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Prediction of coronary artery lesions in children with Kawasaki syndrome based on machine learning
Yaqi Tang1, Yuhai Liu2,3, Zhanhui Du1
1Heart Center, Qingdao Women and Children's Hospital, Qingdao University, Qingdao, China.
Insights
Machine learning models can predict coronary artery lesions (CAL) in children with Kawasaki disease (KD). The random forest algorithm achieved high accuracy (0.930) and AUC (0.925) for early risk assessment.
Area of Science:
- Pediatric Cardiology
- Artificial Intelligence in Medicine
- Computational Biology
Background:
- Kawasaki syndrome (KS) is an acute childhood vasculitis affecting children under 5.
- Coronary artery lesions (CAL) develop in 20-25% of untreated KS cases.
- Early risk assessment is crucial for timely intervention.
Purpose of the Study:
- To develop and evaluate machine learning (ML) models for early risk assessment of CAL in children with KS.
- To compare the performance of different ML algorithms, including random forest (RF), logistic regression (LR), and eXtreme Gradient Boosting (XGBoost).
Main Methods:
- A cohort of 158 children with KS was divided into training (70%) and testing (30%) sets.
- RF, LR, and XGBoost classifiers were trained and validated.
- 5-fold cross-validation was employed to prevent overfitting.
Main Results:
- The RF model demonstrated superior performance with an AUC of 0.925 and an average accuracy of 0.930.
- The LR model achieved an AUC of 0.888 and accuracy of 0.893.
- The XGBoost model yielded an AUC of 0.879 and accuracy of 0.935.
Conclusions:
- The RF algorithm effectively predicts CAL risk in KS patients, offering a valuable tool for clinicians.
- This ML-based model can aid in early treatment decisions for aggressive anti-inflammatory therapy.
- Further external validation and diverse population studies are needed for broader clinical application.
Objective:
Kawasaki syndrome (KS) is an acute vasculitis that affects children < 5 years of age and leads to coronary artery lesions (CAL) in about 20-25% of untreated cases. Machine learning (ML) is a branch of artificial intelligence (AI) that integrates complex data sets on a large scale and uses huge data to predict future events. The purpose of the present study was to use ML to present the model for early risk assessment of CAL in children with KS by different algorithms.
Methods:
A total of 158 children were enrolled from Women and Children's Hospital, Qingdao University, and divided into 70-30% as the training sets and the test sets for modeling and validation studies. There are several classifiers are constructed for models including the random forest (RF), the logistic regression (LR), and the eXtreme Gradient Boosting (XGBoost). Data preprocessing is analyzed before applying the classifiers to modeling. To avoid the problem of overfitting, the 5-fold cross validation method was used throughout all the data.
Results:
The area under the curve (AUC) of the RF model was 0.925 according to the validation of the test set. The average accuracy was 0.930 (95% CI, 0.905 to 0.956). The AUC of the LG model was 0.888 and the average accuracy was 0.893 (95% CI, 0,837 to 0.950). The AUC of the XGBoost model was 0.879 and the average accuracy was 0.935 (95% CI, 0.891 to 0.980).
Conclusion:
The RF algorithm was used in the present study to construct a prediction model for CAL effectively, with an accuracy of 0.930 and AUC of 0.925. The novel model established by ML may help guide clinicians in the initial decision to make a more aggressive initial anti-inflammatory therapy. Due to the limitations of external validation and regional population characteristics, additional research is required to initiate a further application in the clinic.
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