Comparison of Machine Learning Optimal Classification Trees With the Pediatric Emergency Care Applied Research Network Head Trauma Decision Rules.
Authors of this article are:
Bertsimas D, Dunn J, Steele DW, Trikalinos TA, Wang Y.
A summary of the article is shown below:
Importance: Computed tomographic (CT) scanning is the standard for the rapid diagnosis of intracranial injury, but it is costly and exposes patients to ionizing radiation. The Pediatric Emergency Care Applied Research Network (PECARN) rules for identifying children with minor head trauma who are at very low risk of clinically important traumatic brain injury (ciTBI) are widely used to triage CT imaging.Objective: To examine whether optimal classification trees (OCTs), which are novel machine-learning classifiers, improve on PECARN rules’ predictive accuracy.Design, Setting, and Participants: A secondary analysis of prospective, publicly available data on emergency department visits for head trauma used by the PECARN group to develop their tool was conducted to derive OCT-based prediction rules for ciTBI in a development cohort and compare their predictive performance vs the PECARN rules in a validation cohort among children who were younger than 2 years and 2 years or older. Data on 42 412 children with head trauma and without severely altered mental status who were examined between June 1, 2004, and September 30, 2006, were gathered from 25 emergency departments in North America participating in PECARN. Data analysis was conducted from September 15, 2016, to December 18, 2018.Main Outcomes and Measures: The outcome was ciTBI, with predictive performance measured by estimating the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio for the OCT and the PECARN rules. The OCT and PECARN rules’ performance was compared by estimating ratios for each measure.Results: Of the 42 412 children (15 996 [37.7%] girls) included in the analysis, 10 718 were younger than 2 years (25.3%; mean [SD] age, 11.6 [0.6] months) and 31 694 were 2 years or older (74.7%; age, 9.1 [4.9] years). Compared with PECARN rules, OCTs misclassified 0 vs 1 child with ciTBI in the younger and 10 vs 9 children with ciTBI in the older cohort, and correctly identified more children with very low risk of ciTBI in the younger (7605 vs 5701) and older (20 594 vs 18 134) cohorts. In the validation cohorts, compared with the PECARN rules, the OCTs had statistically significantly better specificity (in the younger cohort: 69.3%; 95% CI, 67.4%-71.2% vs 52.8%; 95% CI, 50.8%-54.9%; in the older cohort: 65.6%; 95% CI, 64.5%-66.8% vs 57.6%; 95% CI, 56.4%-58.8%), positive predictive value (odds ratios, 1.54; 95% CI, 1.36-1.74 and 1.23; 95% CI, 1.17-1.30, in younger and older children, respectively), and positive likelihood ratio (risk ratios, 1.54; 95% CI, 1.36-1.74 and 1.23; 95% CI, 1.17-1.30, in younger and older children, respectively). There were no statistically significant differences in the sensitivity, negative predictive value, and negative likelihood ratio between the 2 sets of rules.Conclusions and Relevance: If implemented, OCTs may help reduce the number of unnecessary CT scans, without missing more patients with ciTBI than the PECARN rules.
Check out the article’s website on Pubmed for more information:
This article is a good source of information and a good way to become familiar with topics such as: n/a.
New Chemicals from MOLECULAR DEPOT
-
- Sale!
- Chemicals, Interference, Lipids
Triglyceride Mix for Interference Testing
- Original price was: $495.00.$295.00Current price is: $295.00.
- Add to cart
-
- Sale!
- Chemicals
Microparticle Stabilizer Solution
- Original price was: $595.00.$295.00Current price is: $295.00.
- Add to cart
-
- Sale!
- Buffers & Solutions, Chemicals
Enzyme Acceptor Stabilization Buffer
- Original price was: $495.00.$250.00Current price is: $250.00.
- Add to cart
-
- Sale!
- Buffers & Solutions, Chemicals
Enzyme Donor Stabilization Buffer
- Original price was: $495.00.$250.00Current price is: $250.00.
- Add to cart
-
- Sale!
- Chemicals, Conjugates
Progesterone Biotin Conjugate Solution
- Original price was: $650.00.$350.00Current price is: $350.00.
- Add to cart
-
- Sale!
- Buffers & Solutions, Chemicals
Microparticle Activation Buffer
- Original price was: $595.00.$295.00Current price is: $295.00.
- Add to cart
-
- Sale!
- Buffers & Solutions, Chemicals
Microparticle Washing Buffer
- Original price was: $595.00.$295.00Current price is: $295.00.
- Add to cart
-
- Sale!
- Buffers & Solutions, Chemicals
Microparticle Blocking Buffer
- Original price was: $650.00.$350.00Current price is: $350.00.
- Add to cart
-
- Sale!
- Buffers & Solutions, Chemicals
Microparticle Anti Aggregation Agent
- Original price was: $595.00.$295.00Current price is: $295.00.
- Add to cart
-
- Sale!
- Chemicals
CPRG (Chlorophenol red-β-D-galactopyranoside)
- Original price was: $850.00.$395.00Current price is: $395.00.
- Add to cart
New Proteins from MOLECULAR DEPOT
-
- Sale!
- Proteins, Conjugates
Tacrolimus BSA Conjugate Solution
- Original price was: $695.00.$495.00Current price is: $495.00.
- Add to cart
-
- Sale!
- Enzymes, Proteins
Cholesterol Oxidase from Streptomyces sp.
- Original price was: $595.00.$295.00Current price is: $295.00.
- Add to cart
-
- Sale!
- Proteins
Aprotinin from Bovine Lung (Lyophilized powder)
- Original price was: $450.00.$250.00Current price is: $250.00.
- Add to cart
-
- Sale!
- Proteins, Enzymes
Beta-galactosidase Enzyme Donor
- Original price was: $795.00.$450.00Current price is: $450.00.
- Add to cart
-
- Sale!
- Proteins, Enzymes
Beta-galactosidase Enzyme Acceptor
- Original price was: $795.00.$375.00Current price is: $375.00.
- Add to cart
-
- Sale!
- Enzymes, Proteins
Xanthine Oxidase Grade II (Lyophilized Powder)
- Original price was: $695.00.$395.00Current price is: $395.00.
- Add to cart
-
- Sale!
- Proteins, Enzymes
Ascorbate Oxidase (Lyophilized Powder)
- Original price was: $350.00.$250.00Current price is: $250.00.
- Add to cart
-
- Sale!
- Proteins
Silk Fibroin (Bombyx Mori Silkworm)
- Original price was: $595.00.$295.00Current price is: $295.00.
- Add to cart
-
- Sale!
- Proteins
Fibrinogen from Bovine Plasma Lyophilized
- Original price was: $595.00.$295.00Current price is: $295.00.
- Add to cart
-
- Sale!
- Proteins, Enzymes
Horseradish Peroxidase Biotinylated
- Original price was: $595.00.$295.00Current price is: $295.00.
- Add to cart
New Antibodies from MOLECULAR DEPOT
-
- Sale!
- Antibodies
Antibody to Thyroxine T4 Monoclonal
- Original price was: $995.00.$495.00Current price is: $495.00.
- Add to cart
-
- Antibodies
SAA Antibody Monoclonal Anti-Serum Amyloid A
- $350.00 – $1,550.00
- Select options
-
- Antibodies
Valproic Acid Antibody (Mouse Monoclonal)
- $250.00 – $1,095.00
- Select options
-
- Antibodies
Phenytoin Antibody (Mouse Monoclonal)
- $350.00 – $1,450.00
- Select options
-
- Sale!
- Antibodies
Anti Sheep IgG (H+L) Rabbit Polyclonal
- $250.00 – $1,495.00
- Select options
-
- Sale!
- Antibodies
Anti Human IgM Antibody Polyclonal
- Original price was: $595.00.$295.00Current price is: $295.00.
- Add to cart
-
- Sale!
- Antibodies
Myoglobin Antibody (Human Affinity Purified)
- Original price was: $650.00.$350.00Current price is: $350.00.
- Add to cart
-
- Sale!
- Antibodies, Interference
Rheumatoid Factor Interference Blocker
- Original price was: $595.00.$395.00Current price is: $395.00.
- Add to cart
-
- Sale!
- Antibodies, Interference
HAMA Blocking Reagent (Affinity Purified)
- Original price was: $895.00.$450.00Current price is: $450.00.
- Add to cart
New Research Kits from MOLECULAR DEPOT
-
- Sale!
- Interference, Research Kits
Interference Test Kit
- Original price was: $595.00.$395.00Current price is: $395.00.
- Add to cart
-
- Sale!
- Research Kits
Alpha Complementation Kit Beta-galactosidase
- Original price was: $1,395.00.$695.00Current price is: $695.00.
- Add to cart
-
- Sale!
- Research Kits
Crystallization Screen for Protein-DNA Complexes
- Original price was: $1,295.00.$650.00Current price is: $650.00.
- Add to cart
-
- Sale!
- Molecular Biology, Research Kits
NativeFolder Bacterial Culture Medium
- $350.00 – $19,500.00
- Select options
-
- Sale!
- Research Kits
CycloScreen: Cyclodextrins Kit for Screening
- Original price was: $595.00.$295.00Current price is: $295.00.
- Add to cart
-
- Sale!
- Research Kits
NativePro Bradford Protein Assay Kit (Automated)
- Original price was: $995.00.$495.00Current price is: $495.00.
- Add to cart
-
- Sale!
- Interference, Research Kits
Rheumatoid Factor Interference Kit
- Original price was: $1,495.00.$695.00Current price is: $695.00.
- Add to cart
-
- Sale!
- Interference, Research Kits
Interference Test Kit EXTRA
- Original price was: $795.00.$495.00Current price is: $495.00.
- Add to cart
-
- Sale!
- Interference, Research Kits
HAMA Interference Kit
- Original price was: $895.00.$595.00Current price is: $595.00.
- Add to cart
-
- Sale!
- Buffers & Solutions, ELISA, Research Kits
ELISA Microplate Production Kit
- Original price was: $795.00.$495.00Current price is: $495.00.
- Add to cart