A semi-supervised decision support system to facilitate antibiotic stewardship for urinary tract infections

Sjoerd de Vries*, Thijs ten Doesschate, Joan E.E. Totté, Judith W. Heutz, Yvette G.T. Loeffen, Jan Jelrik Oosterheert, Dirk Thierens, Edwin Boel

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Urinary Tract Infections (UTIs) are among the most frequently occurring infections in the hospital. Urinalysis and urine culture are the main tools used for diagnosis. Whereas urinalysis is sufficiently sensitive for detecting UTI, it has a relatively low specificity, leading to unnecessary treatment with antibiotics and the risk of increasing antibiotic resistance. We performed an evaluation of the current diagnostic process with an expert-based label for UTI as outcome, retrospectively established using data from the Electronic Health Records. We found that the combination of urinalysis results with the Gram stain and other readily available parameters can be used effectively for predicting UTI. Based on the obtained information, we engineered a clinical decision support system (CDSS) using the reliable semi-supervised ensemble learning (RESSEL) method, and found it to be more accurate than urinalysis or the urine culture for prediction of UTI. The CDSS provides clinicians with this prediction within hours of ordering a culture and thereby enables them to hold off on prematurely prescribing antibiotics for UTI while awaiting the culture results.

Original languageEnglish
Article number105621
Number of pages18
JournalComputers in Biology and Medicine
Volume146
DOIs
Publication statusPublished - Jul 2022

Keywords

  • Antibiotic stewardship
  • Clinical decision support
  • Ensemble learning
  • RESSEL
  • Semi-supervised learning
  • Urinary tract infection

Fingerprint

Dive into the research topics of 'A semi-supervised decision support system to facilitate antibiotic stewardship for urinary tract infections'. Together they form a unique fingerprint.

Cite this