{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:44:01Z","timestamp":1785545041321,"version":"3.56.0"},"reference-count":40,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Enterovirus infections cause substantial pediatric morbidity worldwide, with severe cases requiring hospitalization. Accurate forecasting of hospitalization burden supports proactive resource allocation and clinical preparedness. During the postpandemic period (2023\u20102024), Taiwan experienced a resurgence of enterovirus activity following COVID-19\u2013related suppression, although at levels below prepandemic baselines, creating unique operational forecasting challenges.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to develop and validate random forest models for 1-week-ahead enterovirus hospitalization forecasting using postpandemic surveillance data and to evaluate the impact of epidemiological regime alignment on predictive performance.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We analyzed weekly enterovirus surveillance data from Taiwan\u2019s Centers for Disease Control covering 2023 to 2024, including outpatient, emergency department, and hospitalization counts stratified by five age groups (0\u20102, 3\u20104, 5\u20109, 10\u201014, and \u226515 y). Random forest models were trained on data from 2023 week 1 to 2024 week 40 (n=91 wk after lag preprocessing) and validated on a temporally independent test set covering 2024 weeks 41 to 52 (n=11 wk). Feature engineering incorporated age-specific indicators, 1\u2010 to 4-week temporal lags, seasonal variables, and derived epidemiological ratios.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The random forest model achieved strong 1-week-ahead forecasting performance on the test set (\n R<\/jats:italic>\n \u00b2=0.216, root mean square error 23.5 hospitalizations per week, mean absolute percentage error 17.27%). Age-specific outpatient visits among children aged 0 to 2 and 3 to 4 years were the most influential predictors (feature importance=0.0839 and 0.0908, respectively), followed by seasonal week-of-year effects (feature importance=0.0803). The mean absolute error was 17.6 hospitalizations per week, demonstrating practical utility for hospital capacity planning. Test-period hospitalizations averaged 126.5 cases per week, representing a 3.4-fold increase from pandemic suppression levels (28.4 cases per week during 2020\u20102022) while remaining 24% below prepandemic baselines (165 cases per week during 2008\u20102019).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Machine learning models trained on recent postpandemic surveillance data provide useful short-term forecasts of enterovirus hospitalization burden in Taiwan. A mean absolute percentage error of 17.27% represents reasonable accuracy for 1-week-ahead hospital resource planning. Age-specific pediatric outpatient surveillance offers valuable early signals for hospitalization forecasting, supporting the integration of such models into routine public health practice during postpandemic recovery.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/85874","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T08:50:09Z","timestamp":1767948609000},"page":"e85874-e85874","source":"Crossref","is-referenced-by-count":0,"title":["Predictive Modeling of Enterovirus Hospital Burden Using Machine Learning and Age-Specific Surveillance Data: Operational Forecasting in Taiwan During the Postpandemic Era"],"prefix":"10.2196","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7366-8667","authenticated-orcid":false,"given":"Mei-Mei","family":"Kuan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"issue":"11","key":"R1","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1016\/S1473-3099(10)70194-8","article-title":"Virology, epidemiology, pathogenesis, and control of enterovirus 71","volume":"10","author":"Solomon","journal-title":"Lancet Infect Dis"},{"issue":"6","key":"R2","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1542\/pir.19-6-183","article-title":"Enterovirus infections","volume":"19","author":"Zaoutis","journal-title":"Pediatr Rev"},{"issue":"1","key":"R3","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1086\/520149","article-title":"Clinical spectrum of enterovirus 71 infection in children in southern Taiwan, with an emphasis on neurological complications","volume":"29","author":"Wang","journal-title":"Clin Infect Dis"},{"issue":"9125","key":"R4","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1016\/S0140-6736(98)24031-1","article-title":"Fulminant neurogenic pulmonary oedema with hand, foot, and mouth disease","volume":"352","author":"Chang","journal-title":"Lancet"},{"issue":"1","key":"R5","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1111\/j.1574-6976.2002.tb00601.x","article-title":"An overview of the evolution of enterovirus 71 and its clinical and public health significance","volume":"26","author":"McMinn","journal-title":"FEMS Microbiol Rev"},{"issue":"13","key":"R6","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1056\/NEJM199909233411301","article-title":"An epidemic of enterovirus 71 infection in Taiwan","volume":"341","author":"Ho","journal-title":"N Engl J Med"},{"issue":"6","key":"R7","doi-asserted-by":"publisher","DOI":"10.1542\/peds.109.6.e88","article-title":"Risk factors of enterovirus 71 infection and associated hand, foot, and mouth disease\/herpangina in children during an epidemic in Taiwan","volume":"109","author":"Chang","journal-title":"Pediatrics"},{"issue":"3","key":"R8","doi-asserted-by":"publisher","first-page":"291","DOI":"10.3201\/eid0903.020285","article-title":"Enterovirus 71 outbreaks, Taiwan: occurrence and recognition","volume":"9","author":"Lin","journal-title":"Emerg Infect Dis"},{"issue":"1","key":"R9","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-13-134","article-title":"Effect of meteorological variables on the incidence of hand, foot, and mouth disease in children: a time-series analysis in Guangzhou, China","volume":"13","author":"Huang","journal-title":"BMC Infect Dis"},{"issue":"3","key":"R10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0050074","article-title":"Social contacts and mixing patterns relevant to the spread of infectious diseases","volume":"5","author":"Mossong","journal-title":"PLoS Med"},{"issue":"2","key":"R11","doi-asserted-by":"publisher","first-page":"e244","DOI":"10.1542\/peds.2006-3331","article-title":"Epidemiologic features of hand-foot-mouth disease and herpangina caused by enterovirus 71 in Taiwan, 1998-2005","volume":"120","author":"Chen","journal-title":"Pediatrics"},{"key":"R12","unstructured":"Infectious Disease Statistics Query System. 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