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Exhaustive mathematical analysis of simple clinical measurements for childhood pneumonia diagnosis

World Journal of Pediatrics 2017年第5期13卷 446-456页

作者： keegan kosasih Udantha Abeyratne School of ITEE The University of QueenslandSir Fred Schonell DriveSt.LuciaBrisbaneQLDAustralia

Background:Pneumonia is the leading cause of mortality for children below 5 years of *** majority of these occur in poor countries with limited access to *** World Health Organization (WHO) criterion for pneumonia is the de facto method for *** is designed targeting a high sensitivity and uses easy to measure *** WHO criterion has poor ***:We propose a method using common measurements (including the WHO parameters) to diagnose pneumonia at high sensitivity and *** clinical features obtained from 134 subjects were used to create a series of logistic regression *** started with one feature at a time,and continued building models with increasing number of features until we exhausted all possible *** used a k-fold cross validation method to measure the performance of the ***:The sensitivity of our method was comparable to that of the WHO criterion but the specificity was 84%-655% *** the 2-11 month age group,the WHO criteria had a sensitivity and specificity of 92.0%±11.6% and 38.1%±18.5%,*** best model (using the existence of a runny nose,the number of days with runny nose,breathing rate and temperature) performed at a sensitivity of 91.3%±13.0% and specificity of 70.2%±22.80%.In the 12-60 month age group,the WHO algorithm gave a sensitivity of 95.7%±7.6% at a specificity of 9.8%±13.1%,while our corresponding sensitivity and specificity were 94.0%±12.1% and 74.0%±23.3%,respectively (using fever,number of days with cough,heart rate and chest in-drawing).Conclusions:The WHO algorithm can be improved through mathematical analysis of clinical observations and measurements routinely made in the *** method is simple and easy to implement on a mobile *** method allows the freedom to pick the best model in any arbitrary field scenario (e.g.,when an oximeter is not available).

关键词： developing countries diagnosis logistic regression modelling pneumonia

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