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首页> 外文期刊>BMC Pediatrics >The NeBoP score?- a clinical prediction test for evaluation of children with Lyme Neuroborreliosis in Europe
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The NeBoP score?- a clinical prediction test for evaluation of children with Lyme Neuroborreliosis in Europe

机译：NeBoP分数？-用于评估欧洲莱姆病儿童的临床预测测试

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The diagnosis of Lyme neuroborreliosis (LNB) in Europe is based on clinical symptoms and laboratory data, such as pleocytosis and anti-Borrelia antibodies in serum and CSF according to guidelines. However, the decision to start antibiotic treatment on admission cannot be based on Borrelia serology since results are not available at the time of lumbar puncture. Therefore, an early prediction test would be useful in clinical practice. The aim of the study was to develop and evaluate a clinical prediction test for children with LNB in a relevant European setting. Clinical and laboratory data were collected retrospectively from a cohort of children being evaluated for LNB in Southeast Sweden. A clinical neuroborreliosis prediction test, the NeBoP score, was designed to differentiate between a high and a low risk of having LNB. The NeBoP score was then prospectively validated in a cohort of children being evaluated for LNB in Central and Southeast Sweden (n?=?190) and controls with other specific diagnoses (n?=?49). The sensitivity of the NeBoP score was 90?% (CI 95?%; 82–99?%) and the specificity was 90?% (CI 95?%; 85–96?%). Thus, the diagnostic accuracy (i.e. how the test correctly discriminates patients from controls) was 90?% and the area under the curve in a ROC analysis was 0.95. The positive predictive value (PPV) was 0.83 (CI 95?%; 0.75–0.93) and the negative predictive value (NPV) was 0.95 (CI 95?%; 0.90–0.99). The overall diagnostic performance of the NeBoP score is high (90?%) and the test is suggested to be useful for decision-making about early antibiotic treatment in children being evaluated for LNB in European Lyme endemic areas.
机译：在欧洲，根据临床症状和临床数据，如血清和脑脊液中的卵黄细胞增多症和抗Borrelia抗体，对莱姆神经疏螺旋体病（LNB）进行诊断。但是，入院时开始抗生素治疗的决定不能基于Borrelia血清学，因为在腰穿时尚无结果。因此，早期预测测试将在临床实践中有用。该研究的目的是在相关的欧洲环境中开发和评估针对LNB儿童的临床预测测试。回顾性地从瑞典东南部正在评估LNB的一组儿童中收集临床和实验室数据。 NeBoP评分是一项临床神经衰弱预测测试，旨在区分患有LNB的高风险和低风险。然后在瑞典中部和东南部（n≥190）和其他有特定诊断的对照（n≥49）中对一组儿童进行LNB评估，对NeBoP评分进行前瞻性验证。 NeBoP分数的敏感性为90％（CI 95％; 82-99％），特异性为90％（CI 95％; 85-96％）。因此，诊断准确性（即测试如何正确区分患者与对照）为90％，ROC分析中曲线下的面积为0.95。阳性预测值（PPV）为0.83（CI 95％; 0.75–0.93），阴性预测值（NPV）为0.95（CI 95％; 0.90–0.99）。 NeBoP评分的总体诊断性能很高（90％），并且该测试建议对于欧洲莱姆病流行地区评估LNB的儿童早期抗生素治疗的决策很有用。

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