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

• Published in: Medical science monitor Vol. 24; pp. 8627 - 8638
• Main Authors: Chen, Shaoxing, Yi, Kaihong, Chen, Xiaojun, Li, Liping, Tan, Xuerui
• Format: Journal Article
• Language: English
• Published: United States International Scientific Literature, Inc 29.11.2018
• Subjects: Clinical Research
• ISSN: 1643-3750; 1234-1010; 1643-3750
• DOI: 10.12659/MSM.911736

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.