A Machine Learning Model to Predict Intravenous Immunoglobulin-Resistant Kawasaki Disease Patients: A Retrospective Study Based on the Chongqing Population
Objective: We explored the risk factors for intravenous immunoglobulin (IVIG) resistance in children with Kawasaki disease (KD) and constructed a prediction model based on machine learning algorithms.Methods: A retrospective study including 1,398 KD patients hospitalized in 7 affiliated hospitals of...
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Frontiers Media S.A.
2021
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oai:doaj.org-article:5eacca8f125747a398c0e71407d85db02021-11-08T07:29:09ZA Machine Learning Model to Predict Intravenous Immunoglobulin-Resistant Kawasaki Disease Patients: A Retrospective Study Based on the Chongqing Population2296-236010.3389/fped.2021.756095https://doaj.org/article/5eacca8f125747a398c0e71407d85db02021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fped.2021.756095/fullhttps://doaj.org/toc/2296-2360Objective: We explored the risk factors for intravenous immunoglobulin (IVIG) resistance in children with Kawasaki disease (KD) and constructed a prediction model based on machine learning algorithms.Methods: A retrospective study including 1,398 KD patients hospitalized in 7 affiliated hospitals of Chongqing Medical University from January 2015 to August 2020 was conducted. All patients were divided into IVIG-responsive and IVIG-resistant groups, which were randomly divided into training and validation sets. The independent risk factors were determined using logistic regression analysis. Logistic regression nomograms, support vector machine (SVM), XGBoost and LightGBM prediction models were constructed and compared with the previous models.Results: In total, 1,240 out of 1,398 patients were IVIG responders, while 158 were resistant to IVIG. According to the results of logistic regression analysis of the training set, four independent risk factors were identified, including total bilirubin (TBIL) (OR = 1.115, 95% CI 1.067–1.165), procalcitonin (PCT) (OR = 1.511, 95% CI 1.270–1.798), alanine aminotransferase (ALT) (OR = 1.013, 95% CI 1.008–1.018) and platelet count (PLT) (OR = 0.998, 95% CI 0.996–1). Logistic regression nomogram, SVM, XGBoost, and LightGBM prediction models were constructed based on the above independent risk factors. The sensitivity was 0.617, 0.681, 0.638, and 0.702, the specificity was 0.712, 0.841, 0.967, and 0.903, and the area under curve (AUC) was 0.731, 0.814, 0.804, and 0.874, respectively. Among the prediction models, the LightGBM model displayed the best ability for comprehensive prediction, with an AUC of 0.874, which surpassed the previous classic models of Egami (AUC = 0.581), Kobayashi (AUC = 0.524), Sano (AUC = 0.519), Fu (AUC = 0.578), and Formosa (AUC = 0.575).Conclusion: The machine learning LightGBM prediction model for IVIG-resistant KD patients was superior to previous models. Our findings may help to accomplish early identification of the risk of IVIG resistance and improve their outcomes.Jie LiuJian ZhangHaodong HuangYunting WangZuyue ZhangYunfeng MaXiangqian HeFrontiers Media S.A.articlemachine learningKawasaki diseaseintravenous immunoglobulin resistancerisk factorsprediction modelPediatricsRJ1-570ENFrontiers in Pediatrics, Vol 9 (2021) |
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machine learning Kawasaki disease intravenous immunoglobulin resistance risk factors prediction model Pediatrics RJ1-570 |
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machine learning Kawasaki disease intravenous immunoglobulin resistance risk factors prediction model Pediatrics RJ1-570 Jie Liu Jian Zhang Haodong Huang Yunting Wang Zuyue Zhang Yunfeng Ma Xiangqian He A Machine Learning Model to Predict Intravenous Immunoglobulin-Resistant Kawasaki Disease Patients: A Retrospective Study Based on the Chongqing Population |
| description |
Objective: We explored the risk factors for intravenous immunoglobulin (IVIG) resistance in children with Kawasaki disease (KD) and constructed a prediction model based on machine learning algorithms.Methods: A retrospective study including 1,398 KD patients hospitalized in 7 affiliated hospitals of Chongqing Medical University from January 2015 to August 2020 was conducted. All patients were divided into IVIG-responsive and IVIG-resistant groups, which were randomly divided into training and validation sets. The independent risk factors were determined using logistic regression analysis. Logistic regression nomograms, support vector machine (SVM), XGBoost and LightGBM prediction models were constructed and compared with the previous models.Results: In total, 1,240 out of 1,398 patients were IVIG responders, while 158 were resistant to IVIG. According to the results of logistic regression analysis of the training set, four independent risk factors were identified, including total bilirubin (TBIL) (OR = 1.115, 95% CI 1.067–1.165), procalcitonin (PCT) (OR = 1.511, 95% CI 1.270–1.798), alanine aminotransferase (ALT) (OR = 1.013, 95% CI 1.008–1.018) and platelet count (PLT) (OR = 0.998, 95% CI 0.996–1). Logistic regression nomogram, SVM, XGBoost, and LightGBM prediction models were constructed based on the above independent risk factors. The sensitivity was 0.617, 0.681, 0.638, and 0.702, the specificity was 0.712, 0.841, 0.967, and 0.903, and the area under curve (AUC) was 0.731, 0.814, 0.804, and 0.874, respectively. Among the prediction models, the LightGBM model displayed the best ability for comprehensive prediction, with an AUC of 0.874, which surpassed the previous classic models of Egami (AUC = 0.581), Kobayashi (AUC = 0.524), Sano (AUC = 0.519), Fu (AUC = 0.578), and Formosa (AUC = 0.575).Conclusion: The machine learning LightGBM prediction model for IVIG-resistant KD patients was superior to previous models. Our findings may help to accomplish early identification of the risk of IVIG resistance and improve their outcomes. |
| format |
article |
| author |
Jie Liu Jian Zhang Haodong Huang Yunting Wang Zuyue Zhang Yunfeng Ma Xiangqian He |
| author_facet |
Jie Liu Jian Zhang Haodong Huang Yunting Wang Zuyue Zhang Yunfeng Ma Xiangqian He |
| author_sort |
Jie Liu |
| title |
A Machine Learning Model to Predict Intravenous Immunoglobulin-Resistant Kawasaki Disease Patients: A Retrospective Study Based on the Chongqing Population |
| title_short |
A Machine Learning Model to Predict Intravenous Immunoglobulin-Resistant Kawasaki Disease Patients: A Retrospective Study Based on the Chongqing Population |
| title_full |
A Machine Learning Model to Predict Intravenous Immunoglobulin-Resistant Kawasaki Disease Patients: A Retrospective Study Based on the Chongqing Population |
| title_fullStr |
A Machine Learning Model to Predict Intravenous Immunoglobulin-Resistant Kawasaki Disease Patients: A Retrospective Study Based on the Chongqing Population |
| title_full_unstemmed |
A Machine Learning Model to Predict Intravenous Immunoglobulin-Resistant Kawasaki Disease Patients: A Retrospective Study Based on the Chongqing Population |
| title_sort |
machine learning model to predict intravenous immunoglobulin-resistant kawasaki disease patients: a retrospective study based on the chongqing population |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/5eacca8f125747a398c0e71407d85db0 |
| work_keys_str_mv |
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