{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:17:21Z","timestamp":1787062641524,"version":"build-2736575974"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop and validate a machine learning (ML) model for predicting seizure outcomes in infants with infantile epileptic spasms syndrome (IESS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study enrolled pediatric patients diagnosed with infantile epileptic spasms syndrome (IESS) from Wuhan Children's Hospital. The cohort was randomly split into training and validation sets at a 7:3 ratio. Independent prognostic factors were identified using Cox regression analysis. Six machine learning algorithms were then applied to develop predictive models. Model performance was evaluated in terms of discrimination (e.g., AUROC), calibration (calibration curves), and clinical utility (decision curve analysis, DCA). The optimal model (XGBoost) was interpreted via decision tree visualization and SHAP analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Poor seizure outcome was observed in 56% of the cohort. MRI findings of tuberous sclerosis complex or malformations of cortical development were independent risk factors. Among the models, XGBoost demonstrated the best overall performance, achieving an AUROC of 0.921 in the validation set, along with robust calibration and clinical utility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The developed ML model reliably and interpretably predicts poor seizure outcomes in IESS patients using routine clinical data, potentially aiding in clinical decision-making and follow-up planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1777561","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T05:35:06Z","timestamp":1775540106000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Development and validation of a machine learning model to predict prognostic outcomes in infantile epileptic spasms syndrome"],"prefix":"10.3389","volume":"14","author":[{"given":"Caoxue","family":"Zuo","sequence":"first","affiliation":[{"name":"Department of Neurology, Wuhan Children\u2019s Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boen","family":"Xue","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Material Processing and Die & Mould Technology, School of Materials Science and Engineering, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"Mu","sequence":"additional","affiliation":[{"name":"Wuhan Children\u2019s Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongqiang","family":"Cao","sequence":"additional","affiliation":[{"name":"Institute of Maternal and Child Health, Wuhan Children\u2019s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huamin","family":"Zhou","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Material Processing and Die & Mould Technology, School of Materials Science and Engineering, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhisheng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Wuhan Children\u2019s Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Neurology, Wuhan Children\u2019s Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"688","DOI":"10.1016\/S0387-7604(01)00264-9","article-title":"West syndrome: long-term prognosis and social aspects","volume":"23","author":"Appleton","year":"2001","journal-title":"Brain Dev"},{"key":"B2","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1016\/S0140-6736(25)00773-1","article-title":"Childhood epilepsy","volume":"406","author":"Menon","year":"2025","journal-title":"Lancet (London, England)"},{"key":"B3","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1111\/j.1528-1157.1996.tb00573.x","article-title":"Long-term otucome of west syndrome: a study of adults with a history of infantile spasms","volume":"37","author":"Riikonen","year":"1996","journal-title":"Epilepsia"},{"key":"B4","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.pediatrneurol.2020.01.015","article-title":"Infantile spasms: outcome in clinical studies","volume":"108","author":"Riikonen","year":"2020","journal-title":"Pediatr Neurol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1016\/j.seizure.2014.05.010","article-title":"Predictive value of EEG findings at control of epileptic spasms for seizure relapse in patients with west syndrome","volume":"23","author":"Yamada","year":"2014","journal-title":"Seizure"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1195252","DOI":"10.3389\/fneur.2023.1195252","article-title":"Prediction model for long-term seizure and developmental outcomes among children with infantile epileptic spasms syndrome","volume":"14","author":"Arai","year":"2023","journal-title":"Front Neurol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1186\/1471-2431-12-108","article-title":"Infantile spasms (west syndrome): update and resources for pediatricians and providers to share with parents","volume":"12","author":"Wheless","year":"2012","journal-title":"BMC Pediatr"},{"key":"B8","doi-asserted-by":"publisher","first-page":"2202","DOI":"10.1111\/j.1528-1167.2006.00888.x","article-title":"The risk of lower mental outcome in infantile spasms increases after three weeks of hypsarrhythmia duration","volume":"47","author":"Primec","year":"2006","journal-title":"Epilepsia"},{"key":"B9","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1046\/j.1528-1157.2002.14001.x","article-title":"Informative value of magnetic resonance imaging and EEG in the prognosis of infantile spasms","volume":"43","author":"Saltik","year":"2002","journal-title":"Epilepsia"},{"key":"B10","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1016\/S1474-4422(05)70199-X","article-title":"The United Kingdom infantile spasms study (UKISS) comparing hormone treatment with vigabatrin on developmental and epilepsy outcomes to age 14 months: a multicentre randomised trial","volume":"4","author":"Lux","year":"2005","journal-title":"Lancet Neurol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"2037","DOI":"10.1111\/epi.16333","article-title":"Machine learning applications in epilepsy","volume":"60","author":"Abbasi","year":"2019","journal-title":"Epilepsia"},{"key":"B12","doi-asserted-by":"publisher","first-page":"109736","DOI":"10.1016\/j.yebeh.2024.109736","article-title":"Artificial intelligence\/machine learning for epilepsy and seizure diagnosis","volume":"155","author":"Han","year":"2024","journal-title":"Epilepsy Behav"},{"key":"B13","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1007\/s11910-023-01318-7","article-title":"Machine learning and artificial intelligence applications to epilepsy: a review for the practicing epileptologist","volume":"23","author":"Kerr","year":"2023","journal-title":"Curr Neurol Neurosci Rep"},{"key":"B14","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1016\/j.yebeh.2018.10.013","article-title":"Predicting drug-resistant epilepsy\u2014a machine learning approach based on administrative claims data","volume":"89","author":"An","year":"2018","journal-title":"Epilepsy Behav"},{"key":"B15","doi-asserted-by":"publisher","first-page":"107040","DOI":"10.1016\/j.eplepsyres.2022.107040","article-title":"Machine learning and statistic analysis to predict drug treatment outcome in pediatric epilepsy patients with tuberous sclerosis complex","volume":"188","author":"Zhao","year":"2022","journal-title":"Epilepsy Res"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1109\/TBME.2023.3325762","article-title":"Biomimetic deep learning networks with applications to epileptic spasms and seizure prediction","volume":"71","author":"Lucasius","year":"2024","journal-title":"IEEE Trans Biomed Eng"},{"key":"B17","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1186\/s13052-025-01959-z","article-title":"Predictive model for initial response to first-line treatment in children with infantile epileptic spasms syndrome","volume":"51","author":"Ge","year":"2025","journal-title":"Ital J Pediatr"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1349","DOI":"10.1111\/epi.17239","article-title":"ILAE Classification and definition of epilepsy syndromes with onset in neonates and infants: position statement by the ILAE task force on nosology and definitions","volume":"63","author":"Zuberi","year":"2022","journal-title":"Epilepsia"},{"key":"B19","doi-asserted-by":"publisher","first-page":"107578","DOI":"10.1016\/j.pharmthera.2020.107578","article-title":"Modeling epileptic spasms during infancy: are we heading for the treatment yet?","volume":"212","author":"Vel\u00ed\u0161ek","year":"2020","journal-title":"Pharmacol Ther"},{"key":"B20","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1007\/s11906-022-01212-6","article-title":"Machine learning for hypertension prediction: a systematic review","volume":"24","author":"Silva","year":"2022","journal-title":"Curr Hypertens Rep"},{"key":"B21","doi-asserted-by":"publisher","first-page":"e882","DOI":"10.1016\/S2589-7500(23)00179-6","article-title":"Predicting seizure recurrence after an initial seizure-like episode from routine clinical notes using large language models: a retrospective cohort study","volume":"5","author":"Beaulieu-Jones","year":"2023","journal-title":"Lancet Digit Health"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.31083\/j.jin.2020.01.24","article-title":"Epileptic seizure detection: a comparative study between deep and traditional machine learning techniques","volume":"19","author":"Sahu","year":"2020","journal-title":"J Integr Neurosci"},{"key":"B23","doi-asserted-by":"publisher","first-page":"2014","DOI":"10.1111\/epi.17637","article-title":"Predicting seizure outcome after epilepsy surgery: do we need more complex models, larger samples, or better data?","volume":"64","author":"Eriksson","year":"2023","journal-title":"Epilepsia"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1861","DOI":"10.1111\/epi.16305","article-title":"The underlying etiology of infantile spasms (west syndrome): information from the international collaborative infantile spasms study (ICISS)","volume":"60","author":"Osborne","year":"2019","journal-title":"Epilepsia"},{"key":"B25","doi-asserted-by":"publisher","first-page":"774828","DOI":"10.3389\/fped.2022.774828","article-title":"Etiologic classification of 541 infantile spasms cases: a cohort study","volume":"10","author":"Peng","year":"2022","journal-title":"Front Pediatr"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1295","DOI":"10.1177\/0883073812448532","article-title":"Infantile spasms (west syndrome) in children with inborn errors of metabolism: a review of the literature","volume":"27","author":"Gkampeta","year":"2012","journal-title":"J Child Neurol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"701","DOI":"10.2741\/e130","article-title":"The aristaless (arx) gene: one gene for many \u201cinterneuronopathies\u201d","volume":"2","author":"Ruggieri","year":"2010","journal-title":"Front Biosci (Elite Edition)"},{"key":"B28","doi-asserted-by":"publisher","first-page":"728267","DOI":"10.1155\/2012\/728267","article-title":"What we know and would like to know about CDKL5 and its involvement in epileptic encephalopathy","volume":"2012","author":"Kilstrup-Nielsen","year":"2012","journal-title":"Neural Plast"},{"key":"B29","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/S0304-3940(97)00937-3","article-title":"Brain derived neurotrophic factor is increased in cerebrospinal fluid of children suffering from asphyxia","volume":"240","author":"Korhonen","year":"1998","journal-title":"Neurosci Lett"},{"key":"B30","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/S0887-8994(98)00122-2","article-title":"Cerebrospinal nerve growth factor\u2013a marker of asphyxia?","volume":"20","author":"Riikonen","year":"1999","journal-title":"Pediatr Neurol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.braindev.2024.03.003","article-title":"Metabolic etiologies in children with infantile epileptic spasm syndrome: experience at a tertiary pediatric neurology center","volume":"46","author":"Y\u00fcksel","year":"2024","journal-title":"Brain Dev"},{"key":"B32","doi-asserted-by":"publisher","first-page":"2728","DOI":"10.1111\/epi.18054","article-title":"Clinical features and genotype-phenotype correlations in epilepsy patients with de novo DYNC1H1 variants","volume":"65","author":"Cuccurullo","year":"2024","journal-title":"Epilepsia"},{"key":"B33","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.seizure.2023.06.003","article-title":"Nutritional vitamin B12 deficiency-associated infantile epileptic spasms syndrome: clinico-neurophysiological presentation, response to treatment, and neurodevelopmental outcome","volume":"110","author":"Sharawat","year":"2023","journal-title":"Seizure"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1002\/acn3.70034","article-title":"Combination therapy with vigabatrin and prednisolone versus vigabatrin alone for infantile spasms","volume":"12","author":"Boonkrongsak","year":"2025","journal-title":"Ann Clin Transl Neurol"},{"key":"B35","doi-asserted-by":"publisher","first-page":"844","DOI":"10.1055\/s-0043-1772835","article-title":"Brazilian Experts\u2019 consensus on the treatment of infantile epileptic spasm syndrome in infants","volume":"81","author":"Sampaio LP","year":"2023","journal-title":"Arq Neuropsiquiatr"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1773","DOI":"10.1016\/S0140-6736(04)17400-X","article-title":"The United Kingdom infantile spasms study comparing vigabatrin with prednisolone or tetracosactide at 14 days: a multicentre, randomised controlled trial","volume":"364","author":"Lux","year":"2004","journal-title":"Lancet (London, England)"},{"key":"B37","doi-asserted-by":"publisher","first-page":"110055","DOI":"10.1016\/j.yebeh.2024.110055","article-title":"Factors influencing efficacy and relapse of adrenocorticotropic hormone in infantile epileptic spasms syndrome","volume":"161","author":"Mao","year":"2024","journal-title":"Epilepsy Behav"},{"key":"B38","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1111\/ane.12830","article-title":"Efficacy of ketogenic diet for infantile spasms: a systematic review","volume":"137","author":"Prezioso","year":"2018","journal-title":"Acta Neurol Scand"},{"key":"B39","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3389\/fped.2024.1472982","article-title":"Ketogenic diets therapy in the management of epileptic spasms syndrome","author":"Wang","year":"2024","journal-title":"Front Pediatr"},{"key":"B40","doi-asserted-by":"publisher","first-page":"2085","DOI":"10.3390\/nu17132085","article-title":"Role of the ketogenic diet therapy and ACTH as second treatments in drug-resistant infantile epileptic spasms syndrome","volume":"17","author":"Dressler","year":"2025","journal-title":"Nutrients"},{"key":"B41","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1186\/s13023-018-0870-y","article-title":"Incidence of tuberous sclerosis and age at first diagnosis: new data and emerging trends from a national, prospective surveillance study","volume":"13","author":"Ebrahimi-Fakhari","year":"2018","journal-title":"Orphanet J Rare Dis"},{"key":"B42","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1016\/S0140-6736(08)61279-9","article-title":"Tuberous sclerosis","volume":"372","author":"Curatolo","year":"2008","journal-title":"Lancet (London, England)"},{"key":"B43","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.eplepsyres.2013.02.016","article-title":"Predictors of seizure freedom after surgical management of tuberous sclerosis complex: a systematic review and meta-analysis","volume":"105","author":"Zhang","year":"2013","journal-title":"Epilepsy Res"},{"key":"B44","doi-asserted-by":"publisher","first-page":"1236","DOI":"10.1111\/j.1528-1167.2009.02474.x","article-title":"The natural history of epilepsy in tuberous sclerosis complex","volume":"51","author":"Chu-Shore","year":"2010","journal-title":"Epilepsia"},{"key":"B45","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1177\/08830738040190090401","article-title":"Brain abnormalities in tuberous sclerosis complex","volume":"19","author":"DiMario","year":"2004","journal-title":"J Child Neurol"},{"key":"B46","doi-asserted-by":"publisher","first-page":"2497","DOI":"10.1007\/s00381-020-04705-4","article-title":"Neuroimaging in tuberous sclerosis complex","volume":"36","author":"Russo","year":"2020","journal-title":"Child\u2019s Nerv Syst"},{"key":"B47","doi-asserted-by":"publisher","first-page":"2874","DOI":"10.1093\/brain\/awaa174","article-title":"Definitions and classification of malformations of cortical development: practical guidelines","volume":"143","author":"Severino","year":"2020","journal-title":"Brain J Neurol"},{"key":"B48","doi-asserted-by":"publisher","first-page":"1348","DOI":"10.1093\/brain\/aws019","article-title":"A developmental and genetic classification for malformations of cortical development: update 2012","volume":"135","author":"Barkovich","year":"2012","journal-title":"Brain J Neurol"},{"key":"B49","doi-asserted-by":"publisher","first-page":"576","DOI":"10.3389\/fncel.2019.00576","article-title":"Cortical malformations: lessons in human brain development","volume":"13","author":"Subramanian","year":"2019","journal-title":"Front Cell Neurosci"},{"key":"B50","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.nbd.2015.08.003","article-title":"Neuronal migration disorders: focus on the cytoskeleton and epilepsy","volume":"92","author":"Stouffer","year":"2016","journal-title":"Neurobiol Dis"},{"key":"B51","doi-asserted-by":"publisher","first-page":"100802","DOI":"10.1016\/j.ebr.2025.100802","article-title":"Brain tumours as an unrecognized etiology of infantile epileptic spasms syndrome (IESS): the role of resective epilepsy surgery","volume":"31","author":"Pentz","year":"2025","journal-title":"Epilepsy Behav Rep"},{"key":"B52","doi-asserted-by":"publisher","first-page":"1888","DOI":"10.1093\/brain\/awaf094","article-title":"Fetal malformations of cortical development: review and clinical guidance","volume":"148","author":"Russ","year":"2025","journal-title":"Brain J Neurol"},{"key":"B53","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.3389\/fphar.2019.01155","article-title":"Early and accurate prediction of clinical response to methotrexate treatment in juvenile idiopathic arthritis using machine learning","volume":"10","author":"Mo","year":"2019","journal-title":"Front Pharmacol"},{"key":"B54","doi-asserted-by":"publisher","first-page":"1956","DOI":"10.1111\/epi.17320","article-title":"Development and validation of machine learning models for prediction of seizure outcome after pediatric epilepsy surgery","volume":"63","author":"Yossofzai","year":"2022","journal-title":"Epilepsia"},{"key":"B55","doi-asserted-by":"publisher","first-page":"RP98759","DOI":"10.7554\/eLife.98759.3","article-title":"Predictive models for secondary epilepsy in patients with acute ischemic stroke within one year","volume":"13","author":"Liu","year":"2024","journal-title":"eLife"},{"key":"B56","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1007\/s40708-017-0065-7","article-title":"Machine learning-XGBoost analysis of language networks to classify patients with epilepsy","volume":"4","author":"Torlay","year":"2017","journal-title":"Brain Inform"},{"key":"B57","doi-asserted-by":"publisher","first-page":"100384","DOI":"10.1016\/j.advnut.2025.100384","article-title":"Perspective: global burden of iodine deficiency: insights and projections to 2050 using XGBoost and SHAP","volume":"16","author":"Liang","year":"2025","journal-title":"Adv Nutr (Bethesda, Md.)"},{"key":"B58","doi-asserted-by":"publisher","first-page":"10887","DOI":"10.1038\/s41598-024-60622-5","article-title":"The value of linear and non-linear quantitative EEG analysis in paediatric epilepsy surgery: a machine learning approach","volume":"14","author":"Mercier","year":"2024","journal-title":"Sci Rep"},{"key":"B59","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1002\/epi4.12631","article-title":"Asymmetric epileptic spasms after corpus callosotomy in children with west syndrome may be a good indicator for unilateral epileptic focus and subsequent resective surgery","volume":"7","author":"Uchida","year":"2022","journal-title":"Epilepsia Open"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1777561\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T05:35:07Z","timestamp":1775540107000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1777561\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,7]]},"references-count":59,"alternative-id":["10.3389\/fped.2026.1777561"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1777561","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,7]]},"article-number":"1777561"}}