Key result
A simple scoring diagnostic system accurately diagnosed Hand, Foot, and Mouth Disease with an AUC of 0.918 (95% CI 0.874-0.963; P<0.01), yielding a sensitivity of 0.95 and specificity of 0.90.
Why the study?
The study was designed to construct an accurate, reliable, and simple scoring system to improve hand, foot, and mouth disease diagnosis.
Does a simple scoring system accurately diagnose Hand, Foot, and Mouth Disease in patients with skin rashes or fever?
Observational (n=200)
Does a simple scoring system accurately diagnose Hand, Foot, and Mouth Disease in patients with skin rashes or fever?
Effect estimate: AUC 0.918 (95% CI 0.874-0.963)
p-value: p=<0.01
A newly developed simple scoring system using clinical and laboratory markers provides high accuracy for the early diagnosis of Hand, Foot, and Mouth Disease.
May aid rapid HFMD diagnosis in outbreaks; leaves open external validation before clinical use.
BACKGROUND To construct an accurate, reliable, and simple scoring system of improving HFMD diagnosis. MATERIAL AND METHODS Based on the following 3 steps, a simple scoring diagnostic system was built: (1) we selected basic markers (age and sex), markers recommended in HFMD diagnosis guidelines, and significant biomarkers among severity groups found in a large dataset; (2) we used positive constituent ratio for determining scores of each marker; and (3) we applied receiving operating curve in an external dataset to determine the optimal cut-off score. RESULTS The selected markers were sex, age, fever, skin rashes, nervous system disorder, respiratory system disorder, digestive system disorder and cardiopulmonary complications, C-reactive-protein, White Blood Cell, Creatinine Kinase, Creatinine Kinase Isoenzyme, Gamma-Glutamyl Transpeptidase, Albumin, Globulin, Albumin/Globulin Ratio, Natrium, Chloride, Calcium, and Glucose. A simple scoring system with 3.9684 as the lower cut-off was constructed. The AUC was 0.918 (95% CI: 0.874-0.963, P<0.01). The sensitivity, specificity, and Youden Index, which were based on the validation dataset of 200 subjects (80 cases, 120 non-cases with skin rashes or fever), were 0.95, 0.90, and 0.85, respectively. CONCLUSIONS This simple scoring system is an effective method to diagnose HFMD.
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Chen et al. (2018) conducted an observational in Hand, Foot, and Mouth Disease (HFMD) (n=200). Simple scoring diagnostic system vs. Non-cases with skin rashes or fever was evaluated on Diagnostic accuracy (AUC) (AUC 0.918, 95% CI 0.874-0.963, p=<0.01). A simple scoring diagnostic system accurately diagnosed Hand, Foot, and Mouth Disease with an AUC of 0.918 (95% CI 0.874-0.963; P<0.01), yielding a sensitivity of 0.95 and specificity of 0.90.
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