Validation of a risk score to differentiate autoimmune and viral encephalitis: a Nationwide Cohort Study in Denmark
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| Název: | Validation of a risk score to differentiate autoimmune and viral encephalitis: a Nationwide Cohort Study in Denmark |
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| Autoři: | Lasse Fjordside, Mette Scheller Nissen, Anna Maria Florescu, Merete Storgaard, Lykke Larsen, Lothar Wiese, Hans Rudolf von Lüttichau, Micha Phill Grønholm Jepsen, Birgitte Rønde Hansen, Christian Østergaard Andersen, Jacob Bodilsen, Henrik Nielsen, Morten Blaabjerg, Anne-Mette Lebech, Helene Mens |
| Zdroj: | J Neurol Fjordside, L, Nissen, M S, Florescu, A M, Storgaard, M, Larsen, L, Wiese, L, von Lüttichau, H R, Jepsen, M P G, Hansen, B R, Andersen, C Ø, Bodilsen, J, Nielsen, H, Blaabjerg, M, Lebech, A-M & Mens, H 2024, 'Validation of a risk score to differentiate autoimmune and viral encephalitis: a Nationwide Cohort Study in Denmark', Journal of Neurology, vol. 271, no. 8, pp. 4972-4981. https://doi.org/10.1007/s00415-024-12392-3 Fjordside, L, Nissen, M S, Florescu, A M, Storgaard, M, Larsen, L, Wiese, L, von Lüttichau, H R, Jepsen, M P G, Hansen, B R, Andersen, C Ø, Bodilsen, J, Nielsen, H, Blaabjerg, M, Lebech, A-M & Mens, H 2024, ' Validation of a risk score to differentiate autoimmune and viral encephalitis : a Nationwide Cohort Study in Denmark ', Journal of Neurology, vol. 271, no. 8, pp. 4972-4981 . https://doi.org/10.1007/s00415-024-12392-3 Fjordside, L, Nissen, M S, Florescu, A M, Storgaard, M, Larsen, L, Wiese, L, von Lüttichau, H R, Jepsen, M P G, Hansen, B R, Andersen, C Ø, Bodilsen, J, Nielsen, H, Blaabjerg, M, Lebech, A M & Mens, H 2024, 'Validation of a risk score to differentiate autoimmune and viral encephalitis : a Nationwide Cohort Study in Denmark', Journal of Neurology, vol. 271, no. 8, pp. 4972-4981. https://doi.org/10.1007/s00415-024-12392-3 |
| Informace o vydavateli: | Springer Science and Business Media LLC, 2024. |
| Rok vydání: | 2024 |
| Témata: | Male, Adult, Denmark, Risk Assessment, Autoimmune Diseases, Cohort Studies, Diagnosis, Differential, Young Adult, Autoimmune Diseases/epidemiology, Diagnosis, Encephalitis/diagnosis, Validation, 80 and over, Humans, Encephalitis, Viral, Autoimmune encephalitis, Risk Assessment/methods, Aged, Retrospective Studies, Aged, 80 and over, Original Communication, Viral encephalitis, Middle Aged, Denmark/epidemiology, 3. Good health, Differential, Viral/diagnosis, Encephalitis, Risk score, Female |
| Popis: | Background A score to differentiate autoimmune (AE) and viral encephalitis (VE) early upon admission has recently been developed but needed external validation. The objective of this study was to evaluate the performance of the score in a larger and more diagnostically diverse patient cohort. Methods We conducted a retrospective nationwide and population-based cohort study including all adults with encephalitis of definite viral (2015–2022) or autoimmune aetiology (2009–2022) in Denmark. Variables included in the score-model were extracted from patient records and individual risk scores were assessed. The performance of the score was assessed by receiver-operating characteristics (ROC) curve analyses and calculation of the area under the curve (AUC). Results A total of 496 patients with encephalitis [AE n = 90, VE n = 287 and presumed infectious encephalitis (PIE) n = 119] were included in the study. The score was highly accurate in predicting cases of AE reaching an AUC of 0.94 (95% CI 0.92–0.97). Having a score ≥ 3 predicted AE with a PPV of 87% and an NPV of 91%. The risk score was found to perform well across aetiological subgroups and applied to the PIE cohort resulted in an AUC of 0.88 (95% CI 0.84–0.93). Conclusion The excellent performance of the score as reported in the development study was confirmed in this significantly larger and more diverse cohort of patients with encephalitis in Denmark. These results should prompt further prospective testing with wider inclusion criteria. |
| Druh dokumentu: | Article Other literature type |
| Popis souboru: | application/pdf |
| Jazyk: | English |
| ISSN: | 1432-1459 0340-5354 |
| DOI: | 10.1007/s00415-024-12392-3 |
| Přístupová URL adresa: | https://pubmed.ncbi.nlm.nih.gov/38761191 https://vbn.aau.dk/ws/files/741348462/Fjordside_et_al._2024_._Validation_of_a_risk_score_to_differentiate_autoimmune_and_viral_encephalitis_-_a_Nationwide_Cohort_Study_in_Denmark.pdf https://vbn.aau.dk/da/publications/abe48e15-05cf-4c03-8f91-3678dd63c04c https://doi.org/10.1007/s00415-024-12392-3 http://www.scopus.com/inward/record.url?scp=85193820634&partnerID=8YFLogxK https://curis.ku.dk/ws/files/402484994/s00415_024_12392_3.pdf https://portal.findresearcher.sdu.dk/da/publications/9824aaaa-71ef-4ef0-82a9-654fdc8961ad https://doi.org/10.1007/s00415-024-12392-3 https://pure.au.dk/portal/en/publications/ea59f9d3-64de-40ee-89d3-357f4b4bb261 https://doi.org/10.1007/s00415-024-12392-3 http://www.scopus.com/inward/record.url?scp=85193820634&partnerID=8YFLogxK |
| Rights: | CC BY |
| Přístupové číslo: | edsair.doi.dedup.....8768add084c7564752f6f13ac5daaec7 |
| Databáze: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstrakt: | Background A score to differentiate autoimmune (AE) and viral encephalitis (VE) early upon admission has recently been developed but needed external validation. The objective of this study was to evaluate the performance of the score in a larger and more diagnostically diverse patient cohort. Methods We conducted a retrospective nationwide and population-based cohort study including all adults with encephalitis of definite viral (2015–2022) or autoimmune aetiology (2009–2022) in Denmark. Variables included in the score-model were extracted from patient records and individual risk scores were assessed. The performance of the score was assessed by receiver-operating characteristics (ROC) curve analyses and calculation of the area under the curve (AUC). Results A total of 496 patients with encephalitis [AE n = 90, VE n = 287 and presumed infectious encephalitis (PIE) n = 119] were included in the study. The score was highly accurate in predicting cases of AE reaching an AUC of 0.94 (95% CI 0.92–0.97). Having a score ≥ 3 predicted AE with a PPV of 87% and an NPV of 91%. The risk score was found to perform well across aetiological subgroups and applied to the PIE cohort resulted in an AUC of 0.88 (95% CI 0.84–0.93). Conclusion The excellent performance of the score as reported in the development study was confirmed in this significantly larger and more diverse cohort of patients with encephalitis in Denmark. These results should prompt further prospective testing with wider inclusion criteria. |
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| ISSN: | 14321459 03405354 |
| DOI: | 10.1007/s00415-024-12392-3 |