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Integration of population-level data sources into an individual-level clinical prediction model for dengue virus test positivity

The differentiation of dengue virus (DENV) infection, a major cause of acute febrile illness in tropical regions, from other etiologies, may help prioritize laboratory testing and limit the inappropriate use of antibiotics. While traditional clinical prediction models focus on individual patient-lev...

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Detalles Bibliográficos
Autores principales: Williams, RJ, Brintz, Ben J., Santos, Gabriel Ribeiro Dos, Huang, Angkana, Buddhari, Darunee, Kaewhiran, Surachai, Iamsirithaworn, Sopon, Rothman, Alan L., Thomas, Stephen, Farmer, Aaron, Fernandez, Stefan, Cummings, Derek A T, Anderson, Kathryn B, Salje, Henrik, Leung, Daniel T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cold Spring Harbor Laboratory 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10441499/
https://www.ncbi.nlm.nih.gov/pubmed/37609267
http://dx.doi.org/10.1101/2023.08.08.23293840
Descripción
Sumario:The differentiation of dengue virus (DENV) infection, a major cause of acute febrile illness in tropical regions, from other etiologies, may help prioritize laboratory testing and limit the inappropriate use of antibiotics. While traditional clinical prediction models focus on individual patient-level parameters, we hypothesize that for infectious diseases, population-level data sources may improve predictive ability. To create a clinical prediction model that integrates patient-extrinsic data for identifying DENV among febrile patients presenting to a hospital in Thailand, we fit random forest classifiers combining clinical data with climate and population-level epidemiologic data. In cross validation, compared to a parsimonious model with the top clinical predictors, a model with the addition of climate data, reconstructed susceptibility estimates, force of infection estimates, and a recent case clustering metric, significantly improved model performance.