Tuberculostearic acid incorporated predictive model contributes to the clinical diagnosis of tuberculous meningitis
Summary: The conventional confirmation tests of tuberculous meningitis (TBM) are usually low in sensitivity, leading to high TBM mortality. Hence, sensitive methods for indicating the presence of bacilli are required. Tuberculostearic acid (TBSA), a constituent from Mycobacterium tuberculosis had be...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-10-01
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| Series: | iScience |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589004223019351 |
| _version_ | 1797647804461481984 |
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| author | Tsz Hei Fong Wangpan Shi Guohui Ruan Siyi Li Guanghui Liu Leyun Yang Kaibin Wu Jingxian Fan Chung Lam Ng Yafang Hu Haishan Jiang |
| author_facet | Tsz Hei Fong Wangpan Shi Guohui Ruan Siyi Li Guanghui Liu Leyun Yang Kaibin Wu Jingxian Fan Chung Lam Ng Yafang Hu Haishan Jiang |
| author_sort | Tsz Hei Fong |
| collection | DOAJ |
| description | Summary: The conventional confirmation tests of tuberculous meningitis (TBM) are usually low in sensitivity, leading to high TBM mortality. Hence, sensitive methods for indicating the presence of bacilli are required. Tuberculostearic acid (TBSA), a constituent from Mycobacterium tuberculosis had been evaluated as a promising marker, but fails to demonstrate consistent results for definite TBM. This study retrospectively reviewed medical records of 113 TBM suspects, constructing a TBSA-combined scoring system based on multiple factors, which show sensitivity and specificity of 0.8148 and 0.8814, respectively, and the area under the receiver operating characteristic curve of 0.9010. Multivariate analyses revealed four co-predictive factors strongly associated with TBSA: extra-neural tuberculosis, basal meningeal enhancement, CSF glucose/Serum glucose <0.595, and coinfection in CNS (Total). The subsequent machine learning-based validation showed correspondent importance to factors in the TBSA model. This study demonstrates a simple scoring system to facilitate TBM prediction, yield reliable diagnoses and allow timely treatment initiation. |
| first_indexed | 2024-03-11T15:22:54Z |
| format | Article |
| id | doaj.art-2922e96df6d64405ad9b5b2705b954f7 |
| institution | Directory Open Access Journal |
| issn | 2589-0042 |
| language | English |
| last_indexed | 2024-03-11T15:22:54Z |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | iScience |
| spelling | doaj.art-2922e96df6d64405ad9b5b2705b954f72023-10-28T05:08:46ZengElsevieriScience2589-00422023-10-012610107858Tuberculostearic acid incorporated predictive model contributes to the clinical diagnosis of tuberculous meningitisTsz Hei Fong0Wangpan Shi1Guohui Ruan2Siyi Li3Guanghui Liu4Leyun Yang5Kaibin Wu6Jingxian Fan7Chung Lam Ng8Yafang Hu9Haishan Jiang10Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, ChinaThe First Clinical Medical School, Southern Medical University, Guangzhou 510515, ChinaSchool of Biomedical Engineering, Southern Medical University, Guangzhou 510515, ChinaThe First Clinical Medical School, Southern Medical University, Guangzhou 510515, ChinaDepartment of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, ChinaDepartment of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC 20057-1484, USASchool of Biomedical Engineering, Southern Medical University, Guangzhou 510515, ChinaDepartment of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, ChinaThe First Clinical Medical School, Southern Medical University, Guangzhou 510515, ChinaDepartment of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, ChinaDepartment of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; Corresponding authorSummary: The conventional confirmation tests of tuberculous meningitis (TBM) are usually low in sensitivity, leading to high TBM mortality. Hence, sensitive methods for indicating the presence of bacilli are required. Tuberculostearic acid (TBSA), a constituent from Mycobacterium tuberculosis had been evaluated as a promising marker, but fails to demonstrate consistent results for definite TBM. This study retrospectively reviewed medical records of 113 TBM suspects, constructing a TBSA-combined scoring system based on multiple factors, which show sensitivity and specificity of 0.8148 and 0.8814, respectively, and the area under the receiver operating characteristic curve of 0.9010. Multivariate analyses revealed four co-predictive factors strongly associated with TBSA: extra-neural tuberculosis, basal meningeal enhancement, CSF glucose/Serum glucose <0.595, and coinfection in CNS (Total). The subsequent machine learning-based validation showed correspondent importance to factors in the TBSA model. This study demonstrates a simple scoring system to facilitate TBM prediction, yield reliable diagnoses and allow timely treatment initiation.http://www.sciencedirect.com/science/article/pii/S2589004223019351Medical biochemistryClinical neuroscienceMedical informatics |
| spellingShingle | Tsz Hei Fong Wangpan Shi Guohui Ruan Siyi Li Guanghui Liu Leyun Yang Kaibin Wu Jingxian Fan Chung Lam Ng Yafang Hu Haishan Jiang Tuberculostearic acid incorporated predictive model contributes to the clinical diagnosis of tuberculous meningitis iScience Medical biochemistry Clinical neuroscience Medical informatics |
| title | Tuberculostearic acid incorporated predictive model contributes to the clinical diagnosis of tuberculous meningitis |
| title_full | Tuberculostearic acid incorporated predictive model contributes to the clinical diagnosis of tuberculous meningitis |
| title_fullStr | Tuberculostearic acid incorporated predictive model contributes to the clinical diagnosis of tuberculous meningitis |
| title_full_unstemmed | Tuberculostearic acid incorporated predictive model contributes to the clinical diagnosis of tuberculous meningitis |
| title_short | Tuberculostearic acid incorporated predictive model contributes to the clinical diagnosis of tuberculous meningitis |
| title_sort | tuberculostearic acid incorporated predictive model contributes to the clinical diagnosis of tuberculous meningitis |
| topic | Medical biochemistry Clinical neuroscience Medical informatics |
| url | http://www.sciencedirect.com/science/article/pii/S2589004223019351 |
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