Background: A predictive model may help to select likely responders and to anticipate treatment duration in vitiligo. Methods: We aimed to develop a predictive rule based on data from a randomized trial of excimer laser in vitiligo. Information on 325 treated patches was available. The degree of repigmentation was assessed by digital image analysis of UVB-reflected photographs. Since no strong relationship between any single predictive parameter and outcome was initially documented, we relied on artificial neural networks. Results: Using a time-response optimal threshold model, data were divided into 2 groups of responders and nonresponders. A discriminant network was trained in order to detect responders versus nonresponders. A regression network was subsequently used to compute repigmentation time in responders. The neural network discriminator achieved 66.46 ± 5.37% (95% CI) overall accuracy. The mean absolute error of the neural network regressor was 19.5843 ± 2.0930 with a root mean square error of 23.7156 ± 2.2225. Conclusion: Our study offers insight into the difficulty of clinical prediction in vitiligo and presents a way to develop an instrument with which to predict the clinical time response in patients treated by excimer laser.

1.
Kent G, Al’Abadie M: Psychologic effects of vitiligo: a critical incident analysis. J Am Acad Dermatol 1996;35:895–898.
2.
Whitton ME, Ashcroft DM, Barrett CW, Gonzalez U: Interventions for vitiligo. Cochrane Database Syst Rev 2006;1:CD003263.
3.
Njoo MD, Westerhof W, Bos JD, Bossuyt PM: The development of guidelines for the treatment of vitiligo. Arch Dermatol 1999;135:1514–1521.
4.
Lim HW, Hexsel CL: Vitiligo: to treat or not to treat. Arch Dermatol 2007;143:643–646.
5.
Baltas E, Csoma Z, Ignacz F, et al: Treatment of vitiligo with the 308-nm xenon chloride excimer laser. Arch Dermatol 2002;138:1619–1620.
6.
Sassi F, Cazzaniga S, Tessari GP, Chatenoud L, et al: Randomised clinical trial comparing the effectiveness of 308 nm excimer laser alone or in combination with topical hydrocortisone 17-butyrate cream in the treatment of vitiligo of the face and neck. Br J Dermatol 2008;159:1186–1191.
7.
Gonzalez R, Woods R: Digital Image Processing, ed 2. Englewood Cliffs, Prentice Hall, 2002.
8.
Lisboa PJG, Vellido A, Wong H: Outstanding Issues for Clinical Decision Support with Neural Networks. London, Springer, 2002, pp 63–71.
9.
Kanungo T, Mount DM, Netanyahu NS, Piatko CD, Silverman R, Wu AY: An efficient k-means clustering algorithm: analysis and implementation. PAMI 2002;7:881–892.
10.
MacKay DJC: Bayesian interpolation. Neural Comput 1992;4:415–447.
11.
MacKay DJC: A practical bayesian framework for backpropagation networks. Neural Comput 1992;4:448–472.
12.
Ganesh A, Abdesselam B: A generalized feed-forward neural network architecture for classification and regression. Neural Netw 2003;16:561–568.
13.
Jolliffe IT: Principal Component Analysis, ed 2. New York, Springer, 2002.
14.
Lawless JF, Fredette M: Frequentist prediction intervals and predictive distributions. Biometrika 2005;92:529–542.
15.
Kwasnicka H, Michalak K: Correlation-based feature selection strategy in neural classification. ISDA Proc 2006;1:741–746.
16.
Nicolaidou E, Antoniou C, Alexander JS, Stefanaki C, Katsambas AD: Efficacy, predictors of response, and long-term follow-up in patients with vitiligo treated with narrowband UVB phototherapy. J Am Acad Dermatol 2007;56:274–278.
17.
Dave S, Thappa DM, Dsouza M: Clinical predictors of outcome in vitiligo. Indian J Dermatol Venereol Leprol 2002;68:323–325.
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