HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (7) Citing Articles via Google Scholar Google Scholar Articles by Ho, P. L. Articles by Tsang, K. W. Search for Related Content PubMed PubMed Citation Articles by Ho, P. L. Articles by Tsang, K. W.

A prediction rule for clinical diagnosis of severe acute respiratory syndrome

¹ University Depts of Microbiology, ² Statistics and Actuarial Science, and ³ Diagnostic Radiology and Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China.

CORRESPONDENCE: K. W. T. Tsang, Division of Respiratory and Critical Care Medicine, University Dept of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China. Fax: 852 29049443. E-mail: kwttsang@hku.hk

Keywords: Coronavirus infection, diagnosis, pneumonia, severe acute respiratory syndrome

Received: June 25, 2004
Accepted June 2, 2005

A prospective study was undertaken to identify clinical, radiographical, haematological and biochemical profiles of severe acute respiratory syndrome (SARS) patients.

A prediction rule, which demarcates low from high risk patients for SARS in an outbreak situation was developed. A total of 295 patients with unexplained respiratory illnesses, admitted to Queen Mary Hospital, Hong Kong SAR, China, in March to July 2003, were evaluated for clinical, radiological, haematological and alanine transaminase (ALT) data daily for 3 days after hospitalisation.

In total, 44 cases were subsequently confirmed to have SARS by RT-PCR (68.2%) and serology (100%). The scoring system of attributing 11, 10, 3, 3 and 3 points to the presence of independent risk factors, namely: epidemiological link, radiographical deterioration, myalgia, lymphopenia and elevated ALT respectively, generated high and low-risk (total score 11–30 and 0–10, respectively) groups for SARS. The sensitivity and specificity of this prediction rule in positively identifying a SARS patient were 97.7 and 81.3%, respectively. The positive and negative predictive values were 47.8 and 99.5%, respectively.

The prediction rule appears to be helpful in assessing suspected patients with severe acute respiratory syndrome at the bedside, and should be further validated in other severe acute respiratory syndrome cohorts.

This article has been cited by other articles:

				J. Dong, J. P. Olano, J. W. McBride, and D. H. Walker Emerging Pathogens: Challenges and Successes of Molecular Diagnostics J. Mol. Diagn., May 1, 2008; 10(3): 185 - 197. [Abstract] [Full Text] [PDF]