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Development and validation of a machine learning-based diagnostic system for 22 pediatric respiratory pathogens: a

Dubin Su1,2, Qun Chen1,3, Ruizhi Xu1,2

  • 1Institute for Clinical Medical Research, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.

NPJ Digital Medicine
|May 29, 2026
PubMed

Insights

A new system, Pathogen Diagnostic System for Pediatric Respiratory Infections (Pathog-PDx), accurately identifies pediatric respiratory pathogens early. This aids in timely, targeted treatment for better child health outcomes.

Area of Science:

  • Pediatric infectious diseases
  • Medical informatics
  • Computational biology

Background:

  • Respiratory tract infections (RTIs) are a major cause of childhood illness.
  • Accurate pathogen identification is essential for effective treatment of pediatric RTIs.
  • Current diagnostic methods can be slow, delaying targeted therapy.

Purpose of the Study:

  • To develop and validate an interpretable diagnostic system, Pathog-PDx, for early identification of respiratory pathogens in children.
  • To assess the real-world applicability of the Pathog-PDx model.
  • To provide a decision support tool for clinicians treating pediatric RTIs.

Main Methods:

  • Developed an interpretable Pathogen Diagnostic System for Pediatric Respiratory Infections (Pathog-PDx) using 42 clinical and laboratory features from electronic health records (EHR).
  • Conducted a multicenter study involving 134,500 hospitalized children for model development.
  • Performed prospective validation on an independent cohort of 1338 children.

Main Results:

  • Pathog-PDx accurately distinguished 22 pathogen subtypes, outperforming conventional models in identifying single and mixed infections.
  • Achieved high classification performance for key pathogens like influenza virus (AUC=0.95, Sn=0.88, Sp=0.86).
  • Demonstrated a mean AUC of 0.88 for various RTI pathogens.

Conclusions:

  • Pathog-PDx is a validated tool for early identification of respiratory pathogens in pediatric patients.
  • The system provides actionable predictions before conventional test results are available.
  • Pathog-PDx has been deployed as a freely accessible web-based decision support system to guide timely and targeted therapy.

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