{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:59:24Z","timestamp":1792803564915,"version":"4.5.0"},"reference-count":49,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The university hospital of Nice, France, (CHU de Nice)","id":[{"id":"https:\/\/ror.org\/05qsjq305","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Neuromuscular hip dysplasia (NHD) is a common deformity in children with cerebral palsy (CP). Although some predictive factors of NHD are known, the prediction of NHD is in its infancy. We present a Clinical Decision Support System (CDSS) designed to calculate the probability of developing NHD in children with CP. The system utilizes an ensemble of three machine learning (ML) algorithms: Neural Network (NN), Support Vector Machine (SVM), and Logistic Regression (LR). The development and evaluation of the CDSS followed the DECIDE-AI guidelines for AI-driven clinical decision support tools. The ensemble was trained on a data series from 182 subjects. Inclusion criteria were age between 12 and 18 years and diagnosis of CP from two specialized units. Clinical and functional data were collected prospectively between 2005 and 2023, and then analyzed in a cross-sectional study. Accuracy and area under the receiver operating characteristic (AUROC) were calculated for each method. Best logistic regression scores highlighted history of previous orthopedic surgery (p = 0.001), poor motor function (p = 0.004), truncal tone disorder (p = 0.008), scoliosis (p = 0.031), number of affected limbs (p = 0.05), and epilepsy (p = 0.05) as predictors of NHD. Both accuracy and AUROC were highest for NN, 83.7% and 0.92, respectively. The novelty of this study lies in the development of an efficient Clinical Decision Support System (CDSS) prototype, specifically designed to predict future outcomes of neuromuscular hip dysplasia (NHD) in patients with cerebral palsy (CP) using clinical data. The proposed system, PredictMed-CDSS, demonstrated strong predictive performance for estimating the probability of NHD development in children with CP, with the highest accuracy achieved using neural networks (NN). PredictMed-CDSS has the potential to assist clinicians in anticipating the need for early interventions and preventive strategies in the management of NHD among CP patients.<\/jats:p>","DOI":"10.3390\/bioengineering12080846","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T09:25:52Z","timestamp":1754558752000},"page":"846","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["PredictMed-CDSS: Artificial Intelligence-Based Decision Support System Predicting the Probability to Develop Neuromuscular Hip Dysplasia"],"prefix":"10.3390","volume":"12","author":[{"given":"Carlo M.","family":"Bertoncelli","sequence":"first","affiliation":[{"name":"Department of Computer Science, Hal Marcus College of Science & Engineering, University of West Florida, Pensacola, FL 32514, USA"},{"name":"Department of Pediatric Orthopedic Surgery, Pediatric University Hospital Lenval, 06000 Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2735-5330","authenticated-orcid":false,"given":"Federico","family":"Solla","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, Pediatric University Hospital Lenval, 06000 Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7919-0294","authenticated-orcid":false,"given":"Michal","family":"Latalski","sequence":"additional","affiliation":[{"name":"Children Orthopedic Department, Children University Hospital of Lublin, 20-093 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1886-4582","authenticated-orcid":false,"given":"Sikha","family":"Bagui","sequence":"additional","affiliation":[{"name":"Department of Computer Science, Hal Marcus College of Science & Engineering, University of West Florida, Pensacola, FL 32514, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6140-5384","authenticated-orcid":false,"given":"Subhash C.","family":"Bagui","sequence":"additional","affiliation":[{"name":"Department of Computer Science, Hal Marcus College of Science & Engineering, University of West Florida, Pensacola, FL 32514, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5686-6124","authenticated-orcid":false,"given":"Stefania","family":"Costantini","sequence":"additional","affiliation":[{"name":"Department of Information Engineering, Computer Science and Mathematics, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2153-0337","authenticated-orcid":false,"given":"Domenico","family":"Bertoncelli","sequence":"additional","affiliation":[{"name":"Department of Computer Science, Hal Marcus College of Science & Engineering, University of West Florida, Pensacola, FL 32514, USA"},{"name":"Department of Information Engineering, Computer Science and Mathematics, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1111\/j.1469-8749.2012.04385.x","article-title":"The natural history of hip development in cerebral palsy","volume":"54","author":"Terjesen","year":"2012","journal-title":"Dev. 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