SEVMALrisk: An Externally Validated Clinical Risk Score for Early Risk Stratification of Severe Imported Malaria

Clicks: 12
ID: 326969
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Emerging

Ranked #30 of 58 articles by views in international journal of travel medicine and global health

Most read Least read

Bar heights use a square-root scale.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Background Early recognition of severe imported malaria is essential because treatment decisions frequently need to be made before reliable parasite density measurements become available. Objective tools to support early risk stratification during this interval are lacking. This study developed and externally validated SEVMALrisk, an explainable clinical risk score derived from a machine-learning prediction model using routinely available admission laboratory parameters. Methods Adult patients with confirmed malaria from the Rotterdam Malaria Cohort (n = 832) were used for prediction model development. Eight supervised machine-learning algorithms were compared. The best-performing model was optimized, interpreted using SHapley Additive exPlanations (SHAP) and translated into the SEVMALrisk clinical risk score. Independent external validation was performed in a multicenter cohort (n = 124). Results Random Forest showed the highest discriminative performance and was selected for model development. The optimized prediction model achieved an area under the receiver operating characteristic curve (AUROC) of 0.962 with good calibration (Brier score 0.048). SHAP analysis identified eight routinely available laboratory parameters (total bilirubin, ASAT, leukocytes, thrombocytes, erythrocytes, creatinine, CRP and urea) for inclusion in the clinical risk score. The predefined decision threshold (26 points) remained unchanged during external validation. Internal validation yielded likelihood ratios of 9.39 (LR+) and 0.19 (LR−), corresponding to post-test probabilities of 51.9% and 2.1%, respectively. External validation demonstrated comparable performance (LR+ 8.02; LR− 0.18), with post-test probabilities of 59.2% and 3.2%. Conclusion SEVMALrisk is an explainable and externally validated clinical risk score for early risk stratification of severe imported malaria. Rather than replacing parasite density assessment or WHO severity criteria, it supports evidence-based treatment decisions before reliable parasite quantification becomes available.
Reference Key
openalex_W7206199710 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Perry J. J. van Genderen, Michele Fumarola, Robert‐Jan Hassing, Foekje Stelma, Jaap J. van Hellemond
Journal international journal of travel medicine and global health
Year 2026
DOI
10.1093/jtm/taag080
URL
https://doi.org/10.1093/jtm/taag080
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.