Receiver operating characteristic curve of illness scoring scale for cases of severe hand, foot and mouth disease
YUE Li-mei1, SU Li-yuan1, WU Chen-lu2, ZHANG Zhao-yong3
1. Chengdu Municipal Center for Disease Control and Prevention, Chengdu, Sichuan 610000, China; 2. School of Public Health, Xi'an Jiaotong University, Xi'an, Shanxi 710000, China; 3. Public Health Clinical Center of Chengdu, Chengdu, Sichuan 610066, China
Abstract：Objective To establish symptom evaluation indexes of cases of severe hand, foot and mouth disease (HFMD), to explore a convenient, fast and effective method for scoring cases of children with severe HFMD, and to provide a reference basis for early and rapid determination of severe HFMD cases and severity of HFMD in primary-level medical institutions. Methods The data regarding severe HFMD cases and hospitalized cases with mild HFMD in Chengdu city during 2014-2016 were retrospectively analyzed. According to Pediatric Critical Illness Score (PCIS) and previous literature research data, relatively simple and feasible symptoms were selected as the main evaluation indexes, and a scoring method suitable for rapid determination of severe HFMD patients and their severity was established. The receiver operating characteristic (ROC) curve and the corresponding area under the ROC curve (AUC) were used to evaluate and compare the performance of the scoring scale and the scoring system. Results The AUC of cases in severe HFMD group and Ⅳ severe group was 0.99 and 0.97, respectively, and the maximum Yoden indexes corresponding to the optimal threshold score were 0.96 and 0.89, respectively, showing that this evaluation method had a good discrimination for severe and IV severe HFMD cases. However, the scoring scale was not effective for defining cases of stages Ⅱ and Ⅲ HFMD, and the AUC was only 0.62. Conclusions This scoring method of severe HFMD can judge the condition of cases of severe and IV severe HFMD, and provide a reference basis for pediatricians of primary-level medical institutions to early diagnose and treat clinical cases of severe HFMD.
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2020, Vol. 27 
