{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:29:34Z","timestamp":1772990974224,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"1-2","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004241","name":"China Primary Health Care Foundation","doi-asserted-by":"publisher","award":["2021\u2010004"],"award-info":[{"award-number":["2021\u2010004"]}],"id":[{"id":"10.13039\/501100004241","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Necrotizing fasciitis (NF), a fulminant soft tissue infection manifesting acute onset and rapid progression with substantial mortality risks, poses diagnostic challenges due to its predominant reliance on clinical evaluation during initial presentation, frequently leading to diagnostic inaccuracies. This study constructs an interpretable machine learning model leveraging clinical data to optimize early prediction of NF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This single\u2010center retrospective study analyzed 288 soft tissue infection patients, partitioned into training (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009201) and validation (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200987) cohorts using a 7:3 allocation ratio. This study employed LASSO regression to identify key predictors, subsequently implementing five machine learning algorithms\u2014support vector machines (SVM), decision trees (DT), Light Gradient Boosting Machine(LightGBM), eXtreme Gradient Boosting(XGBoost)and random forest(RF). Model performance was assessed through stratified 10\u2010fold cross\u2010validation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 288 enrolled patients, 81 cases (28.1%) demonstrated NF confirmation through pathological\/surgical evaluation. The XGBoost model demonstrated superior discriminative ability (AUC\u2009=\u20090.809), surpassing the conventional nomogram's predictive accuracy (AUC\u2009=\u20090.724).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The XGBoost model facilitates accurate early identification of NF leveraging routine clinical indices. The model's interpretability facilitates clinical decision support systems by providing evidence\u2010based diagnostic workflow optimization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70395","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T11:56:33Z","timestamp":1763985393000},"page":"311-321","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Explainable Machine Learning Models Using Routine Clinical Data for Early Prediction of Necrotizing Fasciitis: A Single\u2010Center Retrospective Study"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3666-5053","authenticated-orcid":false,"given":"Zheng","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Pancreatic and Biliary Surgery The First Affiliated Hospital of Harbin Medical University  Harbin Heilongjiang Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pancreatic and Biliary Surgery The First Affiliated Hospital of Harbin Medical University  Harbin Heilongjiang Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qi","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Pancreatic and Biliary Surgery The First Affiliated Hospital of Harbin Medical University  Harbin Heilongjiang Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4031-6619","authenticated-orcid":false,"given":"Guosheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pancreatic and Biliary Surgery The First Affiliated Hospital of Harbin Medical University  Harbin Heilongjiang Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1534734620973490"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000001187"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2019.06.031"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1428"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2024.3365"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2017.00005"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2017.3.33607"},{"issue":"3","key":"e_1_2_12_9_1","first-page":"312","article-title":"Necrotizing Fasciitis","volume":"53","author":"Artikel Der","year":"2021","journal-title":"Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie: Organ der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie der Peripheren Nerven Und Gefasse : Organ der V"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12894-024-01557-x"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002774"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2021.115323"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-021-08005-6"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-021-03875-9"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2020.10.004"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.14639\/0392-100X-N0790"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.16377"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2021.01.002"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016489.2024.2384433"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002636"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2023.11.008"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13172735"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-024-00571-6"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2023.11.013"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu15224771"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/11772719211027022"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.2174\/1871530319666181129112708"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14820"},{"issue":"6","key":"e_1_2_12_29_1","first-page":"526","article-title":"Necrotizing Fasciitis: Pillaging the Acute Phase Response","volume":"102","author":"Hysong A. 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