Generalizability of a Machine Learning Model for Improving Utilization of Parathyroid Hormone-Related Peptide Testing across Multiple Clinical Centers.

ML offers promise to improve PTHrP test utilization while relieving the burden of manual review. Transporting a ready-made model to external datasets may lead to performance deterioration due to data distribution shift. Model retraining or rebuilding could improve generalizability when there are enough data, and model fine-tuning may be favorable when site-specific data is limited.