| Title | Development and Evaluation of Diagnostic Criteria for Vogt-Koyanagi-Harada Disease |
| Authors | Yang, Peizeng Zhong, Yuanyuan Du, Liping Chi, Wei Chen, Ling Zhang, Rui Zhang, Meifen Wang, Hong Lu, Hong Yang, Liu Zhuang, Wenjuan Yang, Yan Xing, Lin Feng, Lei Jiang, Zhengxuan Zhang, Xiaomin Wang, Yuqin Zhong, Hui Jiang, Liqiong Zhao, Changlin Li, Fuzhen Cao, Shuang Liu, Xiaoli Chen, Xuan Shi, Yanyun Zhao, Weizhong Kijlstra, Aize |
| Affiliation | Chongqing Med Univ, Affiliated Hosp 1, Chongqing Key Lab Ophthalmol, Youyi Rd 1, Chongqing 400016, Peoples R China. Chongqing Eye Inst, Youyi Rd 1, Chongqing 400016, Peoples R China. Sun Yat Sen Univ, Zhongshan Ophthalm Ctr, State Key Lab Ophthalmol, Guangzhou, Guangdong, Peoples R China. Fudan Univ, Eye & ENT Hosp, Shanghai, Peoples R China. Chinese Acad Med Sci, Peking Union Med Coll Hosp, Dept Ophthalmol, Beijing, Peoples R China. Peking Union Med Coll, Beijing, Peoples R China. Capital Med Univ, Beijing Tongren Hosp, Beijing Key Lab Ophthalmol & Visual Sci, Beijing Tongren Eye Ctr, Beijing, Peoples R China. Capital Med Univ, Beijing Chao Yang Hosp, Dept Ophthalmol, Beijing, Peoples R China. Peking Univ, Hosp 1, Dept Ophthalmol, Beijing, Peoples R China. Ningxia Peoples Hosp, Dept Ophthalmol, Yinchuan, Peoples R China. Cent S Univ, Xiangya Hosp 2, Dept Ophthalmol, Changsha, Hunan, Peoples R China. Harbin Med Univ, Affiliated Hosp 1, Dept Ophthalmol, Harbin, Heilongjiang, Peoples R China. Zhejiang Univ, Affiliated Hosp 2, Sch Med, Dept Ophthalmol, Hangzhou, Zhejiang, Peoples R China. Anhui Med Univ, Hosp 2, Dept Ophthalmol, Hefei, Anhui, Peoples R China. Tianjin Med Univ, Eye Hosp, Tianjin, Peoples R China. Wenzhou Med Univ, Eye Hosp, Wenzhou, Peoples R China. Shenzhen Childrens Hosp, Dept Ophthalmol, Shenzhen, Peoples R China. Jinan Univ, Affiliated Hosp 2, Shenzhen Eye Hosp, Shenzhen Key Ophthalm Lab, Shenzhen, Peoples R China. Nanjing Univ, Jinling Hosp, Med Sch, Dept Ophthalmol, Nanjing, Jiangsu, Peoples R China. Zhengzhou Univ, Henan Prov Eye Hosp, Affiliated Hosp 1, Dept Ophthalmol, Zhengzhou, Henan, Peoples R China. Xian 4 Hosp, Dept Ophthalmol, Xian, Shaanxi, Peoples R China. Jilin Univ, Hosp 2, Ophthalm Ctr, Changchun, Jilin, Peoples R China. Second Peoples Hosp Jinan City, Dept Ophthalmol, Jinan, Shandong, Peoples R China. Shanxi Eye Hosp, Taiyuan, Shanxi, Peoples R China. Xiangtan Univ, Coll Informat Engn, Xiangtan, Peoples R China. Univ Eye Clin Maastricht, Maastricht, Netherlands. Chongqing Med Univ, Affiliated Hosp 1, Chongqing Key Lab Ophthalmol, Youyi Rd 1, Chongqing 400016, Peoples R China. Yang, PZ (reprint author), Chongqing Eye Inst, Youyi Rd 1, Chongqing 400016, Peoples R China. |
| Keywords | INDOCYANINE GREEN ANGIOGRAPHY CLASSIFICATION CRITERIA CHOROIDAL THICKNESS MANAGEMENT UVEITIS PATIENT UTILITY |
| Issue Date | 2018 |
| Publisher | JAMA OPHTHALMOLOGY |
| Citation | JAMA OPHTHALMOLOGY. 2018, 136(9), 1025-1031. |
| Abstract | IMPORTANCE To our knowledge, a set of well-defined diagnostic criteria is not yet developed for the diagnosis of Vogt-Koyanagi-Harada (VKH) disease. OBJECTIVE To develop and evaluate a set of diagnostic criteria for VKH disease using data from Chinese patients. DESIGN, SETTING, AND PARTICIPANTS This case-control study reviewed medical records of patients from a tertiary referral center between October 2011 and October 2016. Data from 634 patients with VKH disease and 623 patients with non-VKH uveitis from southern China were used to develop the Diagnostic Criteria for VKH Disease (DCV). Data from an additional group of 537 patients with a definite VKH disease diagnosis and 525 patients with non-VKH uveitis from northern China were used to evaluate the diagnostic criteria. MAIN OUTCOMES AND MEASURES Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristic. RESULTS Of the 1257 patients used to construct the DCV, 665 (52.9%) were male, and the mean (SD) age at disease onset was 38.6 (13.6) years. The 3-class model and 21 clinical findings were selected by latent class analysis. Variables with a high positive rate in the early-phase or late-phase VKH group or high specificity constituted essential parameters. Constellations of these essential parameters constructed the DCV. The sensitivity and NPV of the DCV were higher than those of the Revised Diagnostic Criteria for VKH Disease (RDC) (sensitivity: 94.6% vs 71.9%; difference, 22.7%; 95% CI, 18.5-27.0; NPV: 94.3% vs 76.6%; difference, 17.7%; 95% CI, 13.9-21.5). The specificity and PPV of the DCV were not different from that of the RDC (specificity: 92.2% vs 93.9%; difference, 1.7%; 95% CI, -1.4 to 4.8; PPV: 89.3% vs 92.3%; difference, 3.0%; 95% CI, -1.4 to 4.8). The area under the receiver operating characteristic curve of the DCV and the RDC were 0.934 (95% CI, 0.917-0.951) and 0.829 (95% CI, 0.803-0.855), respectively. CONCLUSIONS AND RELEVANCE The DCV were developed and evaluated using data from Chinese patients with VKH disease and showed a high sensitivity, NPV, and area under the receiver operating characteristic curve in comparison with the RDC. However, they were developed using a retrospective analysis and should be evaluated in prospective studies in other racial/ethnic populations. |
| URI | http://hdl.handle.net/20.500.11897/517667 |
| ISSN | 2168-6165 |
| DOI | 10.1001/jamaophthalmol.2018.2664 |
| Indexed | SCI(E) PubMed |
| Appears in Collections: | 第一医院 |
