Diagnostic Support for Selected Paediatric Pulmonary Diseases Using Answer-Pattern Recognition in Questionnaires Based on Combined Data Mining Applications--A Monocentric Observational Pilot Study.
BACKGROUND
Clinical symptoms in children with pulmonary diseases are frequently non-specific. Rare diseases such as primary ciliary dyskinesia (PCD), cystic fibrosis (CF) or protracted bacterial bronchitis (PBB) can be easily missed at the general practitioner (GP).


OBJECTIVE
To develop and test a questionnaire-based and data mining-supported tool providing diagnostic support for selected pulmonary diseases.


METHODS
First, interviews with parents of affected children were conducted and analysed. These parental observations during the pre-diagnostic time formed the basis for a new questionnaire addressing the parents' view on the disease. Secondly, parents with a sick child (e.g. PCD, PBB) answered the questionnaire and a data base was set up. Finally, a computer program consisting of eight different classifiers (support vector machine (SVM), artificial neural network (ANN), fuzzy rule-based, random forest, logistic regression, linear discriminant analysis, naive Bayes and nearest neighbour) and an ensemble classifier was developed and trained to categorise any given new questionnaire and suggest a diagnosis. For estimating the diagnostic accuracy, we applied ten-fold stratified cross validation.


RESULTS
All questionnaires of patients suffering from CF, asthma (AS), PCD, acute bronchitis (AB) and the healthy control group were correctly diagnosed by the fusion algorithm. For the pneumonia (PM) group 19/21 (90.5%) and for the PBB group 17/18 (94.4%) correct diagnoses could be reached. The program detected the correct diagnoses with an overall sensitivity of 98.8%. Receiver operating characteristics (ROC) analyses confirmed the accuracy of this diagnostic tool. Case studies highlighted the applicability of the tool in the daily work of a GP.


CONCLUSIONS
For children with symptoms of pulmonary diseases a questionnaire-based diagnostic support tool using data mining techniques exhibited good results in arriving at diagnostic suggestions. In the hands of a doctor, this tool could be of value in arousing awareness for rare pulmonary diseases such as PCD or CF.
Department of Paediatric Haematology and Oncology, University Children's Hospital, Hanover Medical School, Hanover, Germany.
Ann-Katrin
AK
Rother
Department of Paediatric Pneumology, Allergy and Neonatology, University Children's Hospital, Hanover Medical School, Hanover, Germany.
Nicolaus
N
Schwerk
Department of Paediatric Pneumology, University Children's Hospital, Ruhr- University Bochum, Bochum, Germany.
Folke
F
Brinkmann
Helmholtz Centre for Infection Research, Braunschweig, Germany; Ostfalia University of Applied Sciences, Wolfenbuettel, Germany.
Frank
F
Klawonn
Improved Medical Diagnostics, Ptd. Ltd., Singapore.
Werner
W
Lechner
Department of Paediatric Haematology and Oncology, University Children's Hospital, Hanover Medical School, Hanover, Germany.
Lorenz
L
Grigull
D002648:Child; D002675:Child, Preschool; D003627:Data Interpretation, Statistical; D057225:Data Mining; D005260:Female; D006801:Humans; D007223:Infant; D008171:Lung Diseases / Q000175:diagnosis*; D008297:Male; D010865:Pilot Projects; D011795:Surveys and Questionnaires