Multi-Modal Machine Learning Approach for COVID-19 Detection Using Biomarkers and X-Ray Imaging

Abstract

Background: Accurate and rapid detection of COVID-19 remains critical for clinical management, especially in resource-limited settings. Current diagnostic methods face challenges in terms of speed and reliability, creating a need for complementary AI-based models that integrate diverse data sources. Objectives: This study aimed to develop and evaluate a multi-modal machine learning model that combines clinical biomarkers and chest X-ray images to enhance diagnostic accuracy and provide interpretable insights. Methods: We used a dataset of 250 patients (180 COVID-19 positive and 70 negative cases) collected from clinical settings. Biomarkers such as CRP, ferritin, NLR, and albumin were included alongside chest X-ray images. Random Forest and Gradient Boosting models were used for biomarkers, and ResNet and VGG CNN architectures were applied to imaging data. A late-fusion strategy integrated predictions from these modalities. Stratified k-fold cross-validation ensured robust evaluation while preventing data leakage. Model performance was assessed using AUC-ROC, F1-score, Specificity, Negative Predictive Value (NPV), and Matthews Correlation Coefficient (MCC), with confidence intervals calculated via bootstrap resampling. Results: The Gradient Boosting + VGG fusion model achieved the highest performance, with an AUC-ROC of 0.94, F1-score of 0.93, Specificity of 93%, NPV of 96%, and MCC of 0.91. SHAP and LIME interpretability analyses identified CRP, ferritin, and specific lung regions as key contributors to predictions. Discussion: The proposed multi-modal approach significantly enhances diagnostic accuracy compared to single-modality models. Its interpretability aligns with clinical understanding, supporting its potential for real-world application.