Development of a machine learning-based predictive nomogram for screening children with juvenile idiopathic arthritis: a pseudo-longitudinal study of 223,195 children in the United States

BackgroundJuvenile idiopathic arthritis (JIA) is a prevalent chronic rheumatological condition in children, with reported prevalence ranging from 12. 8 to 45 per 100,000 and incidence rates from 7.8 to 8.3 per 100,000 person-years. The diagnosis of JIA can be challenging due to its symptoms, such as...

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Main Authors: Yu-Sheng Lee, Kira Gor, Matthew Evan Sprong, Junu Shrestha, Xueli Huang, Heaven Hollender
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1531764/full
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author Yu-Sheng Lee
Kira Gor
Matthew Evan Sprong
Junu Shrestha
Xueli Huang
Heaven Hollender
author_facet Yu-Sheng Lee
Kira Gor
Matthew Evan Sprong
Junu Shrestha
Xueli Huang
Heaven Hollender
author_sort Yu-Sheng Lee
collection DOAJ
description BackgroundJuvenile idiopathic arthritis (JIA) is a prevalent chronic rheumatological condition in children, with reported prevalence ranging from 12. 8 to 45 per 100,000 and incidence rates from 7.8 to 8.3 per 100,000 person-years. The diagnosis of JIA can be challenging due to its symptoms, such as joint pain and swelling, which can be similar to other conditions (e.g., joint pain can be associated with growth in children and adolescents).MethodsThe National Survey of Children's Health (NSCH) database (2016–2021) of the United States was used in the current study. The NSCH database is funded by the Health Resources and Services Administration and Child Health Bureau and surveyed in all 50 states plus the District of Columbia. A total of 223,195 children aged 0 to 17 were analyzed in this study. A least absolute shrinkage and selection operator (LASSO) logistic regression and stepwise logistic regression were used to select the predictors, which were used to create the nomograms to predict JIA.ResultsA total of 555 (248.7 per 100,000) JIA cases were reported in the NSCH. In the LASSO model, the receiver operating characteristic curve demonstrated excellent discrimination, with an area under the curve (AUC) of 0.9002 in the training set and 0.8639 in the validation set. Of the 16 variables selected by LASSO, 13 overlapped with those from the stepwise model. The regression achieved an AUC of 0.9130 in the training set and 0.8798 in the validation set. Sensitivity, specificity, and accuracy were 79.1%, 90.2%, and 90.2% in the training set, and 69.0%, 90.9%, and 90.8% in the validation set.DiscussionUsing two well-validated predictor models, we developed nomograms for the early prediction of JIA in children based on the NSCH database. The tools are also available for parents and health professionals to utilize these nomograms. Our easy-to-use nomograms are not intended to replace the standard diagnostic methods. Still, they are designed to assist parents, clinicians, and researchers in better-estimating children's potential risk of JIA. We advise individuals utilizing our nomogram model to be mindful of potential pre-existing selection biases that may affect referrals and diagnoses.
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spelling doaj-art-79d64b225f5045dbb745e18c57078b6d2025-08-20T03:21:31ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-05-011310.3389/fpubh.2025.15317641531764Development of a machine learning-based predictive nomogram for screening children with juvenile idiopathic arthritis: a pseudo-longitudinal study of 223,195 children in the United StatesYu-Sheng Lee0Kira Gor1Matthew Evan Sprong2Junu Shrestha3Xueli Huang4Heaven Hollender5School of Integrated Sciences, Sustainability, and Public Health, College of Health, Science, and Technology, University of Illinois Springfield, Springfield, IL, United StatesSchool of Integrated Sciences, Sustainability, and Public Health, College of Health, Science, and Technology, University of Illinois Springfield, Springfield, IL, United StatesDepartment of Addictions Studies and Behavioral Health, College of Health and Human Services, Governors State University, University Park, IL, United StatesSchool of Integrated Sciences, Sustainability, and Public Health, College of Health, Science, and Technology, University of Illinois Springfield, Springfield, IL, United StatesDepartment of Computer Science, College of Health, Science, and Technology, University of Illinois Springfield, Springfield, IL, United StatesSchool of Health and Human Sciences, Indiana University Indianapolis, Indianapolis, IN, United StatesBackgroundJuvenile idiopathic arthritis (JIA) is a prevalent chronic rheumatological condition in children, with reported prevalence ranging from 12. 8 to 45 per 100,000 and incidence rates from 7.8 to 8.3 per 100,000 person-years. The diagnosis of JIA can be challenging due to its symptoms, such as joint pain and swelling, which can be similar to other conditions (e.g., joint pain can be associated with growth in children and adolescents).MethodsThe National Survey of Children's Health (NSCH) database (2016–2021) of the United States was used in the current study. The NSCH database is funded by the Health Resources and Services Administration and Child Health Bureau and surveyed in all 50 states plus the District of Columbia. A total of 223,195 children aged 0 to 17 were analyzed in this study. A least absolute shrinkage and selection operator (LASSO) logistic regression and stepwise logistic regression were used to select the predictors, which were used to create the nomograms to predict JIA.ResultsA total of 555 (248.7 per 100,000) JIA cases were reported in the NSCH. In the LASSO model, the receiver operating characteristic curve demonstrated excellent discrimination, with an area under the curve (AUC) of 0.9002 in the training set and 0.8639 in the validation set. Of the 16 variables selected by LASSO, 13 overlapped with those from the stepwise model. The regression achieved an AUC of 0.9130 in the training set and 0.8798 in the validation set. Sensitivity, specificity, and accuracy were 79.1%, 90.2%, and 90.2% in the training set, and 69.0%, 90.9%, and 90.8% in the validation set.DiscussionUsing two well-validated predictor models, we developed nomograms for the early prediction of JIA in children based on the NSCH database. The tools are also available for parents and health professionals to utilize these nomograms. Our easy-to-use nomograms are not intended to replace the standard diagnostic methods. Still, they are designed to assist parents, clinicians, and researchers in better-estimating children's potential risk of JIA. We advise individuals utilizing our nomogram model to be mindful of potential pre-existing selection biases that may affect referrals and diagnoses.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1531764/fulljuvenile idiopathic arthritispediatric arthritispediatric joint inflammationchronic rheumatologyLASSOmachine learning
spellingShingle Yu-Sheng Lee
Kira Gor
Matthew Evan Sprong
Junu Shrestha
Xueli Huang
Heaven Hollender
Development of a machine learning-based predictive nomogram for screening children with juvenile idiopathic arthritis: a pseudo-longitudinal study of 223,195 children in the United States
Frontiers in Public Health
juvenile idiopathic arthritis
pediatric arthritis
pediatric joint inflammation
chronic rheumatology
LASSO
machine learning
title Development of a machine learning-based predictive nomogram for screening children with juvenile idiopathic arthritis: a pseudo-longitudinal study of 223,195 children in the United States
title_full Development of a machine learning-based predictive nomogram for screening children with juvenile idiopathic arthritis: a pseudo-longitudinal study of 223,195 children in the United States
title_fullStr Development of a machine learning-based predictive nomogram for screening children with juvenile idiopathic arthritis: a pseudo-longitudinal study of 223,195 children in the United States
title_full_unstemmed Development of a machine learning-based predictive nomogram for screening children with juvenile idiopathic arthritis: a pseudo-longitudinal study of 223,195 children in the United States
title_short Development of a machine learning-based predictive nomogram for screening children with juvenile idiopathic arthritis: a pseudo-longitudinal study of 223,195 children in the United States
title_sort development of a machine learning based predictive nomogram for screening children with juvenile idiopathic arthritis a pseudo longitudinal study of 223 195 children in the united states
topic juvenile idiopathic arthritis
pediatric arthritis
pediatric joint inflammation
chronic rheumatology
LASSO
machine learning
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1531764/full
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