Evidence map›Paper›PMID 40817605›Full record

ArticleInternational journal of rheumatic diseases2025

Toward Identifying a Multivariate Correlation of Septic Arthritis With a Machine Learning Approach: Time to Reset the Current Australasian Guidelines?

Sourav Bhattacharjee, Imal C Hemachandra, Sudharsan Venkatesan, Robert W Baird, Sachin Khetan

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Article in International journal of rheumatic diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Sourav BhattacharjeeSchool of Veterinary Medicine, University College Dublin, Dublin 4, Ireland.ORCID https://orcid.org/0000-0002-6528-6877
Imal C HemachandraDepartment of Infectious Diseases, Royal Darwin Hospital, Casuarina, Northern Territory, Australia.ORCID https://orcid.org/0009-0003-9701-7836
Sudharsan VenkatesanDepartment of Infectious Diseases, Royal Darwin Hospital, Casuarina, Northern Territory, Australia.ORCID https://orcid.org/0000-0002-6973-4198
Robert W BairdTerritory Pathology, Royal Darwin Hospital, Casuarina, Northern Territory, Australia.ORCID https://orcid.org/0000-0003-2006-5277
Sachin KhetanDepartment of Infectious Diseases, Royal Darwin Hospital, Casuarina, Northern Territory, Australia.ORCID https://orcid.org/0009-0001-5222-6509

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo understand the complexity of disease pathology through the prism of septic arthritis, especially the reliability of popular and, yet, arbitrary thresholds like synovial leucocyte counts of ≥ 100,000/μL suggestive of it, with the help of statistical analysis and logistic regression.

methodsAn anonymized patient dataset comprising 360 swollen joint episodes was collated along with a range of patient attributes, including age, gender, comorbidity (e.g., diabetes, gout, pseudogout, immunosuppression), prior administration of antibiotics and washout of the affected joint, isolation of crystals from synovial aspirate, blood/synovial fluid culture growth, and synovial aspirate cell count. The dataset was subjected to statistical analysis (e.g., sensitivity, specificity, predictive and likelihood ratios) and logistic regression modeling, with results compared to the synovial leucocyte count thresholds of ≥ 100,000/μL and ≥ 50,000/μL.

resultsThe logistic regression model (sensitivity 50%, specificity 97.04%) outperformed the models based on arbitrary thresholds like a synovial leucocyte count of ≥ 100,000/μL (sensitivity 48.21%, specificity 88.16%) or ≥ 50,000/μL (sensitivity 64.29%, specificity 69.74%) in predicting septic arthritis. Independent variables like age, presence of gout, and autoimmune arthritis as comorbidities, hip joint involvement, synovial aspirate leucocyte count, and crystals in aspirated fluid demonstrated a significant (p < 0.05) correlation to septic arthritis.

conclusionSeptic arthritis presents a multivariate correlation that deserves a holistic oversight rather than singling out individual factors. Data mining platforms like logistic regression can investigate the complex interplay among these individual variables while making a diagnosis not only in septic arthritis but also in other diseases with multisystem involvement, infective or non-infective alike.

Indexed as

Arthritis, InfectiousMachine LearningPractice Guidelines as TopicAdultAgedAged, 80 and overAustraliaFemaleHumansLeukocyte CountMaleMiddle AgedPredictive Value of TestsReproducibility of ResultsRisk FactorsSynovial Fluidaseptic arthritisdata mininglogistic regressionmultivariate correlation of diseaseROC analysissensitivityseptic arthritisspecificitysynovial leucocyte count

Identifiers

PMID40817605
PMCPMC12357062

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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.