{
  "abstract": "Sepsis blood-transcriptome signatures are usually judged against healthy controls. Two questions are rarely separated: whether the classifier exceeds chance, and whether its genes outperform an arbitrary list of equal size. We tested both on public microarray data (discovery GSE65682, n = 359; validation GSE57065, n = 53), using the 9983 of 11,222 genes measurable on both platforms. A 10-gene signature was selected by nested cross-validation and applied to validation without refitting. It separated sepsis from health perfectly (area under the receiver operating characteristic curve, AUROC, 1.000). The pipeline exceeded chance: no label permutation in 1000 matched it (p = 0.001). The genes did not outperform random lists: 12.5% of 2000 random 10-gene panels matched or exceeded the signature, as did 67.6% of panels drawn from the same 300 preselected candidates. Against non-infected intensive care patients, cross-fitted AUROC fell to 0.730 (95% confidence interval 0.642–0.818), unchanged after age and sex matching. At a threshold of 0.5, the cross-fitted model called 70 of these 75 patients septic. Selection was unstable: 200 bootstrap resamples gave a median of 6 genes, from 109 distinct genes. A near-perfect AUROC against healthy controls reflects an easy benchmark, not a specific gene list.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Applied Computer Science and Mathematical Modelling, Faculty of Mathematics and Computer Science, University of Warmia and Mazury in Olsztyn, Słoneczna 54, 10-710 Olsztyn, Poland",
    "Department of Mathematics, University of Architecture, Civil Engineering and Geodesy (UACEG), 1 Hristo Smirnenski Blvd., 1164 Sofia, Bulgaria",
    "Department of Mathematical Modelling and Numerical Methods, Faculty of Applied Mathematics and Informatics, Technical University of Sofia, 8 “Kliment Ohridski” Blvd., 1000 Sofia, Bulgaria",
    "Faculty of Mathematics and Informatics, Sofia University “St. Kliment Ohridski”, 5 James Bourchier Blvd., 1164 Sofia, Bulgaria"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Mikhail Kolev"
    },
    {
      "affs": [
        1
      ],
      "name": "Irina Naskinova",
      "orcid": "0009-0009-7794-4265"
    },
    {
      "affs": [
        2
      ],
      "name": "Meglena Lazarova"
    },
    {
      "affs": [
        3
      ],
      "name": "Velin Klisurov",
      "orcid": "0009-0005-8212-6786"
    },
    {
      "affs": [
        3
      ],
      "name": "Hristo Kalinov",
      "orcid": "0009-0002-8548-4907"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6v7zvy96hx54p.bib",
  "cited_by": 0,
  "doi": "10.3390/ijms27209273",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13704978/?tool=EBI",
  "id": "6v7zvy96hx54p",
  "issns": [
    "1422-0067"
  ],
  "landing_url": "https://www.mdpi.com/1422-0067/27/20/9273",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2713|Sepsis Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7222938471",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13704978/pdf/?tool=EBI",
  "pmcid": "PMC13704978",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/6v7zvy96hx54p.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:57Z",
      "native_id": "10.3390/ijms27209273",
      "source": "crossref",
      "url": "https://www.mdpi.com/1422-0067/27/20/9273"
    },
    {
      "first_seen": "2026-10-30T12:21:44Z",
      "native_id": "PMC:PMC13704978",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13704978"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Sepsis Diagnosis and Treatment",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "What a Near-Perfect AUROC Does Not Show: Random-Panel and Label-Permutation Controls for a Sepsis Blood-Transcriptome Signature",
  "title_text": "What a Near-Perfect AUROC Does Not Show: Random-Panel and Label-Permutation Controls for a Sepsis Blood-Transcriptome Signature",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:44Z",
  "url": "https://research.draconitic.com/paper/6v7zvy96hx54p",
  "venue": "International Journal of Molecular Sciences",
  "versions": []
}