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Shaoxing Chen, Kaihong Yi, Xiaojun Chen, Liping Li, Xuerui Tan
(Department of Community Monitoring, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China (mainland))
Med Sci Monit 2018; 24:8627-8638
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.