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Differential Diagnosis of Bacterial and Viral Meningitis Using Dominance-Based Rough Set Approach

机译：基于优势度的粗糙集方法对细菌和病毒性脑膜炎的鉴别诊断

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Differential diagnosis of bacterial and viral meningitis remains an important clinical problem, particularly in the initial hours of hospitalization, before obtaining results of lumbar punction. We conducted a retrospective analysis of the medical records of 193 children hospitalized in St. Joseph Children's Hospital in Poznan. In this study, we applied the original methodology of dominance-based rough set approach (DRSA) to induce diagnostic patterns from meningitis data and to represent them by decision rules useful in discriminating between bacterial and viral meningitis. The rule induction algorithm applied to this end is VC-DomLEM from jRS library. In the studied group of 193 patients, there were 124 boys and 69 girls, and the mean age was 94 months. The patients were characterized by 10 attributes, of which only 5 were used in 5 rules able to discriminate between bacterial and viral meningitis with an average precision of 98%, where C-reactive protein attribute (CRP) appeared to be the most valuable. Factors associated with bacterial meningitis were: CRP level ≥ 85 mg/1, or age < 2 months. Factors associated with viral meningitis were CRP level ≤ 60 mg/l and procalcy-tonin level < 0.5 ng/ml, or CRP level ≤ 84 mg/1 and the presence of vomiting. We established a minimum set of attributes significant for classification of patients with bacterial or viral meningitis. These attributes are analyzed in just 5 rules able to distinguish almost perfectly between bacterial and viral meningitis without the need of lumbar punction.
机译：细菌性和病毒性脑膜炎的鉴别诊断仍然是一个重要的临床问题，尤其是在住院的最初几个小时，在获得腰椎穿刺点结果之前。我们对波兹南圣约瑟夫儿童医院住院的193名儿童的病历进行了回顾性分析。在这项研究中，我们应用了基于优势的粗糙集方法（DRSA）的原始方法，从脑膜炎数据中得出诊断模式，并通过可用于区分细菌性和病毒性脑膜炎的决策规则来代表它们。为此目的应用的规则归纳算法是jRS库中的VC-DomLEM。在研究的193例患者中，男孩124例，女孩69例，平均年龄为94个月。患者具有10个属性，其中5个规则中只有5个能够区分细菌性和病毒性脑膜炎，平均准确度为98％，其中C反应蛋白属性（CRP）似乎是最有价值的。与细菌性脑膜炎相关的因素为：CRP水平≥85 mg / 1，或年龄<2个月。与病毒性脑膜炎相关的因素是CRP水平≤60 mg / l和降钙素原水平<0.5 ng / ml，或CRP水平≤84 mg / 1和有呕吐。我们建立了对细菌或病毒性脑膜炎患者分类具有重要意义的最小属性集。仅用5条规则就可以对这些属性进行分析，这些规则几乎可以完全区分细菌性和病毒性脑膜炎，而无需腰椎穿刺。

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