A retrospective study using machine learning to develop predictive model to identify rotavirus-associated acute gastroenteritis in children

Background Rotavirus is the leading cause of severe dehydrating diarrhea in children under 5 years worldwide. Timely diagnosis is critical, but access to confirmatory testing is limited in hospital settings. Machine learning (ML) models have shown promising potential in supporting symptom-based diagnosis of several diseases in resource-limited settings. Objectives This study aims to develop a machine-learning predictive model integrated with multiple sources of clinical parameters specific to rotavirus infection without relying on laboratory tests. Methods A clinical dataset of 509 children was collected in collaboration with the Regional Institute of Medical Sciences, Imphal, India. The clinical symptoms included diarrhea and its duration, number of stool episodes per day, fever, vomiting and its duration, number of vomiting episodes per day, temperature and dehydration. Correlation analysis is performed to check the feature-feature and feature-outcome collinearity. Feature selection using ANOVA F test is carried out to find the feature importance values and finally obtain the reduced feature subset. Seven supervised learning models were tested and compared viz., support vector machine (SVM), K-nearest neighbor (KNN), naive Bayes (NB), logistic regression (Log_R) , random forest (RF), decision tree (DT), and XGBoost (XGB). A comparison of the performances of the seven models using the classification results obtained. The performance of the models was evaluated based on accuracy, precision, recall, specificity, F1 score, macro F1, F2, and receiver operator characteristic curve. Results The seven ML models were exhaustively experimented on our dataset and compared based on eight evaluation scores which are accuracy, precision, recall, specificity, F1 score, F2 score, macro F1 score, and AUC values computed. We observed that when the seven ML models were applied, RF performed the best with an accuracy of 81.4%, F1 score of 86.9%, macro F1-score of 77.3%, F2 score of 86.5% and area under the curve (AUC) of 89%. Conclusions The machine learning models can contribute to predicting symptom-based diagnosis of rotavirus-associated acute gastroenteritis in children, especially in resource-limited settings. Further validation of the models using a large dataset is needed for predicting pediatric diarrheic populations with optimum sensitivity and specificity.