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| Construction of Early Warning Model for Infectious Diseases Based on Multidimensional Parameters Fusion of Blood Routine and Optimization of Decision Threshold |
| Zhang Yu |
| Weinan Second Hospital,Weinan Shaanxi 714000 |
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Abstract Objective To construct an early warning machine learning model for infectious diseases based on multidimensional parameters of complete blood count(CBC),optimize decision thresholds,and improve the accuracy and clinical utility of infection diagnosis.Methods A multicenter retrospective cohort study was conducted,collecting data from 5,317 suspected infectious disease patients in the emergency departments of three research centers from January 2023 to December 2024,including 1,683 cases in the infection group and 3,634 cases in the non-infection control group.CBC results within 24 hours of hospital admission were collected,and routine,derived inflammatory,and cell population data parameters were extracted to construct three hierarchical feature sets.LASSO regression combined with random forest was used to screen features,and the predictive performance of six machine learning algorithms was compared.Six threshold determination methods were systematically evaluated,with the introduction of clinical utility weighting functions and adaptive threshold strategies.Model performance was assessed through internal and external validation.Results The extended fusion hierarchical XGBoost model achieved an AUC of 0.874 on the internal validation set,superior to the basic fusion hierarchical model;the dynamic fusion hierarchical AUC increased to 0.891.The XGBoost model outperformed other algorithms.The model demonstrated stable performance in external validation.Subgroup analysis of bacteremia showed better predictive performance for Gram-negative bacteremia.SHAP analysis indicated that the top five most contributing features were procalcitonin,etc.The adaptive threshold strategy significantly improved the net recclassification index,with a low threshold in the high-risk group achieving a sensitivity of 91.23%.Conclusion The XGBoost model based on multidimensional parameter fusion of CBC can effectively predict infectious diseases,and the introduction of cell population data enhances model performance.The adaptive threshold strategy enables individualized early warning,demonstrating clinical translational potential to provide decision support for early infection identification in emergency departments and primary healthcare institutions.
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Received: 10 March 2026
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2026, Vol. 46 
