Development and Validation of HSCAPS-1: A Clinical Decision Support Tool for Diagnosis of Hidradenitis Suppurativa over Cutaneous Abscess.

IF 3 3区 医学 Q2 DERMATOLOGY Dermatology Pub Date : 2021-01-01 Epub Date: 2020-10-23 DOI:10.1159/000511077
Amit Garg, Sarah Reddy, Joslyn Kirby, Andrew Strunk
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引用次数: 2

Abstract

Background: A clinical decision support tool may improve recognition of hidradenitis suppurativa (HS) and reduce diagnosis delay.

Objective: To develop and initially validate a clinical decision support to predict diagnosis of HS and distinguish it from cutaneous abscess of the axilla, groin, perineum, and buttock.

Methods: This was a retrospective, cross-sectional analysis between January 2012 and June 2017 (development set) and July 2017 and March 2019 (validation set). We used an electronic records sample of 56 million patients from the Explorys database to identify patients with an ambulatory visit associated with either HS or cutaneous of the axilla, groin, perineum, and buttock. The outcome was predicted probability of HS diagnosis.

Results: Development set included 7,974 patients with mean age of 41.4 years, who were predominantly female (66%) and white (62%). Validation set included 1,560 patients with similar demographic composition. Factors which were stronger independent predictors of HS included female sex (OR 2.17 [95% CI 1.96-2.40]); African American race (1.28 [95% CI 1.15-1.44]); increasing BMI (OR 1.05 [95% CI 1.05-1.06)]; history of acne (OR 3.46 [95% CI 2.83-4.23]); Down syndrome (OR 5.35 [95% CI 2.03-14.12]); and prescription for at least 7 opioid medications in the past year (OR 1.05 [95% CI 0.83-1.33]). Up to age 45 years, increasing age was a stronger predictor of HS diagnosis. The simplified model showed good discrimination (c-statistic 0.746 [SE 0.013]) and moderate calibration (calibration intercept -0.260 [SE 0.055]; calibration slope 1.142 [SE 0.076]).

Conclusion: This clinical decision support tool shows good performance in predicting diagnosis of HS and distinguishing it from cutaneous abscess that involves the axilla, groin, perineum, and buttock.

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HSCAPS-1的开发和验证:一种诊断皮肤脓肿化脓性汗腺炎的临床决策支持工具。
背景:临床决策支持工具可以提高对化脓性汗腺炎(HS)的认识,减少诊断延误。目的:建立并初步验证一种临床决策支持,以预测HS的诊断,并将其与腋窝、腹股沟、会阴和臀部的皮肤脓肿区分开来。方法:对2012年1月至2017年6月(开发组)和2017年7月至2019年3月(验证组)进行回顾性横断面分析。我们使用Explorys数据库中5600万患者的电子记录样本来识别与HS或腋窝、腹股沟、会阴和臀部皮肤相关的门诊患者。结果预测HS诊断的概率。结果:发展组包括7,974例患者,平均年龄41.4岁,主要是女性(66%)和白人(62%)。验证集包括1560例具有相似人口统计学组成的患者。女性是HS较强的独立预测因子(OR 2.17 [95% CI 1.96-2.40]);非裔美国人(1.28 [95% CI 1.15-1.44]);增加BMI (OR 1.05 [95% CI 1.05-1.06)];痤疮病史(OR 3.46 [95% CI 2.83-4.23]);唐氏综合症(OR 5.35 [95% CI 2.03-14.12]);过去一年中至少服用过7种阿片类药物(OR 1.05 [95% CI 0.83-1.33])。直到45岁,年龄增长是HS诊断的更强预测因子。简化模型具有良好的判别性(c-统计量0.746 [SE 0.013])和中等的校正性(校正截距-0.260 [SE 0.055]);校准斜率1.142 [SE 0.076])。结论:该临床决策支持工具在预测HS的诊断和与累及腋窝、腹股沟、会阴和臀部的皮肤脓肿区分方面表现良好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Dermatology
Dermatology 医学-皮肤病学
CiteScore
6.40
自引率
2.90%
发文量
71
审稿时长
1 months
期刊介绍: Published since 1893, ''Dermatology'' provides a worldwide survey of clinical and investigative dermatology. Original papers report clinical and laboratory findings. In order to inform readers of the implications of recent research, editorials and reviews prepared by invited, internationally recognized scientists are regularly featured. In addition to original papers, the journal publishes rapid communications, short communications, and letters to ''Dermatology''. ''Dermatology'' answers the complete information needs of practitioners concerned with progress in research related to skin, clinical dermatology and therapy. The journal enjoys a high scientific reputation with a continually increasing impact factor and an equally high circulation.
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