Bayesian Approach to Predicting Acute Appendicitis Using Ultrasonographic and Clinical Variables in Children

Tristan Reddan; Jonathan Corness; Fiona Harden; Wenbiao Hu; Kerrie Mengersen

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자료유형: 학술저널

저자정보: Tristan Reddan Jonathan Corness Fiona Harden Wenbiao Hu Kerrie Mengersen

저널정보: 대한의료정보학회 Healthcare Informatics Research Healthcare Informatics Research 제25권 제3호

발행연도: 2019.1

수록면: 212 - 220 (9page)

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Objectives: Ultrasound has an established role in the diagnostic pathway for children with suspected appendicitis. Relevant clinical information can influence the diagnostic probability and reporting of ultrasound findings. A Bayesian network (BN) is a directed acyclic graph (DAG) representing variables as nodes connected by directional arrows permitting visualisation of their relationships. This research developed a BN model with ultrasonographic and clinical variables to predict acute appendicitis in children. Methods: A DAG was designed through a hybrid method based on expert opinion and a review of literature to define the model structure; and the discretisation and weighting of identified variables were calculated using principal components analysis, which also informed the conditional probability table of nodes. Results: The acute appendicitis target node was designated as an outcome of interest influenced by four sub-models, including Ultrasound Index, Clinical History, Physical Assessment, and Diagnostic Tests. These sub-models included four sonographic, three blood-test, and six clinical variables. The BN was scenario tested and evaluated for face, predictive, and content validity. A lack of similar networks complicated concurrent and convergent validity evaluation. Conclusions: To our knowledge, this is the first BN model developed for the identification of acute appendicitis incorporating imaging variables. It has particular benefit for cases in which variables are missing because prior probabilities are built into corresponding nodes. It will be of use to clinicians involved in ultrasound examination of children with suspected appendicitis, as well as their treating clinicians. Prospective evaluation and development of an online tool will permit validation and refinement of the BN.

참고문헌 (34)

참고문헌 신청

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