Development and Validation of a Machine Learning Algorithm for Clinical Wellness Visit Classification in Cats and Dogs

Abstract

Early disease detection in veterinary care relies on identifying subclinical abnormalities in asymptomatic animals during wellness visits. This study introduces an algorithm designed to distinguish between wellness and other veterinary visits.The purpose of this study is to validate the use of a visit classification algorithm compared to manual classification of veterinary visits by three board-certified veterinarians. Using a dataset of 11,105 clinical visits from 2012 to 2017 involving 655 animals (85.3% canines and 14.7% felines) across 544 U.S. veterinary establishments, the model was trained using a Gradient Boosting Machine model. Three validators were tasked with classifying 400 visits, including both wellness and other types of visits, selected randomly from the same database used for initial algorithm training, aiming to maintain consistency and relevance between the training and application phases; visit classifications were subsequently categorized into "wellness" or "other" based on majority consensus among validators to assess the algorithm's performance in identifying wellness visits. The algorithm demonstrated a specificity of 0.94 (95% CI: 0.91 to 0.96), implying its accuracy in distinguishing non-wellness visits. The algorithm had a sensitivity of 0.86 (95% CI: 0.80 to 0.92), indicating its ability to correctly identify wellness visits as compared to the annotations provided by veterinary experts. The balanced accuracy, calculated as 0.90 (95% CI: 0.87 to 0.93), further confirms the algorithm's overall effectiveness. The algorithm exhibits strong specificity and sensitivity, ensuring accurate identification of a high proportion of wellness visits. Overall, this algorithm holds promise for advancing research on preventive care's role in subclinical disease identification, but prospective studies are needed for validation.