Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India.
Department of Computer Science & Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India.
PLoS Negl Trop Dis. 2022 Jun 30;16(6):e0010455. doi: 10.1371/journal.pntd.0010455. eCollection 2022 Jun.
Differentiating tropical infections are difficult due to its homogenous nature of clinical and laboratorial presentations among them. Sophisticated differential tests and prediction tools are better ways to tackle this issue. Here, we aimed to develop a clinician assisted decision making tool to differentiate the common tropical infections.
A cross sectional study through 9 item self-administered questionnaire were performed to understand the need of developing a decision making tool and its parameters. The most significant differential parameters among the identified infections were measured through a retrospective study and decision tree was developed. Based on the parameters identified, a multinomial logistic regression model and a machine learning model were developed which could better differentiate the infection.
A total of 40 physicians involved in the management of tropical infections were included for need analysis. Dengue, malaria, leptospirosis and scrub typhus were the common tropical infections in our settings. Sodium, total bilirubin, albumin, lymphocytes and platelets were the laboratory parameters; and abdominal pain, arthralgia, myalgia and urine output were the clinical presentation identified as better predictors. In multinomial logistic regression analysis with dengue as a reference revealed a predictability of 60.7%, 62.5% and 66% for dengue, malaria and leptospirosis, respectively, whereas, scrub typhus showed only 38% of predictability. The multi classification machine learning model observed to have an overall predictability of 55-60%, whereas a binary classification machine learning algorithms showed an average of 79-84% for one vs other and 69-88% for one vs one disease category.
This is a first of its kind study where both statistical and machine learning approaches were explored simultaneously for differentiating tropical infections. Machine learning techniques in healthcare sectors will aid in early detection and better patient care.
由于热带感染的临床和实验室表现具有同质性,因此区分它们具有一定难度。复杂的鉴别测试和预测工具是解决这一问题的更好方法。在这里,我们旨在开发一种临床医生辅助决策工具,以区分常见的热带感染。
通过 9 项自我管理问卷进行横断面研究,以了解开发决策工具及其参数的需求。通过回顾性研究测量了确定感染中最显著的鉴别参数,并开发了决策树。根据确定的参数,开发了多变量逻辑回归模型和机器学习模型,以更好地区分感染。
共纳入 40 名参与热带感染管理的医生进行需求分析。登革热、疟疾、钩端螺旋体病和恙虫病是我们环境中的常见热带感染。钠、总胆红素、白蛋白、淋巴细胞和血小板是实验室参数;腹痛、关节痛、肌痛和尿量是确定的临床表现,被认为是更好的预测指标。在以登革热为参照的多变量逻辑回归分析中,登革热、疟疾和钩端螺旋体病的预测能力分别为 60.7%、62.5%和 66%,而恙虫病的预测能力仅为 38%。多分类机器学习模型观察到总体预测能力为 55-60%,而二进制分类机器学习算法显示一种疾病与其他疾病的平均预测能力为 79-84%,一种疾病与一种疾病类别的平均预测能力为 69-88%。
这是首次同时探索统计和机器学习方法来区分热带感染的研究。机器学习技术在医疗保健领域将有助于早期检测和更好的患者护理。