The identification of risk factors for infectious patients with acute fever and formulation of activation criteria to alert outpatient clinic doctors
Identifieur interne : 000355 ( Istex/Corpus ); précédent : 000354; suivant : 000356The identification of risk factors for infectious patients with acute fever and formulation of activation criteria to alert outpatient clinic doctors
Auteurs : Hongli Xiao ; Haiyu Qi ; Xingwang Li ; Jing Wang ; Xiaoli Li ; Suxia Ma ; Zongli Diao ; Yan Wang ; Fangfang Sun ; Chenghong YinSource :
- Journal of Evaluation in Clinical Practice [ 1356-1294 ] ; 2010-12.
English descriptors
- Teeft :
- Activation criteria, Acute fever, Alanine aminotransferase, Alert outpatient clinic doctors, Bacterial infection, Bacterial infections, Beijing, Beijing ditan hospital, Beijing friendship hospital, Blackwell publishing, Clinical characteristics, Clinical data, Community outbreak, Conjunctival hyperaemia, Contagious diseases, Critical illness, Diagnostic accuracy, Diagnostic reliability, Diarrhoea, Early warning, Early warning infectiosity score, Early warning infectiosity score system, Early warning score, Emergency doctors, Emergency patients, England journal, Ewis, High mortality, Hong kong, Hospital admission, Hospital mortality, Human cases, Human infection, Infection, Infectiosity, Infectious cases, Infectious department, Infectious disease, Infectious diseases, Infectious patients, Kappa test, Kappa value, Kappa values, Laboratory examinations, Mews score, Observation group, Odds ratio, Outbreak, Outpatient clinic doctors, Outpatient clinics, Population distribution, Receiver operator, Reliability, Respiratory syndrome, Risk factors, Sars, Sars patients, Syndrome, Virus infection, Virus investigation team.
Abstract
Rationale, aims and objectives Acute fever is the most common clinical symptom for infectious diseases. It is necessary to identify risk factors for infectious patients with acute fever and formulate activation criteria of early warning infectiosity score system (EWIS) to alert outpatient clinic doctors. Methods Logistic regression analysis was used to determine risk factors for infectious diseases from the clinical data of 758 patients with acute fever. Risk factors were weighted and an EWIS was formulated. A receiver operator characteristic (ROC) analysis of weighted cumulative scores was performed to evaluate the diagnostic accuracy of EWIS, and the Kappa test used to confirm diagnostic reliability. A χ2‐test for trend was applied to determine the relevance between EWIS and incidence of infectious diseases. Results Risk factors for infections included conjunctival hyperaemia, rash, diarrhoea, increased alanine aminotransferase, splenomegaly and abnormal percentage of peripheral neutrophils (NE%). Risk factors were weighted and tabulated. The areas under the ROC curves of the EWIS was 0.929 and ≥4 points predicted infectious diseases, and the Kappa values were 0.750. As the score increased, the incidence of infectious diseases increased. The areas under the ROC curves of the EWIS predicting on single viral and bacterial infectious diseases were 0.961 and 0.896, and the Kappa values were 0.807 and 0.701, respectively. Conclusions Risk factors for infections have been identified, quantified and formulated into a table of EWIS that have high diagnostic accuracy and reliability for the early identification of contagious diseases.
Url:
DOI: 10.1111/j.1365-2753.2009.01306.x
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ISTEX:C063972CB5A1B4B5B08BF082C80D581F8E9E6E51Le document en format XML
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Jing" uniqKey="Wang J" first="Jing" last="Wang">Jing Wang</name><affiliation><mods:affiliation>Resident Doctor,</mods:affiliation></affiliation></author><author><name sortKey="Li, Xiaoli" sort="Li, Xiaoli" uniqKey="Li X" first="Xiaoli" last="Li">Xiaoli Li</name><affiliation><mods:affiliation>Resident Doctor,</mods:affiliation></affiliation></author><author><name sortKey="Ma, Suxia" sort="Ma, Suxia" uniqKey="Ma S" first="Suxia" last="Ma">Suxia Ma</name><affiliation><mods:affiliation>Resident Doctor,</mods:affiliation></affiliation></author><author><name sortKey="Diao, Zongli" sort="Diao, Zongli" uniqKey="Diao Z" first="Zongli" last="Diao">Zongli Diao</name><affiliation><mods:affiliation>Resident Doctor,</mods:affiliation></affiliation></author><author><name sortKey="Wang, Yan" sort="Wang, Yan" uniqKey="Wang Y" first="Yan" last="Wang">Yan Wang</name><affiliation><mods:affiliation>Resident Doctor,</mods:affiliation></affiliation></author><author><name sortKey="Sun, Fangfang" sort="Sun, 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China</mods:affiliation></affiliation></author><author><name sortKey="Wang, Jing" sort="Wang, Jing" uniqKey="Wang J" first="Jing" last="Wang">Jing Wang</name><affiliation><mods:affiliation>Resident Doctor,</mods:affiliation></affiliation></author><author><name sortKey="Li, Xiaoli" sort="Li, Xiaoli" uniqKey="Li X" first="Xiaoli" last="Li">Xiaoli Li</name><affiliation><mods:affiliation>Resident Doctor,</mods:affiliation></affiliation></author><author><name sortKey="Ma, Suxia" sort="Ma, Suxia" uniqKey="Ma S" first="Suxia" last="Ma">Suxia Ma</name><affiliation><mods:affiliation>Resident Doctor,</mods:affiliation></affiliation></author><author><name sortKey="Diao, Zongli" sort="Diao, Zongli" uniqKey="Diao Z" first="Zongli" last="Diao">Zongli Diao</name><affiliation><mods:affiliation>Resident Doctor,</mods:affiliation></affiliation></author><author><name sortKey="Wang, Yan" sort="Wang, Yan" uniqKey="Wang Y" first="Yan" last="Wang">Yan Wang</name><affiliation><mods:affiliation>Resident Doctor,</mods:affiliation></affiliation></author><author><name sortKey="Sun, Fangfang" sort="Sun, Fangfang" uniqKey="Sun F" first="Fangfang" last="Sun">Fangfang Sun</name><affiliation><mods:affiliation>Resident Doctor,</mods:affiliation></affiliation></author><author><name sortKey="Yin, Chenghong" sort="Yin, Chenghong" uniqKey="Yin C" first="Chenghong" last="Yin">Chenghong Yin</name><affiliation><mods:affiliation>Professor, Department of Infectious Disease and Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: modscn@yahoo.com.cn</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Journal of Evaluation in Clinical Practice</title><title level="j" type="alt">JOURNAL OF EVALUATION IN CLINICAL PRACTICE</title><idno type="ISSN">1356-1294</idno><idno type="eISSN">1365-2753</idno><imprint><biblScope unit="vol">16</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="1248">1248</biblScope><biblScope unit="page" to="1253">1253</biblScope><biblScope unit="page-count">6</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2010-12">2010-12</date></imprint><idno type="ISSN">1356-1294</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1356-1294</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Activation criteria</term><term>Acute fever</term><term>Alanine aminotransferase</term><term>Alert outpatient clinic doctors</term><term>Bacterial infection</term><term>Bacterial infections</term><term>Beijing</term><term>Beijing ditan hospital</term><term>Beijing friendship hospital</term><term>Blackwell publishing</term><term>Clinical characteristics</term><term>Clinical data</term><term>Community outbreak</term><term>Conjunctival hyperaemia</term><term>Contagious diseases</term><term>Critical illness</term><term>Diagnostic accuracy</term><term>Diagnostic reliability</term><term>Diarrhoea</term><term>Early warning</term><term>Early warning infectiosity score</term><term>Early warning infectiosity score system</term><term>Early warning score</term><term>Emergency doctors</term><term>Emergency patients</term><term>England journal</term><term>Ewis</term><term>High mortality</term><term>Hong kong</term><term>Hospital admission</term><term>Hospital mortality</term><term>Human cases</term><term>Human infection</term><term>Infection</term><term>Infectiosity</term><term>Infectious cases</term><term>Infectious department</term><term>Infectious disease</term><term>Infectious diseases</term><term>Infectious patients</term><term>Kappa test</term><term>Kappa value</term><term>Kappa values</term><term>Laboratory examinations</term><term>Mews score</term><term>Observation group</term><term>Odds ratio</term><term>Outbreak</term><term>Outpatient clinic doctors</term><term>Outpatient clinics</term><term>Population distribution</term><term>Receiver operator</term><term>Reliability</term><term>Respiratory syndrome</term><term>Risk factors</term><term>Sars</term><term>Sars patients</term><term>Syndrome</term><term>Virus infection</term><term>Virus investigation team</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Rationale, aims and objectives Acute fever is the most common clinical symptom for infectious diseases. It is necessary to identify risk factors for infectious patients with acute fever and formulate activation criteria of early warning infectiosity score system (EWIS) to alert outpatient clinic doctors. Methods Logistic regression analysis was used to determine risk factors for infectious diseases from the clinical data of 758 patients with acute fever. Risk factors were weighted and an EWIS was formulated. A receiver operator characteristic (ROC) analysis of weighted cumulative scores was performed to evaluate the diagnostic accuracy of EWIS, and the Kappa test used to confirm diagnostic reliability. A χ2‐test for trend was applied to determine the relevance between EWIS and incidence of infectious diseases. Results Risk factors for infections included conjunctival hyperaemia, rash, diarrhoea, increased alanine aminotransferase, splenomegaly and abnormal percentage of peripheral neutrophils (NE%). Risk factors were weighted and tabulated. The areas under the ROC curves of the EWIS was 0.929 and ≥4 points predicted infectious diseases, and the Kappa values were 0.750. As the score increased, the incidence of infectious diseases increased. The areas under the ROC curves of the EWIS predicting on single viral and bacterial infectious diseases were 0.961 and 0.896, and the Kappa values were 0.807 and 0.701, respectively. Conclusions Risk factors for infections have been identified, quantified and formulated into a table of EWIS that have high diagnostic accuracy and reliability for the early identification of contagious diseases.</div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>ewis</json:string><json:string>infectious diseases</json:string><json:string>risk factors</json:string><json:string>infectiosity</json:string><json:string>sars</json:string><json:string>beijing</json:string><json:string>early warning infectiosity score</json:string><json:string>infectious patients</json:string><json:string>acute fever</json:string><json:string>blackwell publishing</json:string><json:string>england journal</json:string><json:string>respiratory syndrome</json:string><json:string>receiver operator</json:string><json:string>diagnostic accuracy</json:string><json:string>alanine aminotransferase</json:string><json:string>infectious disease</json:string><json:string>human 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Doctor,</json:string></affiliations></json:item><json:item><name>Zongli Diao MM</name><affiliations><json:string>Resident Doctor,</json:string></affiliations></json:item><json:item><name>Yan Wang MD</name><affiliations><json:string>Resident Doctor,</json:string></affiliations></json:item><json:item><name>Fangfang Sun MM</name><affiliations><json:string>Resident Doctor,</json:string></affiliations></json:item><json:item><name>Chenghong Yin MD PhD</name><affiliations><json:string>Professor, Department of Infectious Disease and Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China</json:string><json:string>E-mail: modscn@yahoo.com.cn</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>activation criteria fever</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>infectious disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>risk factors</value></json:item></subject><articleId><json:string>JEP1306</json:string></articleId><arkIstex>ark:/67375/WNG-8MBJBNF6-P</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Rationale, aims and objectives Acute fever is the most common clinical symptom for infectious diseases. It is necessary to identify risk factors for infectious patients with acute fever and formulate activation criteria of early warning infectiosity score system (EWIS) to alert outpatient clinic doctors. Methods Logistic regression analysis was used to determine risk factors for infectious diseases from the clinical data of 758 patients with acute fever. Risk factors were weighted and an EWIS was formulated. A receiver operator characteristic (ROC) analysis of weighted cumulative scores was performed to evaluate the diagnostic accuracy of EWIS, and the Kappa test used to confirm diagnostic reliability. A χ2‐test for trend was applied to determine the relevance between EWIS and incidence of infectious diseases. Results Risk factors for infections included conjunctival hyperaemia, rash, diarrhoea, increased alanine aminotransferase, splenomegaly and abnormal percentage of peripheral neutrophils (NE%). Risk factors were weighted and tabulated. The areas under the ROC curves of the EWIS was 0.929 and ≥4 points predicted infectious diseases, and the Kappa values were 0.750. As the score increased, the incidence of infectious diseases increased. The areas under the ROC curves of the EWIS predicting on single viral and bacterial infectious diseases were 0.961 and 0.896, and the Kappa values were 0.807 and 0.701, respectively. Conclusions Risk factors for infections have been identified, quantified and formulated into a table of EWIS that have high diagnostic accuracy and reliability for the early identification of contagious diseases.</abstract><qualityIndicators><score>8.031</score><pdfWordCount>3139</pdfWordCount><pdfCharCount>20785</pdfCharCount><pdfVersion>1.2</pdfVersion><pdfPageCount>6</pdfPageCount><pdfPageSize>595.216 x 793.701 pts</pdfPageSize><pdfWordsPerPage>523</pdfWordsPerPage><pdfText>true</pdfText><refBibsNative>true</refBibsNative><abstractWordCount>241</abstractWordCount><abstractCharCount>1659</abstractCharCount><keywordCount>3</keywordCount></qualityIndicators><title>The identification of risk factors for infectious patients with acute fever and formulation of activation criteria to alert outpatient clinic doctors</title><pmid><json:string>20722883</json:string></pmid><genre><json:string>article</json:string></genre><host><title>Journal of Evaluation in Clinical Practice</title><language><json:string>unknown</json:string></language><doi><json:string>10.1111/(ISSN)1365-2753</json:string></doi><issn><json:string>1356-1294</json:string></issn><eissn><json:string>1365-2753</json:string></eissn><publisherId><json:string>JEP</json:string></publisherId><volume>16</volume><issue>6</issue><pages><first>1248</first><last>1253</last><total>6</total></pages><genre><json:string>journal</json:string></genre></host><namedEntities><unitex><date><json:string>between April 1994 and December 2008</json:string><json:string>2005</json:string><json:string>2001</json:string><json:string>2002</json:string><json:string>1248</json:string><json:string>8098</json:string><json:string>2003</json:string><json:string>2010</json:string></date><geogName></geogName><orgName><json:string>Infectious Department, Beijing Ditan Hospital, Capital Medical University, Beijing, China Keywords</json:string><json:string>Mexico, Canada</json:string><json:string>Beijing Friendship Hospital, Capital Medical University, Beijing, China</json:string><json:string>Blackwell Publishing Ltd</json:string><json:string>Department of Infectious Disease and Critical Care</json:string><json:string>Mexico, the United States</json:string><json:string>World Health Organization</json:string></orgName><orgName_funder></orgName_funder><orgName_provider></orgName_provider><persName><json:string>Team</json:string><json:string>The</json:string><json:string>Bin Cao</json:string><json:string>Chenghong Yin</json:string></persName><placeName><json:string>United States</json:string><json:string>Beijing</json:string><json:string>UK</json:string><json:string>Hong Kong</json:string><json:string>China</json:string></placeName><ref_url></ref_url><ref_bibl><json:string>[10,11]</json:string><json:string>[12]</json:string><json:string>[6]</json:string><json:string>[9,16]</json:string><json:string>Lee et al. 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[4]</json:string><json:string>[14]</json:string><json:string>Lam et al.</json:string><json:string>Lee et al.</json:string><json:string>[9]</json:string><json:string>[2]</json:string><json:string>[13]</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/WNG-8MBJBNF6-P</json:string></ark><categories><wos><json:string>1 - science</json:string><json:string>2 - medicine, general & internal</json:string><json:string>2 - medical informatics</json:string><json:string>2 - health care sciences & services</json:string></wos><scienceMetrix><json:string>1 - health sciences</json:string><json:string>2 - public health & health services</json:string><json:string>3 - health policy & services</json:string></scienceMetrix><scopus><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Public Health, Environmental and Occupational Health</json:string><json:string>1 - Health Sciences</json:string><json:string>2 - 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of activation criteria to alert outpatient clinic doctors</title><title level="a" type="short">Early warning infectiosity score</title><author xml:id="author-0000"><persName><forename type="first">Hongli</forename><surname>Xiao</surname><roleName type="degree">MM</roleName></persName><affiliation><address><addrLine>Resident Doctor</addrLine></address></affiliation></author><author xml:id="author-0001"><persName><forename type="first">Haiyu</forename><surname>Qi</surname><roleName type="degree">MM</roleName></persName><affiliation><address><addrLine>Resident Doctor</addrLine></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">Xingwang</forename><surname>Li</surname><roleName type="degree">MD</roleName></persName><affiliation><address><addrLine>Professor</addrLine><addrLine>Infectious Department, Beijing Ditan Hospital, Capital Medical University, Beijing, China</addrLine><country key="CN" xml:lang="en">CHINA</country></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">Jing</forename><surname>Wang</surname><roleName type="degree">MM</roleName></persName><affiliation><address><addrLine>Resident Doctor</addrLine></address></affiliation></author><author xml:id="author-0004"><persName><forename type="first">Xiaoli</forename><surname>Li</surname><roleName type="degree">MM</roleName></persName><affiliation><address><addrLine>Resident Doctor</addrLine></address></affiliation></author><author xml:id="author-0005"><persName><forename type="first">Suxia</forename><surname>Ma</surname><roleName type="degree">MM</roleName></persName><affiliation><address><addrLine>Resident Doctor</addrLine></address></affiliation></author><author xml:id="author-0006"><persName><forename type="first">Zongli</forename><surname>Diao</surname><roleName type="degree">MM</roleName></persName><affiliation><address><addrLine>Resident Doctor</addrLine></address></affiliation></author><author xml:id="author-0007"><persName><forename type="first">Yan</forename><surname>Wang</surname><roleName type="degree">MD</roleName></persName><affiliation><address><addrLine>Resident Doctor</addrLine></address></affiliation></author><author xml:id="author-0008"><persName><forename type="first">Fangfang</forename><surname>Sun</surname><roleName type="degree">MM</roleName></persName><affiliation><address><addrLine>Resident Doctor</addrLine></address></affiliation></author><author xml:id="author-0009" role="corresp"><persName><forename type="first">Chenghong</forename><surname>Yin</surname><roleName type="degree">MD PhD</roleName></persName><affiliation><address><addrLine>Professor</addrLine><addrLine>Department of Infectious Disease and Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China</addrLine><country key="CN" xml:lang="en">CHINA</country></address></affiliation></author><idno type="istex">C063972CB5A1B4B5B08BF082C80D581F8E9E6E51</idno><idno type="ark">ark:/67375/WNG-8MBJBNF6-P</idno><idno type="DOI">10.1111/j.1365-2753.2009.01306.x</idno><idno type="unit">JEP1306</idno><idno type="toTypesetVersion">file:JEP.JEP1306.pdf</idno></analytic><monogr><title level="j" type="main">Journal of Evaluation in Clinical Practice</title><title level="j" type="alt">JOURNAL OF EVALUATION IN CLINICAL PRACTICE</title><idno type="pISSN">1356-1294</idno><idno type="eISSN">1365-2753</idno><idno type="book-DOI">10.1111/(ISSN)1365-2753</idno><idno type="book-part-DOI">10.1111/jep.2010.16.issue-6</idno><idno type="product">JEP</idno><idno type="publisherDivision">ST</idno><imprint><biblScope unit="vol">16</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="1248">1248</biblScope><biblScope unit="page" to="1253">1253</biblScope><biblScope unit="page-count">6</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2010-12"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><encodingDesc><schemaRef type="ODD" url="https://xml-schema.delivery.istex.fr/tei-istex.odd"></schemaRef><appInfo><application ident="pub2tei" version="1.0.10" when="2019-12-20"><label>pub2TEI-ISTEX</label><desc>A set of style sheets for converting XML documents encoded in various scientific publisher formats into a common TEI format.
<ref target="http://www.tei-c.org/">We use TEI</ref></desc></application></appInfo></encodingDesc><profileDesc><abstract xml:lang="en" style="main"><head>Abstract</head><p><hi rend="bold">Rationale, aims and objectives </hi> Acute fever is the most common clinical symptom for infectious diseases. It is necessary to identify risk factors for infectious patients with acute fever and formulate activation criteria of early warning infectiosity score system (EWIS) to alert outpatient clinic doctors.</p><p><hi rend="bold">Methods </hi> Logistic regression analysis was used to determine risk factors for infectious diseases from the clinical data of 758 patients with acute fever. Risk factors were weighted and an EWIS was formulated. A receiver operator characteristic (ROC) analysis of weighted cumulative scores was performed to evaluate the diagnostic accuracy of EWIS, and the Kappa test used to confirm diagnostic reliability. A χ<hi rend="superscript">2</hi>‐test for trend was applied to determine the relevance between EWIS and incidence of infectious diseases.</p><p><hi rend="bold">Results </hi> Risk factors for infections included conjunctival hyperaemia, rash, diarrhoea, increased alanine aminotransferase, splenomegaly and abnormal percentage of peripheral neutrophils (NE%). Risk factors were weighted and tabulated. The areas under the ROC curves of the EWIS was 0.929 and ≥4 points predicted infectious diseases, and the Kappa values were 0.750. As the score increased, the incidence of infectious diseases increased. The areas under the ROC curves of the EWIS predicting on single viral and bacterial infectious diseases were 0.961 and 0.896, and the Kappa values were 0.807 and 0.701, respectively.</p><p><hi rend="bold">Conclusions </hi> Risk factors for infections have been identified, quantified and formulated into a table of EWIS that have high diagnostic accuracy and reliability for the early identification of contagious diseases.</p></abstract><textClass><keywords xml:lang="en"><term xml:id="k1">activation criteria fever</term><term xml:id="k2">infectious disease</term><term xml:id="k3">risk factors</term></keywords><keywords rend="tocHeading1"><term>ORIGINAL ARTICLES</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc><revisionDesc><change when="2019-12-20" who="#istex" xml:id="pub2tei">formatting</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-8MBJBNF6-P/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1365-2753</doi><issn type="print">1356-1294</issn><issn type="electronic">1365-2753</issn><idGroup><id type="product" value="JEP"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="JOURNAL OF EVALUATION IN CLINICAL PRACTICE">Journal of Evaluation in Clinical Practice</title></titleGroup></publicationMeta><publicationMeta level="part" position="12106"><doi origin="wiley">10.1111/jep.2010.16.issue-6</doi><numberingGroup><numbering type="journalVolume" number="16">16</numbering><numbering type="journalIssue" number="6">6</numbering></numberingGroup><coverDate startDate="2010-12">December 2010</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="36" status="forIssue"><doi origin="wiley">10.1111/j.1365-2753.2009.01306.x</doi><idGroup><id type="unit" value="JEP1306"></id></idGroup><countGroup><count type="pageTotal" number="6"></count></countGroup><titleGroup><title type="tocHeading1">ORIGINAL ARTICLES</title></titleGroup><copyright>© 2010 Blackwell Publishing Ltd</copyright><eventGroup><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.4.2 mode:FullText" date="2010-12-21"></event><event type="publishedOnlineEarlyUnpaginated" date="2010-08-15"></event><event type="firstOnline" date="2010-08-15"></event><event type="publishedOnlineFinalForm" date="2010-12-22"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-30"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-30"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="1248">1248</numbering><numbering type="pageLast" number="1253">1253</numbering></numberingGroup><correspondenceTo>Dr Chenghong Yin
Department of Infectious Disease and Critical Care Medicine
Beijing Friendship Hospital
95 Yong'an Road
Xuanwu District
Beijing 100050
China
E‐mail: <email>modscn@yahoo.com.cn</email></correspondenceTo><objectNameGroup><objectName elementName="appendix">Appendix</objectName></objectNameGroup><linkGroup><link type="toTypesetVersion" href="file:JEP.JEP1306.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Accepted for publication: 17 July 2009</unparsedEditorialHistory><countGroup><count type="figureTotal" number="5"></count><count type="tableTotal" number="2"></count><count type="formulaTotal" number="0"></count><count type="referenceTotal" number="16"></count><count type="wordTotal" number="3809"></count><count type="linksPubMed" number="0"></count><count type="linksCrossRef" number="0"></count></countGroup><titleGroup><title type="main">The identification of risk factors for infectious patients with acute fever and formulation of activation criteria to alert outpatient clinic doctors</title><title type="shortAuthors">H. Xiao <i>et al.</i></title><title type="short">Early warning infectiosity score</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1" noteRef="#fn1"><personName><givenNames>Hongli</givenNames><familyName>Xiao</familyName><degrees>MM</degrees></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1" noteRef="#fn1"><personName><givenNames>Haiyu</givenNames><familyName>Qi</familyName><degrees>MM</degrees></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a2"><personName><givenNames>Xingwang</givenNames><familyName>Li</familyName><degrees>MD</degrees></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a1"><personName><givenNames>Jing</givenNames><familyName>Wang</familyName><degrees>MM</degrees></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a1"><personName><givenNames>Xiaoli</givenNames><familyName>Li</familyName><degrees>MM</degrees></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a1"><personName><givenNames>Suxia</givenNames><familyName>Ma</familyName><degrees>MM</degrees></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a1"><personName><givenNames>Zongli</givenNames><familyName>Diao</familyName><degrees>MM</degrees></personName></creator><creator creatorRole="author" xml:id="cr8" affiliationRef="#a1"><personName><givenNames>Yan</givenNames><familyName>Wang</familyName><degrees>MD</degrees></personName></creator><creator creatorRole="author" xml:id="cr9" affiliationRef="#a1"><personName><givenNames>Fangfang</givenNames><familyName>Sun</familyName><degrees>MM</degrees></personName></creator><creator creatorRole="author" xml:id="cr10" affiliationRef="#a3" corresponding="yes"><personName><givenNames>Chenghong</givenNames><familyName>Yin</familyName><degrees>MD PhD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="a1"><unparsedAffiliation>Resident Doctor,</unparsedAffiliation></affiliation><affiliation xml:id="a3" countryCode="CN"><unparsedAffiliation>Professor, Department of Infectious Disease and Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="CN"><unparsedAffiliation>Professor, Infectious Department, Beijing Ditan Hospital, Capital Medical University, Beijing, China</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">activation criteria fever</keyword><keyword xml:id="k2">infectious disease</keyword><keyword xml:id="k3">risk factors</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p><b>Rationale, aims and objectives </b> Acute fever is the most common clinical symptom for infectious diseases. It is necessary to identify risk factors for infectious patients with acute fever and formulate activation criteria of early warning infectiosity score system (EWIS) to alert outpatient clinic doctors.</p><p><b>Methods </b> Logistic regression analysis was used to determine risk factors for infectious diseases from the clinical data of 758 patients with acute fever. Risk factors were weighted and an EWIS was formulated. A receiver operator characteristic (ROC) analysis of weighted cumulative scores was performed to evaluate the diagnostic accuracy of EWIS, and the Kappa test used to confirm diagnostic reliability. A χ<sup>2</sup>‐test for trend was applied to determine the relevance between EWIS and incidence of infectious diseases.</p><p><b>Results </b> Risk factors for infections included conjunctival hyperaemia, rash, diarrhoea, increased alanine aminotransferase, splenomegaly and abnormal percentage of peripheral neutrophils (NE%). Risk factors were weighted and tabulated. The areas under the ROC curves of the EWIS was 0.929 and ≥4 points predicted infectious diseases, and the Kappa values were 0.750. As the score increased, the incidence of infectious diseases increased. The areas under the ROC curves of the EWIS predicting on single viral and bacterial infectious diseases were 0.961 and 0.896, and the Kappa values were 0.807 and 0.701, respectively.</p><p><b>Conclusions </b> Risk factors for infections have been identified, quantified and formulated into a table of EWIS that have high diagnostic accuracy and reliability for the early identification of contagious diseases.</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p>
Joint first author</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>The identification of risk factors for infectious patients with acute fever and formulation of activation criteria to alert outpatient clinic doctors</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Early warning infectiosity score</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>The identification of risk factors for infectious patients with acute fever and formulation of activation criteria to alert outpatient clinic doctors</title></titleInfo><name type="personal"><namePart type="given">Hongli</namePart><namePart type="family">Xiao</namePart><namePart type="termsOfAddress">MM</namePart><affiliation>Resident Doctor,</affiliation><description>Joint first author</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Haiyu</namePart><namePart type="family">Qi</namePart><namePart type="termsOfAddress">MM</namePart><affiliation>Resident Doctor,</affiliation><description>Joint first author</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Xingwang</namePart><namePart type="family">Li</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Professor, Infectious Department, Beijing Ditan Hospital, Capital Medical University, Beijing, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jing</namePart><namePart type="family">Wang</namePart><namePart type="termsOfAddress">MM</namePart><affiliation>Resident Doctor,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Xiaoli</namePart><namePart type="family">Li</namePart><namePart type="termsOfAddress">MM</namePart><affiliation>Resident Doctor,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Suxia</namePart><namePart type="family">Ma</namePart><namePart type="termsOfAddress">MM</namePart><affiliation>Resident Doctor,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Zongli</namePart><namePart type="family">Diao</namePart><namePart type="termsOfAddress">MM</namePart><affiliation>Resident Doctor,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Yan</namePart><namePart type="family">Wang</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Resident Doctor,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Fangfang</namePart><namePart type="family">Sun</namePart><namePart type="termsOfAddress">MM</namePart><affiliation>Resident Doctor,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Chenghong</namePart><namePart type="family">Yin</namePart><namePart type="termsOfAddress">MD PhD</namePart><affiliation>Professor, Department of Infectious Disease and Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China</affiliation><affiliation>E-mail: modscn@yahoo.com.cn</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2010-12</dateIssued><edition>Accepted for publication: 17 July 2009</edition><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><extent unit="figures">5</extent><extent unit="tables">2</extent><extent unit="formulas">0</extent><extent unit="references">16</extent><extent unit="linksCrossRef">0</extent><extent unit="words">3809</extent></physicalDescription><abstract lang="en">Rationale, aims and objectives Acute fever is the most common clinical symptom for infectious diseases. It is necessary to identify risk factors for infectious patients with acute fever and formulate activation criteria of early warning infectiosity score system (EWIS) to alert outpatient clinic doctors. Methods Logistic regression analysis was used to determine risk factors for infectious diseases from the clinical data of 758 patients with acute fever. Risk factors were weighted and an EWIS was formulated. A receiver operator characteristic (ROC) analysis of weighted cumulative scores was performed to evaluate the diagnostic accuracy of EWIS, and the Kappa test used to confirm diagnostic reliability. A χ2‐test for trend was applied to determine the relevance between EWIS and incidence of infectious diseases. Results Risk factors for infections included conjunctival hyperaemia, rash, diarrhoea, increased alanine aminotransferase, splenomegaly and abnormal percentage of peripheral neutrophils (NE%). Risk factors were weighted and tabulated. The areas under the ROC curves of the EWIS was 0.929 and ≥4 points predicted infectious diseases, and the Kappa values were 0.750. As the score increased, the incidence of infectious diseases increased. The areas under the ROC curves of the EWIS predicting on single viral and bacterial infectious diseases were 0.961 and 0.896, and the Kappa values were 0.807 and 0.701, respectively. Conclusions Risk factors for infections have been identified, quantified and formulated into a table of EWIS that have high diagnostic accuracy and reliability for the early identification of contagious diseases.</abstract><subject lang="en"><genre>keywords</genre><topic>activation criteria fever</topic><topic>infectious disease</topic><topic>risk factors</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Evaluation in Clinical Practice</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><identifier type="ISSN">1356-1294</identifier><identifier type="eISSN">1365-2753</identifier><identifier type="DOI">10.1111/(ISSN)1365-2753</identifier><identifier type="PublisherID">JEP</identifier><part><date>2010</date><detail type="volume"><caption>vol.</caption><number>16</number></detail><detail type="issue"><caption>no.</caption><number>6</number></detail><extent unit="pages"><start>1248</start><end>1253</end><total>6</total></extent></part></relatedItem><relatedItem type="references" displayLabel="cit1"><titleInfo><title>Investigation of a nosocomial outbreak of severe acute respiratory syndrome (SARS) in Toronto, Canada</title></titleInfo><name type="personal"><namePart type="given">M.</namePart><namePart type="family">Varia</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S.</namePart><namePart type="family">Wilson</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S.</namePart><namePart type="family">Sarwal</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A.</namePart><namePart type="family">McGeer</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">E.</namePart><namePart type="family">Gournis</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">E.</namePart><namePart type="family">Galanis</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">B.</namePart><namePart type="family">Henry</namePart><role><roleTerm type="text">author</roleTerm></role></name><genre>journal-article</genre><note type="citation/reference">Varia, M., Wilson, S., Sarwal, S., McGeer, A., Gournis, E., Galanis, E. & Henry, B. 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