A clustering analysis was conducted to identify distinct patient subgroups with White Blood Cells (WBC) count alongside Age and Total Immunoglobulin E (IgE) biomarkers. All data were obtained from a coordinated primary care network operating in Apulia (Southern Italy). We analyzed 300 patient records, performed preprocessing and exploratory data analysis, and then applied unsupervised clustering directly to the standardized three-variable feature space (Age, WBC, and Total IgE), followed by supervised validation steps. Several algorithms were applied for clustering. Among the evaluated methods, K-means and Spectral Clustering showed the most favorable internal validation profiles, based on Silhouette Score (SS), Calinski–Harabasz Index (CH), and Davies–Bouldin Index (DB). K-means achieved the best scores (SS = 0.406, CH = 190.00, DB = 0.900), closely followed by Spectral Clustering (SS = 0.398, CH = 182.57, DB = 0.936), outperforming Agglomerative Clustering (SS = 0.361, CH = 160.41, DB = 1.016) and Gaussian Mixture Models (SS = 0.233, CH = 103.89, DB = 1.289). Post-clustering ANOVA analyses indicated significant differences in WBC, age, and total IgE across the five consensus clusters. An evaluation of cluster internal separability occurred through the training of a Random Forest classifier to predict cluster membership. The results indicate internal cluster separability within the analyzed dataset, but more external verification and clinical evidence are necessary for validation. The research group established clinical descriptions along with suggested treatment plans and detected co-existing diseases to help validate model-based findings. A simplified cluster-informed clinical summary based on biomarker ranges was derived to support interpretation of the identified patient profiles. This integrated method preliminarily suggests that patient strata may be identified from routine clinical variables, while highlighting the importance of internal validation and clinical interpretability in clustering research.
Palazzo et al. (Thu,) studied this question.