Single center blind testing of a US multi-center validated diagnostic algorithm for Kawasaki disease in Taiwan.
Single center blind testing of a US multi-center validated diagnostic algorithm for Kawasaki disease in Taiwan.
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DOI：
10.3389/fimmu.2022.1031387
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发表时间：
2022
影响因子：
7.3
通讯作者：
中科院分区：
文献类型：
--
作者：
川崎病（KD）是儿童获得性心脏病的主要原因。KD诊断的主要挑战是它与其他儿童发热控制（FC）受试者具有相同的临床症状。我们试图确定我们的算法方法是否适用于台湾队列。本研究采用台湾长庚纪念医院的单一研究中心，纳入疑似急性KD患者，由当地KD专家进行KD分析。我们先前的单中心开发的基于计算机的两步算法在美国进一步进行了五中心验证。这项首个多中心盲法试验验证了我们的方法，具有足够的灵敏度和阳性的预测价值，可以识别美国各中心诊断的大多数KD患者。本研究涉及台湾长庚纪念医院418名KDs和259名FCs。我们的诊断算法保留了敏感性（418例中有379例，90.7%）、特异性（259例中有223例，86.1%）、PPV（409例中有379例，92.7%）和NPV(247例中有223例，90.3%)，与之前的2016年美国单中心和2020年美国五中心结果相当。只有4.7%（418例中15例）的KD患者和2.3%（259例中6例）的FC患者被确定为不确定。该算法确定了50例（36%）KD患者中有18例具有2或3个主要标准。在418例KD患者中，157例为1岁以下的婴儿，157例中有140例分类正确，占89.2%。在44例有冠状动脉异常的KD患者中，我们的诊断算法正确识别了43例（97.7%），包括所有冠状动脉扩张的患者，但有1例冠状动脉在8周内消退。这项工作证明了我们的算法方法在台湾的适用性和诊断的可移植性。
Kawasaki disease (KD) is the leading cause of acquired heart disease in children. The major challenge in KD diagnosis is that it shares clinical signs with other childhood febrile control (FC) subjects. We sought to determine if our algorithmic approach applied to a Taiwan cohort. A single center (Chang Gung Memorial Hospital in Taiwan) cohort of patients suspected with acute KD were prospectively enrolled by local KD specialists for KD analysis. Our previously single-center developed computer-based two-step algorithm was further tested by a five-center validation in US. This first blinded multi-center trial validated our approach, with sufficient sensitivity and positive predictive value, to identify most patients with KD diagnosed at centers across the US. This study involved 418 KDs and 259 FCs from the Chang Gung Memorial Hospital in Taiwan. Our diagnostic algorithm retained sensitivity (379 of 418; 90.7%), specificity (223 of 259; 86.1%), PPV (379 of 409; 92.7%), and NPV (223 of 247; 90.3%) comparable to previous US 2016 single center and US 2020 fiver center results. Only 4.7% (15 of 418) of KD and 2.3% (6 of 259) of FC patients were identified as indeterminate. The algorithm identified 18 of 50 (36%) KD patients who presented 2 or 3 principal criteria. Of 418 KD patients, 157 were infants younger than one year and 89.2% (140 of 157) were classified correctly. Of the 44 patients with KD who had coronary artery abnormalities, our diagnostic algorithm correctly identified 43 (97.7%) including all patients with dilated coronary artery but one who found to resolve in 8 weeks. This work demonstrates the applicability of our algorithmic approach and diagnostic portability in Taiwan.
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影响因子：
2
作者：
Hu Z;Jin B;Shin AY;Zhu C;Zhao Y;Hao S;Zheng L;Fu C;Wen Q;Ji J;Li Z;Wang Y;Zheng X;Dai D;Culver DS;Alfreds ST;Rogow T;Stearns F;Sylvester KG;Widen E;Ling XB
通讯作者：
Ling XB
影响因子：
3.2
作者：
Zheng L;Wang Y;Hao S;Shin AY;Jin B;Ngo AD;Jackson-Browne MS;Feller DJ;Fu T;Zhang K;Zhou X;Zhu C;Dai D;Yu Y;Zheng G;Li YM;McElhinney DB;Culver DS;Alfreds ST;Stearns F;Sylvester KG;Widen E;Ling XB
通讯作者：
Ling XB
影响因子：
9.3
作者：
Ling XB;Lau K;Kanegaye JT;Pan Z;Peng S;Ji J;Liu G;Sato Y;Yu TT;Whitin JC;Schilling J;Burns JC;Cohen HJ
通讯作者：
Cohen HJ
影响因子：
9.3
作者：
Ling, Xuefeng B.;Macaubas, Claudia;Mellins, Elizabeth D.
通讯作者：
Mellins, Elizabeth D.
影响因子：
3.7
作者：
Duong SQ;Zheng L;Xia M;Jin B;Liu M;Li Z;Hao S;Alfreds ST;Sylvester KG;Widen E;Teuteberg JJ;McElhinney DB;Ling XB
通讯作者：
Ling XB