Establishment of a differential diagnosis method and an online prediction platform for AOSD and sepsis based on machine learning

Abstract Objective. The differential diagnosis between Adult-onset Still's disease (AOSD) and sepsis has always been a challenge. In this study, a machine learning model for differential diagnosis of AOSD and sepsis was developed and an online platform was developed to facilitate the clinical application of the model. Methods. All data were collected from 42 AOSD patients and 50 sepsis patients admitted to Affiliated Hospital of Xuzhou Medical University from December 2018 to December 2021. In addition, 5 AOSD patients and 10 sepsis patients diagnosed in our hospital after March 2022 were collected for external validation. All models were built using the scikit-learn library (version 1·0·2) in Python(version 3·9·7), and feature selection was performed using the SHAP (Shapley Additive exPlanation) package developed in Python. Results. The results showed that the gradient boosting decision tree(GBDT) optimization model based on arthralgia, ferritin × lymphocyte count, white blood cell count, ferritin × platelet count, and α1-acid glycoprotein/creatine kinase could well identify AOSD and sepsis. The training set interaction test (AUC: 0·9916, ACC: 0·9457, Sens: 0·9556, Spec: 0·9578) and the external validation also achieved satisfactory results (AUC: 0·9800, ACC: 0·9333, Sens: 0·8000, Spec: 1·000). We named this discrimination method AIADSS (AI-assisted discrimination of Still's disease and Sepsis) and created an online service platform for practical operation, the website is http://cppdd.cn/STILL1/. Conclusion. We created a method for the identification of AOSD and sepsis based on machine learning. This method can provide a reference for clinicians to formulate the next diagnosis and treatment plan.