The Use of Artificial Neural Networks for Differential Diagnosis between Vesicoureteral Reflux and Urinary Tract Infection in Children

Özet

Aim: Vesicoureteral reflux (VUR) and urinary tract infection (UTI) are common problems in children. Our goal is to use different models for theclinical decision of differential diagnosis of VUR and UTI in children.Materials and Methods: This was a retrospective cross-sectional study with 611 pediatric patients enrolled. Detailed information for the patientswas obtained from hospital records and patient files. Three models including different variables were evaluated via an artificial neural networkfor the differential diagnosis of VUR and recurrent UTI. Clinical findings were included in Model 1, clinical and laboratory findings were includedin Model 2, and clinical, laboratory and detailed urinary ultrasonography (USG) findings were included in Model 3. A cross-validation techniquewas used to evaluate predictive models by partitioning the original sample into a training set to train the model, and a test set to evaluate it.Results: Of the 611 children, 425 (69.6%) had VUR and 186 (30.4%) had UTI. The sensitivity of Model 1 and Model 2 were 0.682 and 0.856,respectively. Also, Model 3 showed the best performance and highest sensitivity with 0.939 for differential diagnosis.Conclusion: Differential diagnosis between VUR and UTI in children can be predicted by using clinical, laboratory and USG variables via anArtificial Neural Network. Model 3, which included clinical, laboratory and USG variables together, showed the best performance and highestsensitivity.