title: A Classification Tool for Differentiation of Kawasaki Disease from Other Febrile Illnesses.
abstract: To develop and validate a novel decision tree-based clinical algorithm to differentiate Kawasaki disease (KD) from other pediatric febrile illnesses that share common clinical characteristics.
  
  
  
  Using clinical and laboratory data from 801 subjects with acute KD (533 for development, and 268 for validation) and 479 febrile control subjects (318 for development, and 161 for validation), we developed a stepwise KD diagnostic algorithm combining our previously developed linear discriminant analysis (LDA)-based model with a newly developed tree-based algorithm.
  
  
  
  The primary model (LDA) stratified the 1280 subjects into febrile controls (n = 276), indeterminate (n = 247), and KD (n = 757) subgroups. The subsequent model (decision trees) further classified the indeterminate group into febrile controls (n = 103) and KD (n = 58) subgroups, leaving only 29 of 801 KD (3.6%) and 57 of 479 febrile control (11.9%) subjects indeterminate. The 2-step algorithm had a sensitivity of 96.0% and a specificity of 78.5%, and correctly classified all subjects with KD who later developed coronary artery aneurysms.
  
  
  
  The addition of a decision tree step increased sensitivity and specificity in the classification of subject with KD and febrile controls over our previously described LDA model. A multicenter trial is needed to prospectively determine its utility as a point of care diagnostic test for KD.
authors.affiliation: Department of Surgery, Stanford University, Stanford, CA.
authors.forename: Shiying
authors.initials: S
authors.lastname: Hao
authors.affiliation: Department of Surgery, Stanford University, Stanford, CA.
authors.forename: Bo
authors.initials: B
authors.lastname: Jin
authors.affiliation: Department of Surgery, Stanford University, Stanford, CA.
authors.forename: Zhou
authors.initials: Z
authors.lastname: Tan
authors.affiliation: Department of Surgery, Stanford University, Stanford, CA.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Surgery, Stanford University, Stanford, CA.
authors.forename: Jun
authors.initials: J
authors.lastname: Ji
authors.affiliation: Department of Surgery, Stanford University, Stanford, CA.
authors.forename: Guang
authors.initials: G
authors.lastname: Hu
authors.affiliation: Department of Surgery, Stanford University, Stanford, CA.
authors.forename: Yue
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Surgery, Stanford University, Stanford, CA.
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Deng
authors.affiliation: Department of Pediatrics, University of California San Diego, La Jolla, CA; Rady Children's Hospital San Diego, San Diego, CA.
authors.forename: John T
authors.initials: JT
authors.lastname: Kanegaye
authors.affiliation: Department of Pediatrics, University of California San Diego, La Jolla, CA; Rady Children's Hospital San Diego, San Diego, CA.
authors.forename: Adriana H
authors.initials: AH
authors.lastname: Tremoulet
authors.affiliation: Department of Pediatrics, University of California San Diego, La Jolla, CA; Rady Children's Hospital San Diego, San Diego, CA.
authors.forename: Jane C
authors.initials: JC
authors.lastname: Burns
authors.affiliation: Department of Pediatrics, Stanford University, Stanford, CA.
authors.forename: Harvey J
authors.initials: HJ
authors.lastname: Cohen
authors.affiliation: Department of Surgery, Stanford University, Stanford, CA. Electronic address: bxling@stanford.edu.
authors.forename: Xuefeng B
authors.initials: XB
authors.lastname: Ling
mesh_terms: D000465:Algorithms; D002675:Child, Preschool; D003663:Decision Trees; D003937:Diagnosis, Differential; D005260:Female; D005334:Fever / Q000145:classification* / Q000175:diagnosis*; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000145:classification* / Q000175:diagnosis*; D015203:Reproducibility of Results
keywords: 2-step algorithm; KD diagnosis; LDA; incomplete KD; random forest