Mücke Urs, Klemann Christian, Baumann Ulrich, Meyer-Bahlburg Almut, Kortum Xiaowei, Klawonn Frank, Lechner Werner M, Grigull Lorenz
Department of Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany.
Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany.
Front Immunol. 2017 Apr 5;8:384. doi: 10.3389/fimmu.2017.00384. eCollection 2017.
Primary immunodeficiency disorders (PIDs) are a heterogeneous group of more than 200 rare diseases. Timely diagnosis is of uttermost importance. Therefore, we aimed to develop a diagnostic questionnaire with computerized pattern-recognition in order to support physicians to identify suspicious patient histories.
Standardized interviews were conducted with guardians of children with PID. The questionnaire based on parental observations was developed using Colaizzis' framework for content analysis. Answers from 64 PID patients and 62 controls were analyzed by data mining methods in order to make a diagnostic prediction. Performance was evaluated by -fold stratified cross-validation.
The diagnostic support tool achieved a diagnostic sensitivity of up to 98%. The analysis of 12 interviews revealed 26 main phenomena observed by parents in the pre-diagnostic period. The questions were systematically phrased and selected resulting in a 36-item questionnaire. This was answered by 126 patients with or without PID to evaluate prediction. Item analysis revealed significant questions.
Our approach proved suitable for recognizing patterns and thus differentiates between observations of PID patients and control groups. These findings provide the basis for developing a tool supporting physicians to consider a PID with a questionnaire. These data support the notion that patient's experience is a cornerstone in the diagnostic process.
原发性免疫缺陷病(PID)是一组超过200种罕见病的异质性疾病。及时诊断至关重要。因此,我们旨在开发一种具有计算机模式识别功能的诊断问卷,以帮助医生识别可疑的患者病史。
对PID患儿的监护人进行标准化访谈。基于家长观察结果的问卷采用科莱齐斯内容分析法编制。采用数据挖掘方法分析64例PID患者和62例对照的答案,以进行诊断预测。通过k折分层交叉验证评估性能。
诊断支持工具的诊断敏感性高达98%。对12份访谈的分析揭示了家长在诊断前期观察到的26个主要现象。问题经过系统措辞和筛选,形成了一份包含36个条目的问卷。126例有或无PID的患者回答了该问卷以评估预测效果。项目分析揭示了重要问题。
我们的方法被证明适用于识别模式,从而区分PID患者和对照组的观察结果。这些发现为开发一种支持医生通过问卷考虑PID的工具提供了基础。这些数据支持了患者体验是诊断过程基石这一观点。