scholarly journals A Clinical Decision Tree to Predict Whether a Bacteremic Patient Is Infected With an Extended-Spectrum β-Lactamase–Producing Organism

2016 ◽  
Vol 63 (7) ◽  
pp. 896-903 ◽  
Author(s):  
Katherine E. Goodman ◽  
Justin Lessler ◽  
Sara E. Cosgrove ◽  
Anthony D. Harris ◽  
Ebbing Lautenbach ◽  
...  
Keyword(s):  
Decision Tree ◽  
Clinical Decision ◽  
Extended Spectrum ◽  
Bacteremic Patient

scholarly journals Bayesian Network Models with Decision Tree Analysis for Management of Childhood Malaria in Malawi

2020 ◽  
Author(s):  
Sanya B. Taneja ◽  
Gerald P. Douglas ◽  
Gregory F. Cooper ◽  
Marian G. Michaels ◽  
Marek J. Druzdzel ◽  
...  
Keyword(s):  
Decision Tree ◽  
Bayesian Network ◽  
Clinical Features ◽  
Predictive Models ◽  
Clinical Decision Making ◽  
Performance Metrics ◽  
Expert Knowledge ◽  
Clinical Decision ◽  
Automated Method ◽  
Childhood Malaria

Abstract Background: Malaria is a major cause of death in children under five years old in low- and middle-income countries such as Malawi. Accurate diagnosis and management of malaria can help reduce the global burden of childhood morbidity and mortality. Trained healthcare workers in rural health centers manage malaria with limited supplies of malarial diagnostic tests and drugs for treatment. A clinical decision support system that integrates predictive models to provide an accurate prediction of malaria based on clinical features could aid healthcare worker in judicious use of testing and treatment. We developed Bayesian network (BN) models to predict the probability of malaria from clinical features and an illustrative decision tree to model the decision to use or not use a malaria rapid diagnostic test (mRDT).Methods: We developed two BN models from data that were collected in a national survey of outpatient encounters of children in Malawi. The target diagnosis is taken as the result of mRDT. The first BN model was created manually with expert knowledge, and the second model was derived using an automated method followed by modifications guided by expert knowledge. The performance of the BN models was compared to other statistical models on a range of performance metrics. We developed a decision tree that integrates predictions from these predictive models with the costs of mRDT and a course of recommended treatment. Results: Compared to the logistic regression and random forest models, the BN models had similar accuracy of 64% but had higher sensitivity at the cost of lower specificity at the default threshold. Sensitivity analysis of the decision tree showed that at low (below 0.04) and high (above 0.4) probabilities of malaria in a child, the preferred decision that minimizes expected costs is not to perform mRDT.Conclusion: In resource-constrained settings, judicious use of mRDT is important. Predictive models in combination with decision analysis can provide personalized guidance on when to use mRDT in the management of childhood malaria. BN models can be efficiently derived from data to support such clinical decision making.

scholarly journals Bayesian Network Models with Decision Tree Analysis for Management of Childhood Malaria in Malawi

2021 ◽  
Author(s):  
Sanya B. Taneja ◽  
Gerald P. Douglas ◽  
Gregory F. Cooper ◽  
Marian G. Michaels ◽  
Marek J. Druzdzel ◽  
...  
Keyword(s):  
Decision Tree ◽  
Bayesian Network ◽  
Clinical Features ◽  
Predictive Models ◽  
Healthcare Workers ◽  
Expert Knowledge ◽  
Clinical Decision ◽  
Automated Method ◽  
Multiple Thresholds ◽  
Childhood Malaria

Abstract Background: Malaria is a major cause of death in children under five years old in low- and middle-income countries such as Malawi. Accurate diagnosis and management of malaria can help reduce the global burden of childhood morbidity and mortality. Trained healthcare workers in rural health centers manage malaria with limited supplies of malarial diagnostic tests and drugs for treatment. A clinical decision support system that integrates predictive models to provide an accurate prediction of malaria based on clinical features could aid healthcare workers in the judicious use of testing and treatment. We developed Bayesian network (BN) models to predict the probability of malaria from clinical features and an illustrative decision tree to model the decision to use or not use a malaria rapid diagnostic test (mRDT).Methods: We developed two BN models to predict malaria from a dataset of outpatient encounters of children in Malawi. The first BN model was created manually with expert knowledge, and the second model was derived using an automated method. The performance of the BN models was compared to other statistical models on a range of performance metrics at multiple thresholds. We developed a decision tree that integrates predictions with the costs of mRDT and a course of recommended treatment. Results: The manually created BN model achieved an area under the ROC curve (AUC) equal to 0.60 that was statistically significantly higher than the other models. The BN models had high sensitivity and specificity values (0.74 and 0.42 respectively for the manual BN model, 0.45 and 0.68 respectively for the automated BN model) at the optimal threshold for classification. The balanced accuracy values were similar across all the models. Sensitivity analysis of the decision tree showed that at low (below 0.04) and high (above 0.40) probabilities of malaria in a child, the preferred decision that minimizes expected costs is not to perform mRDT.Conclusion: In resource-constrained settings, judicious use of mRDT is important. Predictive models in combination with decision analysis can provide personalized guidance on when to use mRDT in the management of childhood malaria. BN models can be efficiently derived from data to support such clinical decision making.

scholarly journals Peripheral Exophytic Oral Lesions: A Clinical Decision Tree

2017 ◽  
Vol 2017 ◽  
pp. 1-19 ◽  
Author(s):  
Hamed Mortazavi ◽  
Yaser Safi ◽  
Maryam Baharvand ◽  
Somayeh Rahmani ◽  
Soudeh Jafari
Keyword(s):  
Decision Tree ◽  
English Language ◽  
Clinical Decision ◽  
Malignant Neoplasms ◽  
Oral Lesions ◽  
Pubmed Central ◽  
Oral Tumor ◽  
General Search ◽  
General Frequency ◽  
Oral Soft Tissue

Diagnosis of peripheral oral exophytic lesions might be quite challenging. This review article aimed to introduce a decision tree for oral exophytic lesions according to their clinical features. General search engines and specialized databases including PubMed, PubMed Central, Medline Plus, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of keywords such as “oral soft tissue lesion,” “oral tumor like lesion,” “oral mucosal enlargement,” and “oral exophytic lesion.” Related English-language articles published since 1988 to 2016 in both medical and dental journals were appraised. Upon compilation of data, peripheral oral exophytic lesions were categorized into two major groups according to their surface texture: smooth (mesenchymal or nonsquamous epithelium-originated) and rough (squamous epithelium-originated). Lesions with smooth surface were also categorized into three subgroups according to their general frequency: reactive hyperplastic lesions/inflammatory hyperplasia, salivary gland lesions (nonneoplastic and neoplastic), and mesenchymal lesions (benign and malignant neoplasms). In addition, lesions with rough surface were summarized in six more common lesions. In total, 29 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by a stepwise progression method.

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