An interpretable machine learning-assisted diagnostic model for Kawasaki disease in children

Kawasaki disease (KD) is a syndrome of acute systemic vasculitis commonly observed in children. Due to its unclear pathogenesis and the lack of specific diagnostic markers, it is prone to being confused with other diseases that exhibit similar symptoms, making early and accurate diagnosis challenging. This study aimed to develop an interpretable machine learning (ML) diagnostic model for KD. We collected demographic and laboratory data from 3650 patients (2299 with KD, 1351 with similar symptoms but different diseases) and employed 10 ML algorithms to construct the diagnostic model. Diagnostic performance was evaluated using several metrics, including area under the receiver-operating characteristic curve (AUC). Additionally, the shapley additive explanations (SHAP) method was employed to select important features and explain the final model. Using the Streamlit framework, we converted the model into a user-friendly web application to enhance its practicality in clinical settings. Among the 10 ML algorithms, XGBoost demonstrates the best diagnostic performance, achieving an AUC of 0.9833. SHAP analysis revealed that features, including age in months, fibrinogen, and human interferon gamma, are important for diagnosis. When relying on the top 10 most important features, the model's AUC remains at 0.9757. The proposed model can assist clinicians in making early and accurate diagnoses of KD. Furthermore, its interpretability enhances model transparency, facilitating clinicians' understanding of prediction reliability.