Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.
Int J Public Health. 2022 Sep 6;67:1604794. doi: 10.3389/ijph.2022.1604794. eCollection 2022.
To develop and internally validate two clinical risk scores to detect coronavirus disease 2019 (COVID-19) during local outbreaks. Medical records were extracted for a retrospective cohort of 336 suspected patients admitted to Baodi hospital between 27 January to 20 February 2020. Multivariate logistic regression was applied to develop the risk-scoring models, which were internally validated using a 5-fold cross-validation method and Hosmer-Lemeshow (H-L) tests. Fifty-six cases were diagnosed from the cohort. The first model was developed based on seven significant predictors, including age, close contact with confirmed/suspected cases, same location of exposure, temperature, leukocyte counts, radiological findings of pneumonia and bilateral involvement (the mean area under the receiver operating characteristic curve [AUC]:0.88, 95% CI: 0.84-0.93). The second model had the same predictors except leukocyte and radiological findings (AUC: 0.84, 95% CI: 0.78-0.89, Z = 2.56, = 0.01). Both were internally validated using H-L tests and showed good calibration (both > 0.10). Two clinical risk scores to detect COVID-19 in local outbreaks were developed with excellent predictive performances, using commonly measured clinical variables. Further external validations in new outbreaks are warranted.
开发并内部验证两种临床风险评分模型,以在当地疫情爆发期间检测 2019 年冠状病毒病(COVID-19)。回顾性队列研究纳入了 2020 年 1 月 27 日至 2 月 20 日期间因疑似 COVID-19 入住宝坻医院的 336 例疑似患者的病历资料。应用多变量逻辑回归建立风险评分模型,采用 5 折交叉验证法和 Hosmer-Lemeshow(H-L)检验进行内部验证。从队列中诊断出 56 例病例。第一个模型是基于 7 个有显著预测意义的指标建立的,包括年龄、与确诊/疑似病例的密切接触、暴露地点相同、体温、白细胞计数、肺炎的影像学表现和双侧受累(受试者工作特征曲线下面积 [AUC] 的平均值:0.88,95%CI:0.84-0.93)。第二个模型除了白细胞计数和影像学表现外,其余指标相同(AUC:0.84,95%CI:0.78-0.89,Z=2.56,P=0.01)。两个模型均通过 H-L 检验进行内部验证,显示出良好的校准度(均 P>0.10)。使用常用的临床变量开发了两种临床风险评分模型,用于在当地疫情爆发时检测 COVID-19,具有出色的预测性能。需要在新的疫情爆发中进行进一步的外部验证。