{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T05:33:35Z","timestamp":1772256815195,"version":"3.50.1"},"update-to":[{"DOI":"10.1371\/journal.pntd.0012736","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T00:00:00Z","timestamp":1735257600000}}],"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T00:00:00Z","timestamp":1734048000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Snakebite envenoming is a serious condition that affects 2.5 million people and causes 81,000\u2013138,000 deaths every year, particularly in tropical and subtropical regions. The World Health Organization has set a goal to halve the deaths and disabilities related to snakebite envenoming by 2030. However, significant challenges in achieving this goal include a lack of robust research evidence related to snakebite incidence and treatment, particularly in sub-Saharan Africa. This study aimed to combine established methodologies with the latest tools in Artificial Intelligence to assess the barriers to effective snakebite treatment in Ghana.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Method<\/jats:title>\n<jats:p>We used a MaxDiff statistical experiment design to collect data, and six supervised machine learning models were applied to predict responses whose performance showed an advantage over the other through 6921 data points partitioned using the hold-back validation method, with 70% training and 30% validation. The results were compared using key metrics: Akaike Information Criterion corrected, Bayesian Information Criterion, Root Average Squared Error, and Fit Time in milliseconds.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Considering all the responses, none of the six machine learning algorithms proved superior, but the Generalized Regression Model (Ridge) performed consistently better among the candidate models. The model consistently predicted several key significant barriers to effective snakebite treatment, such as the high cost of antivenoms, increased use of unorthodox, harmful practices, lack of access to effective antivenoms in remote areas when needed, and resorting to unorthodox and harmful practices in addition to hospital treatment.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The combination of a MaxDiff statistical experiment design to collect data and six machine learning models allowed the identification of barriers to accessing effective therapies for snakebite envenoming in Ghana. Addressing these barriers through targeted policy interventions, including intensified advocacy, continuous education, community engagement, healthcare worker training, and strategic investments, can enhance the effectiveness of snakebite treatment, ultimately benefiting snakebite victims and reducing the burden of snakebite envenoming. There is a need for robust regulatory frameworks and increased antivenom production to address these barriers.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0012736","type":"journal-article","created":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T18:39:43Z","timestamp":1734115183000},"page":"e0012736","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["A supervised machine learning statistical design of experiment approach to modeling the barriers to effective snakebite treatment in Ghana"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1666-7489","authenticated-orcid":true,"given":"Eric","family":"Nyarko","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edmund Fosu","family":"Agyemang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ebenezer Kwesi","family":"Ameho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis","family":"Agyekum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Mar\u00eda","family":"Guti\u00e9rrez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo Alberto","family":"Fernandez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,12,13]]},"reference":[{"issue":"1","key":"pntd.0012736.ref001","article-title":"Snakebite envenoming.","volume":"3","author":"JM Guti\u00e9rrez","year":"2017","journal-title":"Nature Reviews Disease Primers"},{"issue":"2","key":"pntd.0012736.ref002","doi-asserted-by":"crossref","first-page":"e0007059","DOI":"10.1371\/journal.pntd.0007059","article-title":"Strategy for a globally coordinated response to a priority neglected tropical disease: Snakebite envenoming.","volume":"13","author":"DJ Williams","year":"2019","journal-title":"PLOS Neglected Tropical Diseases"},{"issue":"5","key":"pntd.0012736.ref003","first-page":"515","article-title":"Snake-bites: appraisal of the global situation","volume":"76","author":"JP Chippaux","year":"1998","journal-title":"Bulletin of the World Health Organization"},{"issue":"4","key":"pntd.0012736.ref004","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1016\/j.toxicon.2010.12.022","article-title":"Estimate of the burden of snakebites in sub-Saharan Africa: A meta-analytic approach","volume":"57","author":"JP Chippaux","year":"2011","journal-title":"Toxicon"},{"key":"pntd.0012736.ref005","first-page":"129","volume-title":"Guidelines for the Prevention and Clinical Management of Snakebite in Africa","author":"WHO","year":"2010"},{"key":"pntd.0012736.ref006","first-page":"50","volume-title":"Strategy for Prevention and Control","author":"WHO","year":"2019"},{"issue":"2","key":"pntd.0012736.ref007","doi-asserted-by":"crossref","first-page":"103","DOI":"10.4314\/gmj.v50i2.8","article-title":"Secondary analysis of snake bite data in the Western Region of Ghana: 2006\u20132010","volume":"50","author":"EK Mensah","year":"2016","journal-title":"Ghana Medical Journal"},{"issue":"1","key":"pntd.0012736.ref008","article-title":"Analysis of snakebite data in Volta and Oti Regions, Ghana, 2019","volume":"40","author":"B Ceesay","year":"2019","journal-title":"Pan African Medical Journal"},{"issue":"5","key":"pntd.0012736.ref009","doi-asserted-by":"crossref","first-page":"e0010322","DOI":"10.1371\/journal.pntd.0010322","article-title":"What the snake leaves in its wake: Functional limitations and disabilities among snakebite victims in Ghanaian communities.","volume":"16","author":"Aglanu Leslie Mawuli","year":"2022","journal-title":"PLOS Neglected Tropical Diseases"},{"issue":"1","key":"pntd.0012736.ref010","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1080\/00224065.2018.1404881","article-title":"50 years of the Journal of Quality Technology","volume":"50","author":"WA Jensen","year":"2018","journal-title":"Journal of Quality Technology"},{"issue":"1","key":"pntd.0012736.ref011","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.infoandorg.2018.02.005","article-title":"Working and organizing in the age of the learning algorithm.","volume":"28","author":"S Faraj","year":"2018","journal-title":"Information and Organization"},{"issue":"10","key":"pntd.0012736.ref012","doi-asserted-by":"crossref","first-page":"2674","DOI":"10.1080\/02664763.2021.1907840","article-title":"Machine learning and design of experiments with an application to product innovation in the chemical industry.","volume":"49","author":"R Arboretti","year":"2021","journal-title":"Journal of Applied Statistics."},{"issue":"1","key":"pntd.0012736.ref013","doi-asserted-by":"crossref","DOI":"10.1186\/s12911-021-01488-9","article-title":"The role of artificial intelligence in healthcare: a structured literature review.","volume":"21","author":"S Secinaro","year":"2021","journal-title":"BMC Medical Informatics and Decision Making"},{"issue":"8","key":"pntd.0012736.ref014","doi-asserted-by":"crossref","first-page":"e0010647","DOI":"10.1371\/journal.pntd.0010647","article-title":"An artificial intelligence model to identify snakes from across the world: Opportunities and challenges for global health and herpetology.","volume":"16","author":"I Bolon","year":"2022","journal-title":"PLoS neglected tropical diseases"},{"issue":"5","key":"pntd.0012736.ref015","doi-asserted-by":"crossref","first-page":"e202","DOI":"10.1016\/S2589-7500(19)30086-X","article-title":"Snakebite and snake identification: empowering neglected communities and health-care providers with AI","volume":"1","author":"RR de Casta\u00f1eda","year":"2019","journal-title":"The Lancet Digital Health"},{"key":"pntd.0012736.ref016","first-page":"52","article-title":"Image Classification for Snake Species Using Machine Learning Techniques","author":"A Amir","year":"2016","journal-title":"Advances in Intelligent Systems and Computing"},{"issue":"1","key":"pntd.0012736.ref017","doi-asserted-by":"crossref","first-page":"19142","DOI":"10.1038\/s41598-021-96031-1","article-title":"A comparative study on image-based snake identification using machine learning.","volume":"11","author":"M Rajabizadeh","year":"2021","journal-title":"Scientific Reports."},{"key":"pntd.0012736.ref018","first-page":"105024","article-title":"Artificial intelligence-based snakebite identification using snake images, snakebite wound images, and other modalities of information: A systematic review.","volume":"173","author":"J Zhang","year":"2023"},{"issue":"6","key":"pntd.0012736.ref019","doi-asserted-by":"crossref","first-page":"1837","DOI":"10.1002\/qre.2579","article-title":"Machine learning and Design of Experiments: Alternative approaches or complementary methodologies for quality improvement?","volume":"36","author":"F Johannes","year":"2020","journal-title":"Quality and Reliability Engineering International"},{"key":"pntd.0012736.ref020","doi-asserted-by":"crossref","first-page":"213533","DOI":"10.1016\/j.bioadv.2023.213533","article-title":"Design of experiment and machine learning inform on the 3D printing of hydrogels for biomedical applications.","volume":"153","author":"N Madadian Bozorg","year":"2023","journal-title":"Biomaterials Advances."},{"key":"pntd.0012736.ref021","doi-asserted-by":"crossref","first-page":"107594","DOI":"10.1016\/j.toxicon.2023.107594","article-title":"Challenges associated with the availability, accessibility, and use of antivenoms for treating snakebite envenoming in Ghana: A MaxDiff experiment design","volume":"238","author":"E Nyarko","year":"2024","journal-title":"Toxicon"},{"key":"pntd.0012736.ref022","doi-asserted-by":"crossref","first-page":"100086","DOI":"10.1016\/j.toxcx.2021.100086","article-title":"Access to antivenoms in the developing world: A multidisciplinary analysis.","volume":"12","author":"J Potet","year":"2021","journal-title":"Toxicon: X."},{"issue":"3","key":"pntd.0012736.ref023","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1007\/s10551-006-9112-7","article-title":"Using Best\u2013Worst Scaling Methodology to Investigate Consumer Ethical Beliefs Across Countries","volume":"70","author":"P Auger","year":"2006","journal-title":"Journal of Business Ethics"},{"issue":"1","key":"pntd.0012736.ref024","doi-asserted-by":"crossref","DOI":"10.1186\/s12992-024-01027-x","article-title":"Drivers of consumer food choices of multinational corporations\u2019 products over local foods in Ghana: a maximum difference scaling study.","volume":"20","author":"E Nyarko","year":"2024","journal-title":"Globalization and health."},{"key":"pntd.0012736.ref025","author":"S. Cohen","year":"2003","journal-title":"Maximum Difference Scaling: Improved Measures of Importance and Preference for Segmentation Maximum Difference Scaling: Improved Measures of Importance and Preference for Segmentation"},{"key":"pntd.0012736.ref026","doi-asserted-by":"crossref","first-page":"100394","DOI":"10.1016\/j.jocm.2022.100394","article-title":"R packages and tutorial for case 1 best\u2013worst scaling.","volume":"46","author":"H Aizaki","year":"2022","journal-title":"Journal of Choice Modelling."},{"issue":"1","key":"pntd.0012736.ref027","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1108\/17511060910948008","article-title":"Applying best-worst scaling to wine marketing","volume":"21","author":"E. Cohen","year":"2009","journal-title":"International Journal of Wine Business Research"},{"key":"pntd.0012736.ref028","doi-asserted-by":"crossref","first-page":"104210","DOI":"10.1016\/j.jngse.2021.104210","article-title":"Hybrid machine learning algorithms to predict condensate viscosity in the near wellbore regions of gas condensate reservoirs","author":"AR Behesht Abad","year":"2021","journal-title":"Journal of Natural Gas Science and Engineering"},{"issue":"6","key":"pntd.0012736.ref029","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1038\/s41573-019-0024-5","article-title":"Applications of machine learning in drug discovery and development","volume":"18","author":"J Vamathevan","year":"2019","journal-title":"Nature Reviews Drug Discovery"},{"key":"pntd.0012736.ref030","first-page":"1","article-title":"Regularization and variable selection with triple shrinkage in linear regression: a generalization of lasso.","author":"M Gen\u00e7","year":"2023","journal-title":"Communications in Statistics\u2014Simulation and Computation."},{"key":"pntd.0012736.ref031","doi-asserted-by":"crossref","first-page":"108818","DOI":"10.1016\/j.sigpro.2022.108818","article-title":"High-performance reversible data hiding based on ridge regression prediction algorithm.","volume":"204","author":"X Wang","year":"2023","journal-title":"Signal Processing"},{"key":"pntd.0012736.ref032","doi-asserted-by":"crossref","first-page":"122958","DOI":"10.1016\/j.eswa.2023.122958","article-title":"Elastic net-based high dimensional data selection for regression","volume":"244","author":"Hasna Chamlal","year":"2024","journal-title":"Expert Systems with Applications"},{"key":"pntd.0012736.ref033","volume-title":"Springer Series in Statistics","author":"FE Harrell","year":"2015"},{"key":"pntd.0012736.ref034","first-page":"123","article-title":"Support vector regression.","author":"F Zhang","year":"2020","journal-title":"Machine Learning."},{"key":"pntd.0012736.ref035","first-page":"10820","volume-title":"In International Conference on Machine Learning","author":"Mao Ye","year":"2020"},{"issue":"1","key":"pntd.0012736.ref036","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3390\/toxins11010005","article-title":"Global Availability of Antivenoms: The Relevance of Public Manufacturing Laboratories.","volume":"11","author":"J. Guti\u00e9rrez","year":"2018","journal-title":"Toxins"},{"issue":"8","key":"pntd.0012736.ref037","doi-asserted-by":"crossref","first-page":"e0007221","DOI":"10.1371\/journal.pntd.0007221","article-title":"Epidemiology, ecology and human perceptions of snakebites in a savanna community of northern Ghana","volume":"13","author":"Y Musah","year":"2019","journal-title":"PLOS Neglected Tropical Diseases"},{"key":"pntd.0012736.ref038","doi-asserted-by":"crossref","first-page":"100100","DOI":"10.1016\/j.toxcx.2022.100100","article-title":"\u201cAt the hospital they do not treat venom from snakebites\u201d: A qualitative assessment of health seeking perspectives and experiences among snakebite victims in Rwanda.","volume":"14","author":"JM Schurer","year":"2022","journal-title":"Toxicon: X."},{"issue":"4","key":"pntd.0012736.ref039","doi-asserted-by":"crossref","first-page":"e0009298","DOI":"10.1371\/journal.pntd.0009298","article-title":"\u201cThe medicine is not for sale\u201d: Practices of traditional healers in snakebite envenoming in Ghana.","volume":"15","author":"J Steinhorst","year":"2021","journal-title":"PLOS Neglected Tropical Diseases"},{"issue":"7","key":"pntd.0012736.ref040","doi-asserted-by":"crossref","first-page":"e0011504","DOI":"10.1371\/journal.pntd.0011504","article-title":"Community members and healthcare workers\u2019 priorities for the control and prevention of snakebite envenoming in Ghana.","volume":"17","author":"Aglanu Leslie Mawuli","year":"2023","journal-title":"PLOS Neglected Tropical Diseases"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0012736","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T00:00:00Z","timestamp":1735257600000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0012736","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T18:38:05Z","timestamp":1735324685000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0012736"}},"subtitle":[],"editor":[{"given":"Wuelton","family":"Monteiro","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,12,13]]},"references-count":40,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,13]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0012736","relation":{"new_version":[{"id-type":"doi","id":"10.1371\/journal.pntd.0012736","asserted-by":"object"}]},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,13]]}}}