Modest Clostridiodes difficile infection prediction using machine learning models in a tertiary care hospital.

Journal: Diagnostic microbiology and infectious disease
PMID:

Abstract

Previous studies have shown promising results of machine learning (ML) models for predicting health outcomes. We develop and test ML models for predicting Clostridioides difficile infection (CDI) in hospitalized patients. This is a retrospective cohort study conducted during 2015-2017. All inpatients tested for C. difficile were included. CDI was defined as having a positive glutamate dehydrogenase and toxin results. We restricted analyses to the first record of C. difficile testing per patient. Of 3514 patients tested, 136 (4%) had CDI. Age and antibiotic use within 90 days before C. difficile testing were associated with CDI (P < 0.01). We tested 10 ML methods with and without resampling. Logistic regression, random forest and naïve Bayes models yielded the highest AUC ROC performance: 0.6. Predicting CDI was difficult in our cohort of patients tested for CDI. Multiple ML models yielded only modest results in a real-world population of hospitalized patients tested for CDI.

Authors

  • Alexandre R Marra
    Hospital Israelita Albert Einstein, São Paulo, Brazil.
  • Mohammed Alzunitan
    Quality Improvement Program, University of Iowa Hospitals & Clinics, Iowa City, IA; Department of Infection Prevention and Control, King Abdulaziz Medical City, National Guard - Health Affairs, Riyadh, Saudi Arabia.
  • Oluchi Abosi
    Quality Improvement Program, University of Iowa Hospitals & Clinics, Iowa City, IA.
  • Michael B Edmond
    Quality Improvement Program, University of Iowa Hospitals & Clinics, Iowa City, IA; Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA.
  • W Nick Street
    Department of Business Analytics, Henry B. Tippie College of Business, University of Iowa, Iowa City, IA.
  • John W Cromwell
    Quality Improvement Program, University of Iowa Hospitals & Clinics, Iowa City, IA.
  • Jorge L Salinas
    Quality Improvement Program, University of Iowa Hospitals & Clinics, Iowa City, IA; Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA.