{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T05:05:52Z","timestamp":1784351152073,"version":"3.55.0"},"reference-count":31,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,10,17]],"date-time":"2021-10-17T00:00:00Z","timestamp":1634428800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>The DRSA method (dominance-based rough set approach) was used to create decision-making rules based on the results of physical examination and additional laboratory tests in the differential diagnosis of Kawasaki disease (KD), infectious mononucleosis and S. pyogenes pharyngitis in children. The study was conducted retrospectively. The search was based on the ICD-10 (International Classification of Diseases) codes of final diagnosis. Demographic and laboratory data from one Polish hospital (Poznan) were collected. Traditional statistical methods and the DRSA method were applied in data analysis. The algorithm formed 45 decision rules recognizing KD. The rules with the highest sensitivity (number of false negatives equals zero) were based on the presence of conjunctivitis and CRP (C-reactive Protein) \u2265 40.1 mg\/L, thrombocytosis and ESR (Erythrocyte Sedimentation Rate) \u2265 77 mm\/h; fair general condition and fever \u2265 5 days and rash; fair general condition and fever \u2265 5 days and conjunctivitis; fever \u2265 5 days and rash and CRP \u2265 7.05 mg\/L. The DRSA analysis may be helpful in diagnosing KD at an early stage of the disease. It can be used even with a small amount of clinical or laboratory data.<\/jats:p>","DOI":"10.3390\/children8100929","type":"journal-article","created":{"date-parts":[[2021,10,17]],"date-time":"2021-10-17T23:13:32Z","timestamp":1634512412000},"page":"929","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Can AI Help Pediatricians? Diagnosing Kawasaki Disease Using DRSA"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2846-5996","authenticated-orcid":false,"given":"Bartosz","family":"Siewert","sequence":"first","affiliation":[{"name":"Department of Preventive Health, Poznan University of Medical Science, 60-781 Poznan, Poland"},{"name":"Infectious Diseases Ward, Children\u2019s Hospital in Poznan, 63-734 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerzy","family":"B\u0142aszczy\u0144ski","sequence":"additional","affiliation":[{"name":"Institute of Computing Science, Pozna\u0144 University of Technology, 60-965 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewelina","family":"Gowin","sequence":"additional","affiliation":[{"name":"Department of Preventive Health, Poznan University of Medical Science, 60-781 Poznan, Poland"},{"name":"Infectious Diseases Ward, Children\u2019s Hospital in Poznan, 63-734 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5200-7795","authenticated-orcid":false,"given":"Roman","family":"S\u0142owi\u0144ski","sequence":"additional","affiliation":[{"name":"Institute of Computing Science, Pozna\u0144 University of Technology, 60-965 Poznan, Poland"},{"name":"Systems Research Institute, Polish Academy of Sciences, 01-447, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek","family":"Wysocki","sequence":"additional","affiliation":[{"name":"Department of Preventive Health, Poznan University of Medical Science, 60-781 Poznan, Poland"},{"name":"Infectious Diseases Ward, Children\u2019s Hospital in Poznan, 63-734 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/j.jemermed.2018.01.031","article-title":"Clinical Mimics: An Emergency Medicine-Focused Review of Streptococcal Pharyngitis Mimics","volume":"54","author":"Gottlieb","year":"2018","journal-title":"J. Emerg. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"211","DOI":"10.3389\/fonc.2018.00211","article-title":"Epstein-Barr Virus Epidemiology, Serology, and Genetic Variability of LMP-1 Oncogene Among Healthy Population: An Update","volume":"8","author":"Smatti","year":"2018","journal-title":"Front. Oncol."},{"key":"ref_3","unstructured":"Smatti, M.K., Al-Sadeq, D.W., Ali, N.H., Pintus, G., Abou-Saleh, H., and Nasrallah, G.K. (2021, August 10). Recommendations for the Procedure in Community-Acquired Infections Respiratory System. Available online: http:\/\/antybiotyki.edu.pl\/wp-content\/uploads\/Rekomendacje\/Rekomendacje2016.pdf."},{"key":"ref_4","unstructured":"Soldin, S.J., Wong, E.C., Brugnara, C., Straseski, J., Straseski, M., and Adeli, K. (2011). Pediatric Reference Intervals, AACC Press."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1093\/clinchem\/34.8.1622","article-title":"Age- and sex-specific pediatric reference intervals for biochemistry analytes as measured with the Ektachem-700 analyzer","volume":"34","author":"Lockitch","year":"1988","journal-title":"Clin. Chem."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1053\/j.gastro.2009.12.052","article-title":"SAFETY study: Alanine aminotransferase cutoff values are set too high for reliable detection of pediatric chronic liver disease","volume":"138","author":"Schwimmer","year":"2010","journal-title":"Gastroenterology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.engappai.2011.09.003","article-title":"Inductive discovery of laws using monotonic rules","volume":"25","author":"Greco","year":"2012","journal-title":"Eng. Appl. Artif. Intell."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/j.ins.2010.10.030","article-title":"Sequential covering rule induction algorithm for variable consistency rough set approaches","volume":"181","author":"Szel","year":"2011","journal-title":"Inf. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Slowinski, R., Greco, S., and Matarazzo, B. (2009). Rough sets in decision making. Encyclopedia of Complexity and Systems Science, Springer.","DOI":"10.1007\/978-0-387-30440-3_460"},{"key":"ref_10","first-page":"40","article-title":"Variable consistency bagging ensembles","volume":"11","author":"Stefanowski","year":"2010","journal-title":"Trans. Rough Sets Lect. Notes Comput. Sci. Springer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/978-3-319-00969-8_26","article-title":"Extending bagging for imbalanced data","volume":"Volume 226","author":"Stefanowski","year":"2013","journal-title":"Advances in Intelligent Systems and Computing"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1007\/978-3-642-24425-4_7","article-title":"Rule-Based Estimation of Attribute Relevance","volume":"Volume 6954","author":"Susmaga","year":"2011","journal-title":"International Conference on Rough Sets and Knowledge Technology"},{"key":"ref_13","first-page":"802","article-title":"Immunoglobulins in bacterial and viral meningitis. Results of a controlled randomized clinical study of intravenous and intrathecal application","volume":"100","author":"Neu","year":"1982","journal-title":"Fortschr. Der. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1111\/j.1651-2227.2008.00789.x","article-title":"The value of clinical features in differentiating between viral, pneumococcal and atypical bacterial pneumonia in children","volume":"97","author":"Korppi","year":"2008","journal-title":"Acta Padiatr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"A45","DOI":"10.1186\/1824-7288-41-S2-A45","article-title":"Atypical and incomplete Kawasaki disease","volume":"41","author":"Maggio","year":"2015","journal-title":"Ital. J. Pediatr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.jpeds.2020.05.031","article-title":"Prediction Model for the Differential Diagnosis of Kawasaki Disease and Acute Cervical Lymphadenitis in Patients Initially Presenting with Fever and Cervical Lymphadenitis","volume":"225","author":"Kim","year":"2020","journal-title":"J. Pediatr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"754","DOI":"10.3389\/fimmu.2018.00754","article-title":"Role of C-Reactive Protein at Sites of Inflammation and Infection","volume":"9","author":"Sproston","year":"2018","journal-title":"Front. Immunol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"242","DOI":"10.3389\/fped.2019.00242","article-title":"Biomarkers for Kawasaki Disease: Clinical Utility and the Challenges Ahead","volume":"7","author":"Chaudhary","year":"2019","journal-title":"Front. Pediatr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"187","DOI":"10.3389\/fped.2020.00187","article-title":"Risk Factors of Intravenous Immunoglobulin Resistance in Children with Kawasaki Disease: A Meta-Analysis of Case-Control Studies","volume":"8","author":"Liu","year":"2020","journal-title":"Front. Pediatr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"501","DOI":"10.3346\/jkms.2004.19.4.501","article-title":"Inflammatory processes in Kawasaki disease reach their peak at the sixth day of fever onset: Laboratory profiles according to duration of fever","volume":"19","author":"Lee","year":"2004","journal-title":"J. Korean Med. Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1186\/s13052-018-0585-7","article-title":"Differentiating Kawasaki disease from urinary tract infection in febrile children with pyuria and C-reactive protein elevation","volume":"44","author":"Han","year":"2018","journal-title":"Ital. J. Pediatr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"221","DOI":"10.3389\/fped.2020.00221","article-title":"Clinical Characteristics for Differentiating Febrile Children with Suspected Kawasaki Disease Diagnosis","volume":"8","author":"Yan","year":"2020","journal-title":"Front. Pediatr."},{"key":"ref_23","first-page":"28","article-title":"Significance of very high erythrocyte sedimentation rates (100 mm or above in one hour) in 360 cases in Singapore","volume":"74","author":"Cheah","year":"1971","journal-title":"J. Trop Med. Hyg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1177\/000992288001900303","article-title":"Illnesses associated with extreme elevation of the erythrocyte sedimentation rate in children","volume":"19","author":"Schimmelpfennig","year":"1980","journal-title":"Clin. Pediatr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"175","DOI":"10.5144\/0256-4947.2007.175","article-title":"Extreme elevation of the erythrocyte sedimentation rate in children","volume":"27","author":"Abbag","year":"2007","journal-title":"Ann. Saudi. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.1016\/j.amjmed.2010.04.021","article-title":"Agreement between erythrocyte sedimentation rate and C-reactive protein in hospital practice","volume":"123","author":"Colombet","year":"2010","journal-title":"Am. J. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e927","DOI":"10.1161\/CIR.0000000000000484","article-title":"Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals from the American Heart Association","volume":"135","author":"McCrindle","year":"2017","journal-title":"Circulation"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1007\/s00431-018-3182-2","article-title":"Predictors of intravenous immunoglobulin-resistant Kawasaki disease in children: A meta-analysis of 4442 cases","volume":"177","author":"Li","year":"2018","journal-title":"Eur. J. Pediatr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.pedneo.2011.11.003","article-title":"Kawasaki Disease: An Update on Diagnosis and Treatment","volume":"53","author":"Kuo","year":"2012","journal-title":"Pediatrics Neonatol."},{"key":"ref_30","first-page":"507","article-title":"Thrombocytosis in children","volume":"63","author":"Chiarello","year":"2011","journal-title":"Minerva Pediatr."},{"key":"ref_31","unstructured":"World Health Organization (2008). Iron deficiency anaemia assessment, prevention, and control. A Guide for Programme Managers, World Health Organization."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/8\/10\/929\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:16:23Z","timestamp":1760166983000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/8\/10\/929"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,17]]},"references-count":31,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,10]]}},"alternative-id":["children8100929"],"URL":"https:\/\/doi.org\/10.3390\/children8100929","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,17]]}}}