Development of Ebola virus disease prediction scores: Screening tools for Ebola suspects at the triage-point during an outbreak

Antoine Oloma Tshomba, Daniel-Ricky Mukadi-Bamuleka, Anja De Weggheleire, Olivier M Tshiani, Richard O Kitenge, Charles T Kayembe, Bart K M Jacobs, Lutgarde Lynen, Placide Mbala-Kingebeni, Jean-Jacques Muyembe-Tamfum, Steve Ahuka-Mundeke, Dieudonné N Mumba, Désiré D Tshala-Katumbay and Sabue Mulangu

PLOS ONE, 2022, vol. 17, issue 12, 1-25

Abstract: Background: The control of Ebola virus disease (EVD) outbreaks relies on rapid diagnosis and prompt action, a daunting task in limited-resource contexts. Methods: We computed accuracy measurements of EVD predictors to assess their diagnosing ability compared with the reference standard GeneXpert® results, during the eastern DRC EVD outbreak. We developed predictive scores using the Spiegelhalter-Knill-Jones approach and constructed a clinical prediction score (CPS) and an extended clinical prediction score (ECPS). We plotted the receiver operating characteristic curves (ROCs), estimated the area under the ROC (AUROC) to assess the performance of scores, and computed net benefits (NB) to assess the clinical utility (decision-making ability) of the scores at a given cut-off. We performed decision curve analysis (DCA) to compare, at a range of threshold probabilities, prediction scores’ decision-making ability and to quantify the number of unnecessary isolation. Results: The analysis was done on data from 10432 subjects, including 651 EVD cases. The EVD prevalence was 6.2% in the whole dataset, 14.8% in the subgroup of suspects who fitted the WHO Ebola case definition, and 3.2% for the set of suspects who did not fit this case definition. The WHO clinical definition yielded 61.6% sensitivity and 76.4% specificity. Fatigue, difficulty in swallowing, red eyes, gingival bleeding, hematemesis, confusion, hemoptysis, and a history of contact with an EVD case were predictors of EVD. The AUROC for ECPS was 0.88 (95%CI: 0.86–0.89), significantly greater than this for CPS, 0.71 (95%CI: 0.69–0.73) (p

Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0278678 (text/html)
https://journals.plos.org/plosone/article/file?id= ... 78678&type=printable (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0278678

DOI: 10.1371/journal.pone.0278678

Access Statistics for this article

More articles in PLOS ONE from Public Library of Science
Bibliographic data for series maintained by plosone ().