara, C, Toldo, L, Eberhardt, W. 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