Evidence map›Paper›PMID 33404516›Full record

ArticleJournal of medical Internet research2021

Accurately Differentiating Between Patients With COVID-19, Patients With Other Viral Infections, and Healthy Individuals: Multimodal Late Fusion Learning Approach.

Ming Xu, Liu Ouyang, Lei Han, Kai Sun, Tingting Yu, Qian Li, Hua Tian, Lida Safarnejad, Hengdong Zhang, Yue Gao and 7 more

Open access · goldAbstract read
In one paragraph

Article in Journal of medical Internet research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
4.5field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it, 52 citations in OpenAlex.

  1. Pooled it
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  3. Review of multimodal machine learning approaches in healthcare.An international journal on information fusion · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 6 institutions in 2 countries.

Ming Xu *Department of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.ORCID 0000-0001-8846-2880
Liu Ouyang *Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.ORCID 0000-0002-1404-1263
Lei Han *Department of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.ORCID 0000-0002-8176-4912
Kai Sun *Department of Emergency Medicine, The First Hospital of Nanjing Medical University, Nanjing, China.ORCID 0000-0001-9512-3764
Tingting Yu *Department of Medical Genetics, School of Basic Medical Science Jiangsu Key Laboratory of Xenotransplantation, Nanjing Medical University, Nanjing, China.ORCID 0000-0003-1694-7592
Qian Li *Department of Pediatrics, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China.ORCID 0000-0002-4268-3909
Hua Tian *Department of Acute Infectious Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.ORCID 0000-0002-9006-4416
Lida SafarnejadSchool of Medicine, Stanford University, Stanford, CA, United States.ORCID 0000-0002-6377-7314
Hengdong ZhangDepartment of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.ORCID 0000-0002-6292-8459
Yue GaoDepartment of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.ORCID 0000-0002-2641-782X
Forrest Sheng BaoDepartment of Computer Science, Iowa State University, Ames, IA, United States.ORCID 0000-0002-5722-5337
Yuanfang ChenInstitute of HIV/AIDS/STI Prevention and Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.ORCID 0000-0002-1109-8491
Patrick RobinsonDepartment of Public Health Sciences, College of Health and Human Services, University of North Carolina Charlotte, Charlotte, NC, United States.ORCID 0000-0001-9237-9414
Yaorong GeDepartment of Software and Information Systems, College of Computing and Informatics, University of North Carolina Charlotte, Charlotte, NC, United States.ORCID 0000-0002-9576-0293
Baoli ZhuCenter for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.ORCID 0000-0001-9408-8266
Jie LiuDepartment of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.ORCID 0000-0002-7927-8309
Shi ChenDepartment of Public Health Sciences, College of Health and Human Services, University of North Carolina Charlotte, Charlotte, NC, United States.ORCID 0000-0002-2316-111X
Jiangsu Provincial Center for Disease Control and Prevention · CNUniversity of North Carolina at Charlotte · USNanjing Medical University · CNUnion Hospital · CNIowa State University · USJiangsu University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEffectively identifying patients with COVID-19 using nonpolymerase chain reaction biomedical data is critical for achieving optimal clinical outcomes. Currently, there is a lack of comprehensive understanding in various biomedical features and appropriate analytical approaches for enabling the early detection and effective diagnosis of patients with COVID-19.

objectiveWe aimed to combine low-dimensional clinical and lab testing data, as well as high-dimensional computed tomography (CT) imaging data, to accurately differentiate between healthy individuals, patients with COVID-19, and patients with non-COVID viral pneumonia, especially at the early stage of infection.

methodsIn this study, we recruited 214 patients with nonsevere COVID-19, 148 patients with severe COVID-19, 198 noninfected healthy participants, and 129 patients with non-COVID viral pneumonia. The participants' clinical information (ie, 23 features), lab testing results (ie, 10 features), and CT scans upon admission were acquired and used as 3 input feature modalities. To enable the late fusion of multimodal features, we constructed a deep learning model to extract a 10-feature high-level representation of CT scans. We then developed 3 machine learning models (ie, k-nearest neighbor, random forest, and support vector machine models) based on the combined 43 features from all 3 modalities to differentiate between the following 4 classes: nonsevere, severe, healthy, and viral pneumonia.

resultsMultimodal features provided substantial performance gain from the use of any single feature modality. All 3 machine learning models had high overall prediction accuracy (95.4%-97.7%) and high class-specific prediction accuracy (90.6%-99.9%).

conclusionsCompared to the existing binary classification benchmarks that are often focused on single-feature modality, this study's hybrid deep learning-machine learning framework provided a novel and effective breakthrough for clinical applications. Our findings, which come from a relatively large sample size, and analytical workflow will supplement and assist with clinical decision support for current COVID-19 diagnostic methods and other clinical applications with high-dimensional multimodal biomedical features.

Indexed as

Decision Support Systems, ClinicalHealthMachine LearningCOVID-19Diagnosis, DifferentialHumansMiddle AgedPneumonia, ViralSARS-CoV-2Support Vector MachineTomography, X-Ray Computedbiomedical imagingCOVID-19deep learningdiagnosisdiagnosis supportdiagnosticdifferentiationfeature fusionimagingmachine learningmultimodaltesting

Identifiers

PMID33404516
PMCPMC7790733
OpenAlexW3111402128

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.