Shenoy S, Rajan AK, Rashid M, Chandran VP, Poojari PG, Kunhikatta V, Acharya D, Nair S, Varma M, Thunga G. Artificial intelligence in differentiating tropical infections: A step ahead.
PLoS Negl Trop Dis 2022;
16:e0010455. [PMID:
35771774 PMCID:
PMC9246149 DOI:
10.1371/journal.pntd.0010455]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/29/2022] [Indexed: 11/19/2022] Open
Abstract
Background and objective
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.
Methodology
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.
Results
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.
Conclusion
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.
Distinguishing tropical infections is difficult due to its homogeneous nature from clinical and laboratory presentations among them. This is a first of its kind study where both statistical and machine learning approaches were explored simultaneously for differentiating tropical infections. Dengue, malaria, leptospirosis and scrub typhus were the common tropical infections in our settings as per the need analysis. Better predictors in terms of laboratory parameters and clinical presentations were identified from retrospective analysis and used for the regression and machine learning models. The parameters such as accuracy, true positive rate/sensitivity/recall, false positive rate, precision/positive predictive value, F-measure and ROC area for both the training and validation sets (10-fold cross validation) for all modelling approaches and diseases (One vs One and One vs others) were calculated. All the models observed to have an acceptable range of model performance in differentiating tropical infections. Albumin can be considered as the main parameter in differentiating these tropical infections. These models should be implemented in daily clinical routine practice via mobile or desktop assisted applications or tools.
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