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Diagnostic Machine Learning Models of Infectious Mononucleosis in Children Based on Clinical Data: A Retrospective

Wenshen Gu1,2, Shoufu He1,2, Xiaohui Li3

  • 1College of Medical Technology, Guangdong Medical University, Dongguan, Guangdong, P.R. China.

Journal of Medical Virology
|August 1, 2025
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Summary

This study developed cost-effective machine learning models to diagnose infectious mononucleosis (IM) in children, outperforming traditional methods. These models use clinical features and inflammatory markers, aiding diagnosis in settings without specialized tests.

Keywords:
IMSHAPdiagnostic modelmachine learningserum inflammatory indices

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Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Machine Learning in Medicine

Background:

  • Infectious mononucleosis (IM) and acute respiratory tract infections (ARTI) share similar clinical symptoms in children.
  • Accurate and timely diagnosis of IM is crucial but can be challenging due to overlapping presentations.
  • Existing diagnostic methods may be costly or inaccessible in certain healthcare settings.

Purpose of the Study:

  • To develop and validate cost-efficient diagnostic models for IM in children using machine learning.
  • To leverage the Shapley Additive explanation (SHAP) algorithm for model interpretability and feature selection.
  • To compare the performance of novel diagnostic models against traditional indicators and EBV-specific tests.

Main Methods:

  • Retrospective analysis of 853 pediatric patients diagnosed with IM across three medical centers.
  • Application of four machine learning techniques (GBM, XGBoost, RSF identified as best performers) using 49 clinical features and serum inflammatory markers.
  • Model evaluation via ROC curve analysis and interpretation using SHAP to identify key predictive features (Lymphocyte, PLR, LDH, SII, Age).

Main Results:

  • The developed models achieved diagnostic performance comparable to EBV-specific tests.
  • The five-indicator models demonstrated higher diagnostic value than atypical lymphocytes and EBV-DNA load.
  • Models proved effective across different pediatric age groups and are independent of EBV-specific test results.

Conclusions:

  • Novel machine learning models offer a superior and cost-efficient diagnostic tool for differentiating IM from ARTI in children.
  • These models are particularly valuable for primary healthcare units and institutions lacking EBV-specific diagnostic capabilities.
  • The study provides a promising alternative for accurate IM diagnosis, improving patient management and reducing healthcare costs.