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29 November 2018 : Clinical Research  

A Simple Scoring System for Quick, Accurate, and Reliable Early Diagnosis of Hand, Foot, and Mouth Disease

Shaoxing Chen1ACDE, Kaihong Yi1BF, Xiaojun Chen1DE, Liping Li2AG*, Xuerui Tan3ADG

DOI: 10.12659/MSM.911736

Med Sci Monit 2018; 24: CLR8627-8638

Abstract

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.

Keywords: Epidemiologic Study Characteristics as Topic, Hand, Foot and Mouth Disease, Research Design

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750