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AI Can Predict Need for CT in Pediatric Patients After Mild Traumatic Brain Injury

By MedImaging International staff writers
Posted on 06 Apr 2022

Image: Deep neural networks can predict the need for CT in pediatric mild traumatic brain injury (Photo courtesy of Unsplash)

Only 10% of CT scans unveil positive findings in mild traumatic brain injury, raising concerns of its overuse in this population. A number of clinical rules have been developed to address this issue, but they still suffer limitations in their specificity. Machine learning models have been applied in limited studies to mimic clinical rules; however, further improvement in terms of balanced sensitivity and specificity is still needed. In a new study, researchers have found that deep neural networks can be uesd to predict the need for CT in pediatric mild traumatic brain injury.

For their study, researchers at The University of Queensland (Brisbane, Australia) applied a deep artificial neural networks (DANN) model and an instance hardness threshold algorithm to reproduce the Pediatric emergency Care Applied Research Network (PECARN) clinical rule in a pediatric population collected as a part of the PECARN study between 2004 and 2006. The DANN model was applied using 14,983 patients younger than 18 years with Glasgow Coma Scale scores ≥ 14 who had head CT reports. The clinical features of the PECARN rules, PECARN-A (group A, age < 2 years) and PECARN-B (group B, age ≤ 2 years), were used to directly evaluate the model. The average accuracy, sensitivity, precision, and specificity were calculated by comparing the model’s prediction outcome to that reported by the PECARN investigators. The instance hardness threshold and DANN model were applied to predict the need for CT in pediatric patients using fivefold cross-validation.

Based on the findings, the researchers concluded that a DANN model achieved comparable sensitivity and outstanding specificity for replicating the PECARN clinical rule and predicting the need for CT in pediatric patients after mild traumatic brain injury compared with the original statistically derived clinical rule.

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72 (52.928924560547): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (68.902969360352): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (48.160552978516): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (66.041946411133): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294792307 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (36.001205444336): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294792307 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (43.153762817383): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (65.088272094727): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (97.036361694336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND published='1' LIMIT 1

105 (73.909759521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND published='1' LIMIT 1

106 (75.101852416992): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294792307 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (66.995620727539): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294792307 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (98.943710327148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND published='1' LIMIT 1

109 (63.896179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND published='1' LIMIT 1

110 (65.088272094727): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294792307 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (597.00012207031): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294792307 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (852.10800170898): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (797.03330993652): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (890.01655578613): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND published='1' LIMIT 1

115 (212.9077911377): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND published='1' LIMIT 1

116 (520.94459533691): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND published='1' LIMIT 1

117 (266.07513427734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND published='1' LIMIT 1

118 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND published='1' LIMIT 1

119 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND published='1' LIMIT 1

120 (357.15103149414): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 30925.989151001): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (148.05793762207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND published='1' LIMIT 1

123 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND published='1' LIMIT 1

124 (563.8599395752): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294792307 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294792307 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 803184.9861145): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (143.05114746094): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (380.03921508789): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (49.114227294922): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (!!!!! 6345.0336456299): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (73.909759521484): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (392.91381835938): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (46.014785766602): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (537.87231445312): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (401.97372436523): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (154.97207641602): SELECT name FROM jos_deeppockets WHERE id=215

136 (40.054321289062): SELECT name FROM jos_deeppockets WHERE id=215

137 (563.8599395752): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (566.95938110352): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND published='1' LIMIT 1

140 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND published='1' LIMIT 1

141 (!!!!! 21990.060806274): TRUNCATE TABLE jos_trademed_module

142 (499.01008605957): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294792307 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (139.95170593262): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294792307 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (449.18060302734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (131.84547424316): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (97.990036010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND published='1' LIMIT 1

147 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND published='1' LIMIT 1

148 (!!!!! 1461.0290527344): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (80.82389831543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND published='1' LIMIT 1

150 (59.843063354492): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND published='1' LIMIT 1

151 (55.074691772461): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294792307 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294792307 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (40.054321289062): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

153 (35.04753112793): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

154 (36.001205444336): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (313.04359436035): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND published='1' LIMIT 1

156 (156.87942504883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294792307 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294792307 AND published='1' LIMIT 1

157 (561.95259094238): select jos_twitters.link from jos_twitters where cat=10

158 (114.91775512695): select jos_facebook.link from jos_facebook where cat=10

159 (149.96528625488): select jos_google_plus.link from jos_google_plus where cat=10

160 (100.13580322266): select jos_linkedin.link from jos_linkedin where cat=10

161 (316.85829162598): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 3502.1305084229): insert into jos_banners_delta values (14615,'2025-05-01 18:41:58','18.226.88.23','view'),(14202,'2025-05-01 18:41:58','18.226.88.23','view'),(14203,'2025-05-01 18:41:58','18.226.88.23','view')

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