Novel multiple Z-score models for detection of coronary artery dilation: application in Kawasaki disease

Abstract Background This study aims to develop Z-Score models to normalize measurements of three coronary arteries and enhance the diagnosis of Kawasaki disease (KD) in children from newborns to 10 years old. Developing a reliable Z-Score model is challenging, as some existing models fail the normal...

Full description

Saved in:
Bibliographic Details
Main Authors: Ho-Chang Kuo, Shih-Hsin Chen, I-Fei Chen, Wen-Ing Cheng, Shih-Feng Liu, Mindy Ming-Huey Guo, Yu-Chi Lin, Yi-Hui Chen
Format: Article
Language:English
Published: BMC 2024-12-01
Series:Pediatric Rheumatology Online Journal
Subjects:
Online Access:https://doi.org/10.1186/s12969-024-01040-9
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850134499983097856
author Ho-Chang Kuo
Shih-Hsin Chen
I-Fei Chen
Wen-Ing Cheng
Shih-Feng Liu
Mindy Ming-Huey Guo
Yu-Chi Lin
Yi-Hui Chen
author_facet Ho-Chang Kuo
Shih-Hsin Chen
I-Fei Chen
Wen-Ing Cheng
Shih-Feng Liu
Mindy Ming-Huey Guo
Yu-Chi Lin
Yi-Hui Chen
author_sort Ho-Chang Kuo
collection DOAJ
description Abstract Background This study aims to develop Z-Score models to normalize measurements of three coronary arteries and enhance the diagnosis of Kawasaki disease (KD) in children from newborns to 10 years old. Developing a reliable Z-Score model is challenging, as some existing models fail the normality test. Overcoming these challenges is crucial for improving KD diagnosis. Method Detailed measurements of the left main coronary artery (LCA), left anterior descending coronary artery (LAD), and right coronary artery (RCA) were collected, along with patient demographics such as age, height, weight, and body surface area (BSA). Several Z-Score models, named the Kuo Z-Score models, were proposed, with separate designs for different coronary arteries and different age groups, resulting in multiple Z-Score models. The Z-Score model for the RCA employs the Box-Cox method for data transformation. Finally, we tested various age group combinations, selecting models that passed the Anderson–Darling normality test and had higher R-square values for robustness and best data fit. Results The study included 1180 participants free from coronary or heart diseases. The Kuo Z-Score models were optimized for LCA, LAD, and RCA across the five age groups 0–6 years, 6–7 years, 7–8 years, 8–9 years, and 9–10 years. Only the normality test for the RCA in the 7–8 year age group failed. The proposed model fitted to the normality assumption outperforming the other models. Conclusion The Kuo Z-Score models, applicable across a broad age range, provides robust identification of coronary artery dilatation and aneurysm in KD. The models’ capability to normalize diverse data sets marks a significant advancement in KD diagnostic sensitivity, aiding in better clinical decision-making and potentially improving patient outcomes.
format Article
id doaj-art-a6491a3e714844c8957f992ecb985105
institution OA Journals
issn 1546-0096
language English
publishDate 2024-12-01
publisher BMC
record_format Article
series Pediatric Rheumatology Online Journal
spelling doaj-art-a6491a3e714844c8957f992ecb9851052025-08-20T02:31:41ZengBMCPediatric Rheumatology Online Journal1546-00962024-12-0122111010.1186/s12969-024-01040-9Novel multiple Z-score models for detection of coronary artery dilation: application in Kawasaki diseaseHo-Chang Kuo0Shih-Hsin Chen1I-Fei Chen2Wen-Ing Cheng3Shih-Feng Liu4Mindy Ming-Huey Guo5Yu-Chi Lin6Yi-Hui Chen7Department of Pediatrics, Kaohsiung Chang Gung Memorial HospitalDepartment of Computer Science and Information Engineering, Tamkang UniversityDepartment of Management Sciences, Tamkang UniversityDepartment of Management Sciences, Tamkang UniversityDepartment of Respiratory Therapy, Kaohsiung Chang Gung Memorial HospitalDepartment of Pediatrics, Kaohsiung Chang Gung Memorial HospitalKawasaki Disease Center, Kaohsiung Chang Gung Memorial HospitalKawasaki Disease Center, Kaohsiung Chang Gung Memorial HospitalAbstract Background This study aims to develop Z-Score models to normalize measurements of three coronary arteries and enhance the diagnosis of Kawasaki disease (KD) in children from newborns to 10 years old. Developing a reliable Z-Score model is challenging, as some existing models fail the normality test. Overcoming these challenges is crucial for improving KD diagnosis. Method Detailed measurements of the left main coronary artery (LCA), left anterior descending coronary artery (LAD), and right coronary artery (RCA) were collected, along with patient demographics such as age, height, weight, and body surface area (BSA). Several Z-Score models, named the Kuo Z-Score models, were proposed, with separate designs for different coronary arteries and different age groups, resulting in multiple Z-Score models. The Z-Score model for the RCA employs the Box-Cox method for data transformation. Finally, we tested various age group combinations, selecting models that passed the Anderson–Darling normality test and had higher R-square values for robustness and best data fit. Results The study included 1180 participants free from coronary or heart diseases. The Kuo Z-Score models were optimized for LCA, LAD, and RCA across the five age groups 0–6 years, 6–7 years, 7–8 years, 8–9 years, and 9–10 years. Only the normality test for the RCA in the 7–8 year age group failed. The proposed model fitted to the normality assumption outperforming the other models. Conclusion The Kuo Z-Score models, applicable across a broad age range, provides robust identification of coronary artery dilatation and aneurysm in KD. The models’ capability to normalize diverse data sets marks a significant advancement in KD diagnostic sensitivity, aiding in better clinical decision-making and potentially improving patient outcomes.https://doi.org/10.1186/s12969-024-01040-9Kawasaki diseaseZ-ScoreNormality TestBox-Cox Transformation
spellingShingle Ho-Chang Kuo
Shih-Hsin Chen
I-Fei Chen
Wen-Ing Cheng
Shih-Feng Liu
Mindy Ming-Huey Guo
Yu-Chi Lin
Yi-Hui Chen
Novel multiple Z-score models for detection of coronary artery dilation: application in Kawasaki disease
Pediatric Rheumatology Online Journal
Kawasaki disease
Z-Score
Normality Test
Box-Cox Transformation
title Novel multiple Z-score models for detection of coronary artery dilation: application in Kawasaki disease
title_full Novel multiple Z-score models for detection of coronary artery dilation: application in Kawasaki disease
title_fullStr Novel multiple Z-score models for detection of coronary artery dilation: application in Kawasaki disease
title_full_unstemmed Novel multiple Z-score models for detection of coronary artery dilation: application in Kawasaki disease
title_short Novel multiple Z-score models for detection of coronary artery dilation: application in Kawasaki disease
title_sort novel multiple z score models for detection of coronary artery dilation application in kawasaki disease
topic Kawasaki disease
Z-Score
Normality Test
Box-Cox Transformation
url https://doi.org/10.1186/s12969-024-01040-9
work_keys_str_mv AT hochangkuo novelmultiplezscoremodelsfordetectionofcoronaryarterydilationapplicationinkawasakidisease
AT shihhsinchen novelmultiplezscoremodelsfordetectionofcoronaryarterydilationapplicationinkawasakidisease
AT ifeichen novelmultiplezscoremodelsfordetectionofcoronaryarterydilationapplicationinkawasakidisease
AT weningcheng novelmultiplezscoremodelsfordetectionofcoronaryarterydilationapplicationinkawasakidisease
AT shihfengliu novelmultiplezscoremodelsfordetectionofcoronaryarterydilationapplicationinkawasakidisease
AT mindyminghueyguo novelmultiplezscoremodelsfordetectionofcoronaryarterydilationapplicationinkawasakidisease
AT yuchilin novelmultiplezscoremodelsfordetectionofcoronaryarterydilationapplicationinkawasakidisease
AT yihuichen novelmultiplezscoremodelsfordetectionofcoronaryarterydilationapplicationinkawasakidisease