检测儿童登革热:使用症状模式排序在线评估方法

T. Chien, J. Chow, Yu Chang, W. Chou
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引用次数: 0

摘要

背景:登革热(DF)是亚洲一个重要的卫生问题。我们用它的临床症状来预测DF。方法:采用(1)未加权的总和评分和(2)非参数HT人拟合统计,结合(3)加权评分(由逻辑回归得出),从177例确诊为DF的儿童患者(69例确诊为DF)的17种DF相关临床症状中提取具有统计学意义的特征,以预测DF风险。结果:6种症状(家族史、发热≥39°C、皮疹、瘀点、腹痛和虚弱)可显著预测DF。当截断点为- 1.03 (p = 0.26)时,加权评分与HT系数相结合,敏感性为0.91,特异性为0.76。ROC曲线下面积为0.88,是较好的预测指标,特异性较传统logistic回归提高5.56%。结论:使用逻辑回归分析6种简单症状对儿童DF风险的早期检测是有用和有效的。将非参数HT系数与加权回归评分结合后,预测特异性增强。可使用患者智能手机进行自我评估,以区分登革热,并可能消除进行昂贵且耗时的登革热实验室检测的需要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Detecting Dengue Fever in Children: Using Sequencing Symptom Patterns for An Online Assessment Approach
Background: Dengue fever (DF) is an important health problem in Asia. We examined it using its clinical symptoms to predict DF.Methods: We extracted statistically significant features from 17 DF-related clinical symptoms in 177 pediatric patients (69 diagnosed with DF) using (1) the unweighted summation score and (2) the non-parametric HT person fit statistic, which jointly combine (3) the weighted score (yielded by logistic regression) to predict DF risk.Results: Six symptoms (Family History, Fever ≥ 39°C, Skin Rash, Petechiae, Abdominal Pain, and Weakness) significantly predicted DF. When a cutoff point of −1.03 (p = 0.26) suggested combining the weighted score and the HT coefficient, the sensitivity was 0.91 and the specificity was 0.76. The area under the ROC curve was 0.88, which was a better predictor: specificity was 5.56% higher than for the traditional logistic regression.Conclusions: Six simple symptoms analyzed using logistic regression were useful and valid for early detection of DF risk in children. A better predictive specificity increased after combining the non-parametric HT coefficient to the weighted regression score. A self-assessment using patient smartphones is available to discriminate DF and may eliminate the need for a costly and time-consuming dengue laboratory test.
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