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Diagnostic tool may help risk-stratify suspected Ebola cases
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A newly developed clinical prediction model allowed clinicians to confirm or eliminate patients suspected of having Ebola disease, according to results of a retrospective cohort study.
“The Ebola Prediction Score can be used by clinicians in the context of an active Ebola virus epidemic for the purpose of cohorting, or separating, patients within an Ebola treatment unit or community-based isolation center or as an additional triage aid when available resources are overwhelmed,” Adam C. Levine, MD, MPH, an emergency medicine physician at Rhode Island Hospital and The Miriam Hospital, and colleagues wrote in the Annals of Emergency Medicine.
Levine and colleagues retrospectively examined patient data collected at the 52-bed Bong County Ebola Treatment Unit in Suakoko, Liberia, from September 2014 to January. They compared the predictive power of 14 clinical and epidemiologic variables with the primary outcome of laboratory-confirmed Ebola virus disease.
Adam C. Levine
During the study, 395 patients were admitted to the Ebola treatment unit, and definitive testing results were available for 382 of these patients. In all, 160 patients tested positive for Ebola.
Six variables were independent predictors of laboratory-confirmed Ebola (AUC = 0.75; 95% CI, 0.7-0.8): sick contact, diarrhea, loss of appetite, muscle pains, difficulty swallowing and lack of abdominal pain, according to the researchers. Higher prediction scores were associated with a greater likelihood of laboratory-confirmed Ebola virus.
“Determining which patients to admit to an Ebola treatment unit for definitive testing and treatment requires balancing the epidemiologic imperative to break the train of transmission in the community against the ethical imperative to do no harm to each patient, all within the context of severe resource constraints,” Levine and colleagues wrote.
Even the best clinical prediction scores had their limitations, however, so developing low-cost, point-of-care testing that quickly confirms or eliminates Ebola in patients must be a research priority, they wrote.
“The Ebola Prediction Score will help clinicians risk-stratify patients already meeting one or more suspect definitions of Ebola virus,” Levine said in a press release. – by Colleen Owens
Disclosure: The researchers report no relevant financial disclosures.
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