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@article{Ming:2022:10.3389/fdgth.2022.849641,
author = {Ming, DK and Tuan, NM and Hernandez, B and Sangkaew, S and Vuong, NL and Chanh, HQ and Chau, NVV and Simmons, CP and Wills, B and Georgiou, P and Holmes, AH and Yacoub, S},
doi = {10.3389/fdgth.2022.849641},
journal = {Frontiers in Digital Health},
title = {The diagnosis of dengue in patients presenting with acute febrile illness using supervised machine learning and impact of seasonality},
url = {http://dx.doi.org/10.3389/fdgth.2022.849641},
volume = {4},
year = {2022}
}

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TY  - JOUR
AB  - Background: Symptomatic dengue infection can result in a life-threatening shock syndrome and timely diagnosis is essential. Point-of-care tests for non-structural protein 1 and IgM are used widely but performance can be limited. We developed a supervised machine learning model to predict whether patients with acute febrile illnesses had a diagnosis of dengue or other febrile illnesses (OFI). The impact of seasonality on model performance over time was examined.Methods: We analysed data from a prospective observational clinical study in Vietnam. Enrolled patients presented with an acute febrile illness of <72 h duration. A gradient boosting model (XGBoost) was used to predict final diagnosis using age, sex, haematocrit, platelet, white cell, and lymphocyte count collected on enrolment. Data was randomly split 80/20% into a training and hold-out set, respectively, with the latter not used in model development. Cross-validation and hold out set testing was used, with performance over time evaluated through a rolling window approach.Results: We included 8,100 patients recruited between 16th October 2010 and 10th December 2014. In total 2,240 (27.7%) patients were diagnosed with dengue infection. The optimised model from training data had an overall median area under the receiver operator curve (AUROC) of 0.86 (interquartile range 0.84–0.86), specificity of 0.92, sensitivity of 0.56, positive predictive value of 0.73, negative predictive value (NPV) of 0.84, and Brier score of 0.13 in predicting the final diagnosis, with similar performances in hold-out set testing (AUROC of 0.86). Model performances varied significantly over time as a function of seasonality and other factors. Incorporation of a dynamic threshold which continuously learns from recent cases resulted in a more consistent performance throughout the year (NPV >90%).Conclusion: Supervised machine learning models are able to discriminate between dengue and OFI diagnoses in patients presenting with
AU  - Ming,DK
AU  - Tuan,NM
AU  - Hernandez,B
AU  - Sangkaew,S
AU  - Vuong,NL
AU  - Chanh,HQ
AU  - Chau,NVV
AU  - Simmons,CP
AU  - Wills,B
AU  - Georgiou,P
AU  - Holmes,AH
AU  - Yacoub,S
DO  - 10.3389/fdgth.2022.849641
PY  - 2022///
SN  - 2673-253X
TI  - The diagnosis of dengue in patients presenting with acute febrile illness using supervised machine learning and impact of seasonality
T2  - Frontiers in Digital Health
UR  - http://dx.doi.org/10.3389/fdgth.2022.849641
UR  - https://www.frontiersin.org/articles/10.3389/fdgth.2022.849641/full
UR  - http://hdl.handle.net/10044/1/96075
VL  - 4
ER  -

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