Revolutionizing Infection Risk Scoring: An Ensemble “From Weak to Strong” Deduction Strategy and Enhanced Point‐of‐Care Testing Tools

Author:

Chen Haoman123,Ye Hui1,Chen Fanxuan34,Shi Yi23,Li Jiahe23,Li Yuhang23,Wei Chaoyi2,Zhang Chengxi5,Jin Jinhao36,Zhang Quanyue34,Pan Shuo3,Chen Dong17,Quan Shichao8910,Xu Xiaowei6,Yang Zongxing11,Xu Lijun12,Zhang Yungui13,Wang Yi414,Zhou Yunlong414,Liu Ou2,Jiang Xiaoming2,Liu Liyu2,He Qingzu15,Hu Xiaoqu616,Pan Jingye8910,Shuai Jianwei249,Su Feifei17ORCID

Affiliation:

1. Department of Infectious Diseases Wenzhou Central Hospital Wenzhou Zhejiang 325000 China

2. Wenzhou Institute and Wenzhou Key Laboratory of Biophysics Wenzhou Institute University of Chinese Academy of Sciences Wenzhou Zhejiang 325001 China

3. Wenzhou Medical University Wenzhou Zhejiang 325000 China

4. School of Biomedical Engineering School of Ophthalmology and Optometry Eye Hospital Wenzhou Medical University Wenzhou Zhejiang 325001 China

5. School of Materials Science and Engineering Shandong Jianzhu University Jinan Shandong 250101 China

6. The First Affiliated Hospital of Wenzhou Medical University Wenzhou Zhejiang 325000 China

7. Wenzhou Key Laboratory for the Diagnosis and Treatment of Emerging and Re-emerging Infectious Diseases Wenzhou Zhejiang 325000 China

8. Department of Big Data in Health Science The First Affiliated Hospital of Wenzhou Medical University Wenzhou Zhejiang 325100 China

9. Key Laboratory of Intelligent Treatment and Life Support for Critical Diseases of Zhejiang Province Wenzhou Zhejiang 325000 China

10. Zhejiang Engineering Research Center for Hospital Emergency and Process Digitization Wenzhou Zhejiang 325000 China

11. Department of Infectious Diseases Hangzhou Xixi Hospital Hangzhou Zhejiang 320000 China

12. Department of Infectious Diseases The First Affiliated Hospital of Zhejiang University School of Medicine Hangzhou Zhejiang 320000 China

13. Yunnan Provincial Infectious Disease Hospital Kunming Yunnan 650000 China

14. Engineering Research Center of Clinical Functional Materials and Diagnosis & Treatment Devices of Zhejiang Province Wenzhou Institute University of Chinese Academy of Sciences Wenzhou Zhejiang 325001 China

15. Department of Physics, and Fujian Provincial Key Laboratory for Soft Functional Materials Research Xiamen University Xiamen Fujian 361005 China

16. Department of Thyroid and Breast Surgery The First Affiliated Hospital of Wenzhou Medical University Wenzhou Zhejiang 325000 China

Abstract

The COVID‐19 pandemic exacerbates challenges faced by human immunodeficiency virus patients, who are at heightened risk for infection due to compromised immune systems. This study aims to develop a reliable, home‐based point‐of‐care testing (POCT) tool for early screening of acquired immunodeficiency syndrome (AIDS) coinfected with Talaromyces marneffei infection. Employing a “From weak to strong” deduction strategy for feature selection, data from 464 AIDS patients across four cohorts between February 5th, 2014, and January 8th, 2022, are analyzed. The top three features consistently observed are D‐dimer, cluster of differentiation 4+, and aspartate transaminase. Based on these features, the simplest risk‐scoring model is constructed, with the area under the receiver operating characteristic curve values of 0.91, 0.80, and 0.69 in the hold‐out cohort, external cohort 1, and external cohort 2, respectively. This “From weak to strong” deduction strategy identifies advantageous clinical features, enabling the development of simplified clinical risk scores with multiple biomarkers. To facilitate practical implementation, enhanced POCT tools are introduced, specifically a strip with segmented testing capabilities that demonstrates sensitivity and strong correlation with clinical scoring models. Furthermore, an open‐access website and a free Android mobile app are created to support community utilization. The findings underscore the effectiveness of the innovative deduction strategy and enhanced test strips, which enable bedside measurements without laboratory dependency.

Funder

National Natural Science Foundation of China

Publisher

Wiley

Subject

General Medicine

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