Data-driven rapid detection of infection through machine learning with limited laboratory parameters in Chinese primary clinics.

BACKGROUND

is a significant global health concern, posing a high risk for gastric cancer. Conventional diagnostic and screening approaches are inaccessible, invasive, inaccurate, time-consuming, and expensive in primary clinics.

OBJECTIVE

This study aims to apply machine learning (ML) models to detect infection using limited laboratory parameters from routine blood tests and to investigate the association of these biomarkers with clinical outcomes in primary clinics.

METHODS

A retrospective analysis with three ML and five ensemble models was conducted on 1409 adults from Hubei Provincial Hospital of Traditional Chinese Medicine. evaluating twenty-three blood test parameters and using the urea breath test as the gold standard for diagnosing infection.

RESULTS

In our comparative study employing three different feature selection strategies, Random Forest (RF) model exhibited superior performance over other ML and ensemble models. Multiple evaluation metrics underscored the optimal performance of the RF model (ROC = 0.951, sensitivity = 0.882, specificity = 0.906, F1 = 0.906, accuracy = 0.894, PPV = 0.908, NPV = 0.880) without feature selection. Key biomarkers identified through importance ranking and shapley additive Explanations (SHAP) analysis using the RF model without feature selection include White Blood Cell Count (WBC), Mean Platelet Volume (MPV), Hemoglobin (Hb), Red Blood Cell Count (RBC), Platelet Crit (PCT), and Platelet Count (PLC). These biomarkers were found to be significantly associated with the presence of infection, reflecting the immune response and inflammation levels.

CONCLUSION

Abnormalities in key biomarkers could prompt clinical workers to consider infection. The RF model effectively identifies infection using routine blood tests, offering potential for clinical application in primary clinics. This ML approach can enhance diagnosis and screening, reducing medical burdens and reliance on invasive diagnostics.