Predicting smear negative pulmonary tuberculosis with classification trees and logistic regression: a cross-sectional study

Abstract Background Smear negative pulmonary tuberculosis (SNPT) accounts for 30% of pulmonary tuberculosis cases reported yearly in Brazil. This study aimed to develop a prediction model for SNPT for outpatients in areas with scarce resources. Methods The study enrolled 551 patients with clinical-radiological suspicion of SNPT, in Rio de Janeiro, Brazil. The original data was divided into two equivalent samples for generation and validation of the prediction models. Symptoms, physical signs and chest X-rays were used for constructing logistic regression and classification and regression tree models. From the logistic regression, we generated a clinical and radiological prediction score. The area under the receiver operator characteristic curve, sensitivity, and specificity were used to evaluate the model's performance in both generation and validation samples. Results It was possible to generate predictive models for SNPT with sensitivity ranging from 64% to 71% and specificity ranging from 58% to 76%. Conclusion The results suggest that those models might be useful as screening tools for estimating the risk of SNPT, optimizing the utilization of more expensive tests, and avoiding costs of unnecessary anti-tuberculosis treatment. Those models might be cost-effective tools in a health care network with hierarchical distribution of scarce resources.

Evolving decision trees with beam search-based initialization and lexicographic multi-objective evaluation

Decision tree induction algorithms represent one of the most popular techniques for dealing with classification problems. However, traditional decision-tree induction algorithms implement a greedy approach for node splitting that is inherently susceptible to local optima convergence. Evolutionary algorithms can avoid the problems associated with a greedy search and have been successfully employed to the induction of decision trees. Previously, we proposed a lexicographic multi-objective genetic algorithm for decision-tree induction, named LEGAL-Tree. In this work, we propose extending this approach substantially, particularly w.r.t. two important evolutionary aspects: the initialization of the population and the fitness function. We carry out a comprehensive set of experiments to validate our extended algorithm. The experimental results suggest that it is able to outperform both traditional algorithms for decision-tree induction and another evolutionary algorithm in a variety of application domains.