Development and validation of the AF score for diagnosis of adult-onset Still's disease in fever of unknown origin

IF 4.7 Q2 IMMUNOLOGY
Shuni Ying , Duo Lv , Dingxian Zhu , Sheng Li , Yuwei Ding , Chuanyin Sun , Yu Shi , Hong Fang , Jianjun Qiao
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引用次数: 0

Abstract

Objective

To develop and validate a diagnostic score to identify adult-onset Still's disease (AOSD) in fever of unknown origin (FUO).

Methods

A single center, retrospective case-control study of inpatients with FUO from January 2018 to December 2021. Using clinical and laboratory data from 178 cases with AOSD and 486 cases with FUO, we developed an AOSD/FUO (AF) score with a Bayesian Model Averaging approach. AF score and Yamaguchi's criteria were evaluated by sensitivity, specificity, accuracy, and positive/negative predictive value for diagnosis of AOSD in developmental and validation samples.

Results

Persistent pruritic eruptions (PPEs) in patients with rashes was higher in AOSD group than FUO group (52.3% vs 7.4%; P < 0.01). PPEs yielded a specificity of 97.5% and a sensitivity of 44.9%. AF score = PPEs × 3.795+Evanescent rash × 2.774+Serum ferritin × 1.678+Myalgia × 0.958+Neutrophil count × 0.185+Platelet count × 0.004. A cut-off value ≥ 5.245 revealed the maximizing sensitivity of 88.7% and specificity of 95.8% in discriminating AOSD from FUO in the validation group. And AF score improved the accuracy from 82.6% to 93.3% compared with Yamaguchi's criteria.

Conclusions

We developed and validated a new score which can identify AOSD in FUO with higher classification accuracy than Yamaguchi's criteria. Future multi-centric prospective studies need to be designed to confirm the diagnosis value of AF score.

Abstract Image

发展和验证AF评分诊断成人起病不明原因发热斯蒂尔氏病
目的建立并验证不明原因发热(FUO)成人发病斯蒂尔氏病(AOSD)的诊断评分。方法对2018年1月至2021年12月住院的FUO患者进行单中心、回顾性病例对照研究。利用178例AOSD和486例FUO的临床和实验室数据,我们采用贝叶斯模型平均方法建立了AOSD/FUO (AF)评分。在发展样本和验证样本中,评估AF评分和Yamaguchi标准诊断AOSD的敏感性、特异性、准确性和阳性/阴性预测值。结果AOSD组皮疹患者持续瘙痒性发疹(PPEs)发生率高于FUO组(52.3% vs 7.4%;P & lt;0.01)。PPEs的特异性为97.5%,敏感性为44.9%。AF评分= PPEs × 3.795+消逝性皮疹× 2.774+血清铁蛋白× 1.678+肌痛× 0.958+中性粒细胞计数× 0.185+血小板计数× 0.004。截断值≥5.245时,验证组区分AOSD和FUO的最大灵敏度为88.7%,特异度为95.8%。与山口标准相比,AF评分将准确率从82.6%提高到93.3%。结论建立并验证了一种新的诊断FUO中AOSD的评分方法,其分类准确率高于Yamaguchi标准。未来需要设计多中心前瞻性研究来证实房颤评分的诊断价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Translational Autoimmunity
Journal of Translational Autoimmunity Medicine-Immunology and Allergy
CiteScore
7.80
自引率
2.60%
发文量
33
审稿时长
55 days
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