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The NeBoP score: a clinical prediction test for evaluation of children with Lyme Neuroborreliosis in Europe
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Center for Clinical Research Dalarna. Falun Gen Hosp, Paediat Clin, S-79182 Falun, Sweden..
Linkoping Univ, Clin Infect Dis, S-58185 Linkoping, Sweden..
Linkoping Univ, Dept Clin & Expt Med, S-58185 Linkoping, Sweden.;Cty Hosp Ryhov, Med Serv, Microbiol Lab, S-55185 Jonkoping, Sweden..
2015 (English)In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 15, 214Article in journal (Refereed) PublishedText
Abstract [en]

Background: 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. Method: 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). Results: 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). Conclusion: 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.

Place, publisher, year, edition, pages
2015. Vol. 15, 214
Keyword [en]
Lyme neuroborreliosis, Lyme borreliosis, Predictive test, Diagnostic accuracy, Children
National Category
Pediatrics Infectious Medicine
URN: urn:nbn:se:uu:diva-274446DOI: 10.1186/s12887-015-0537-yISI: 000366968200001PubMedID: 26678681OAI: oai:DiVA.org:uu-274446DiVA: diva2:896479
Available from: 2016-01-21 Created: 2016-01-21 Last updated: 2016-01-21Bibliographically approved

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