{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T16:41:09Z","timestamp":1768322469298,"version":"3.49.0"},"reference-count":50,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015045","name":"Kaohsiung Armed Forces General Hospital","doi-asserted-by":"publisher","award":["KAFGH-E_113060"],"award-info":[{"award-number":["KAFGH-E_113060"]}],"id":[{"id":"10.13039\/501100015045","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Myocardial perfusion scintigraphy (MPS) is an important tool for evaluating ischemia in diabetic populations. However, applications of advanced predictive models like multivariate adaptive regression splines (MARS) to estimate summed stress scores (SSS) are lacking. Methods: In this study, 1028 diabetic women undergoing Thallium-201 MPS were analyzed. The dataset was split into training (80%) and testing (20%) subsets. MARS and multiple linear regression (MLR) models were constructed to predict SSS, and their performance was evaluated using root mean square error (RMSE), relative absolute error (RAE), root relative squared error (RRSE), Mean Absolute Percentage Error (MAPE), and Symmetric Mean Absolute Percentage Error (SMAPE). Results: On the testing dataset, the MARS model outperformed the MLR model across all metrics, with an RMSE of 3.25 compared to 3.89 for MLR, an RAE of 0.52 vs. 0.64, and an RRSE of 0.53 vs. 0.67. Similar trends were observed in MAPE (18.7% vs. 22.1%) and SMAPE (17.3% vs. 20.5%). Conclusions: The superior predictive accuracy of the MARS model suggests its potential to enhance non-invasive myocardial risk stratification in diabetic women.<\/jats:p>","DOI":"10.3390\/diagnostics15172270","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T10:29:07Z","timestamp":1757327347000},"page":"2270","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Using Multivariate Adaptive Regression Splines to Estimate Summed Stress Score on Myocardial Perfusion Scintigraphy in Chinese Women with Type 2 Diabetes: A Comparative Study with Multiple Linear Regression"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5939-6781","authenticated-orcid":false,"given":"Chien-Han","family":"Yuan","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Kaohsiung Armed Forces General Hospital, Kaohsiung 802, Taiwan"},{"name":"Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung 804, Taiwan"},{"name":"Department of Otolaryngology, National Defense Medical University, Taipei 114, Taiwan"},{"name":"Medical Education and Research Center, Kaohsiung Armed Forces General Hospital, Kaohsiung 802, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3985-7517","authenticated-orcid":false,"given":"Po-Chun","family":"Lee","sequence":"additional","affiliation":[{"name":"Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung 804, Taiwan"},{"name":"Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung 802, Taiwan"},{"name":"School of Medicine, National Defense Medical University, Taipei 114, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheng-Tang","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical University, Taipei 114, Taiwan"},{"name":"Division of Urology, Department of Surgery, Kaohsiung Armed Forces General Hospital, Kaohsiung 802, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8271-2885","authenticated-orcid":false,"given":"Chung-Chi","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan"},{"name":"Cardiovascular Division, Tri-Service General Hospital, National Defense Medical University, Taipei 114, Taiwan"},{"name":"School of Medicine, National Tsing Hua University, Hsinchu 300, Taiwan"},{"name":"Institute of Bioinformatics and Structural Biology, National Tsing Hua University, Hsinchu 300, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7629-7854","authenticated-orcid":false,"given":"Ta-Wei","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical University, Taipei 114, Taiwan"},{"name":"MJ Health Research Foundation, Taipei 114, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong-Feng","family":"Yeih","sequence":"additional","affiliation":[{"name":"School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan"},{"name":"Division of Cardiology, Department of Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 243, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"434","DOI":"10.2337\/diacare.16.2.434","article-title":"Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial","volume":"16","author":"Stamler","year":"1993","journal-title":"Diabetes Care"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1161\/CIRCULATIONAHA.107.720847","article-title":"Diabetes patients requiring glucose-lowering therapy and nondiabetics with a prior myocardial infarction carry the same cardiovascular risk: A population study of 3.3 million people","volume":"117","author":"Schramm","year":"2008","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1136\/jech-2016-207402","article-title":"Long-term excess mortality associated with diabetes following acute myocardial infarction: A population-based cohort study","volume":"71","author":"Alabas","year":"2017","journal-title":"J. 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