{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T02:35:07Z","timestamp":1768962907904,"version":"3.49.0"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>We aimed to develop and test machine learning algorithms for the prediction of severe outcomes associated with MIS\u2010C.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>An observational ambispective cohort study was conducted including children aged from 1\u2009month to 18\u2009years old in 84 hospitals from the REKAMLATINA (Red de la Enfermedad de Kawasaki en America Latina) network diagnosed with MIS\u2010C from 1st January 2020 to 31st June 2022. Multiple models were developed to predict four main outcomes: paediatric intensive care unit (PICU) admission, need for inotropes, need for mechanical ventilation, and death. Performance measures were accuracy for PICU admission, inotropes use and mechanical ventilation, and the area under the receiver operating characteristic curve (AUROC) for death. Variable contribution was analysed using Shapley Additive Explanations (SHAP) values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 1303 children with a diagnosis of MIS\u2010C. The model for the prediction of PICU admission (random forest [RF]) reached an accuracy of 0.80 (95% CI: 0.76\u20130.84), the model for inotrope use (RF) an accuracy of 0.86 (95% CI: 0.82\u20130.90), the model for mechanical ventilation (histogram\u2010based gradient boosting [HBGB]) an accuracy of 0.84 (95% CI 0.80\u20130.88), and the model for death (RF) reached an AUROC of 0.85 (95% CI 0.77\u20130.93).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We developed and validated machine learning models for the prediction of MIS\u2010C related outcomes that can help clinicians risk stratify patients to identify those most likely to have a severe outcome from MIS\u2010C.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apa.70290","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T14:06:08Z","timestamp":1756735568000},"page":"133-145","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Validation of Multivariable Machine\u2010Learning Models for the Prediction of Multisystemic Inflammatory Syndrome Outcomes in Latin American Children"],"prefix":"10.1111","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8567-2639","authenticated-orcid":false,"given":"Danilo","family":"Buonsenso","sequence":"first","affiliation":[{"name":"Department of Woman and Child Health and Public Health Fondazione Policlinico Universitario A. Gemelli IRCCS  Rome Italy"},{"name":"Area Pediatrica, Dipartimento di Scienze della Vita e Sanit\u00e0 Pubblica Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1853-4927","authenticated-orcid":false,"given":"Luca","family":"Mastrantoni","sequence":"additional","affiliation":[{"name":"Medical Oncology Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9157-9227","authenticated-orcid":false,"given":"Rolando","family":"Ulloa\u2010Gutierrez","sequence":"additional","affiliation":[{"name":"Servicio de Aislamiento Pedi\u00e1trico, Hospital Nacional de Ni\u00f1os \u201cDr. Carlos S\u00e1enz Herrera\u201d Caja Costarricense de Seguro Social (CCSS)  San Jos\u00e9 Costa Rica"},{"name":"Universidad de Ciencias M\u00e9dicas (UCIMED) e Instituto de Investigaci\u00f3n en Ciencias M\u00e9dicas UCIMED (IICIMED)  San Jos\u00e9 Costa Rica"},{"name":"Academia Nacional de Medicina de Costa Rica (ACANAMED)  San Jos\u00e9 Costa Rica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jimena","family":"Garc\u00eda\u2010Silva","sequence":"additional","affiliation":[{"name":"Departamento de Pediatr\u00eda, Hospital Universitario \u201cJos\u00e9 Eleuterio Gonz\u00e1lez\u201d Universidad Aut\u00f3noma de Nuevo Le\u00f3n  Monterrey Nuevo Le\u00f3n Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9675-3143","authenticated-orcid":false,"given":"Gabriela","family":"Ivankovich\u2010Escoto","sequence":"additional","affiliation":[{"name":"Servicio de Inmunolog\u00eda y Reumatolog\u00eda Pedi\u00e1trica, Hospital Nacional de Ni\u00f1os \u201cDr. Carlos S\u00e1enz Herrera\u201d Caja Costarricense de Seguro Social (CCSS)  San Jos\u00e9 Costa Rica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7609-3923","authenticated-orcid":false,"given":"Marco A.","family":"Yamazaki\u2010Nakashimada","sequence":"additional","affiliation":[{"name":"Departamento de Inmunolog\u00eda Cl\u00ednica Instituto Nacional de Pediatr\u00eda  Ciudad de M\u00e9xico Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7807-1296","authenticated-orcid":false,"given":"Enrique","family":"Faugier\u2010Fuentes","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda Hospital Infantil de M\u00e9xico Federico G\u00f3mez  Ciudad de M\u00e9xico Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3085-0148","authenticated-orcid":false,"given":"Olguita","family":"del \u00c1guila","sequence":"additional","affiliation":[{"name":"Unidad de Infectolog\u00eda Pedi\u00e1trica Hospital Nacional Edgardo Rebagliati Martins  Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0472-798X","authenticated-orcid":false,"given":"German","family":"Camacho\u2010Moreno","sequence":"additional","affiliation":[{"name":"Unidad de Infectolog\u00eda Pedi\u00e1trica, HOMI, Fundaci\u00f3n Hospital Pedi\u00e1trico La Misericordia &amp; Departamento de Pediatr\u00eda, Facultad de Medicina Universidad Nacional de Colombia  Bogot\u00e1 Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2042-0817","authenticated-orcid":false,"given":"Dora","family":"Estripeaut","sequence":"additional","affiliation":[{"name":"Servicio de Infectolog\u00eda Hospital del Ni\u00f1o Dr. Jos\u00e9 Ren\u00e1n Esquivel  Ciudad de Panam\u00e1 Panama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iv\u00e1n F.","family":"Guti\u00e9rrez\u2010Tobar","sequence":"additional","affiliation":[{"name":"Servicio de 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