Abstract O.32: An Improved Point-of-care Differentiation Of Kawasaki Disease From Other Febrile Illnesses

Background: Kawasaki disease (KD) shares many clinical features with other pediatric febrile illnesses (FC). Clinical confusion can lead to a missed or delayed diagnosis that increases the risk of coronary artery damage. In the present study, we improved our previous KD diagnostic algorithm for point-of-care diagnosis. Methods and Results: We reviewed clinical records of 534 acute KD and 318 FC patients (development dataset) and subsequent 268 acute KD and 161 FC patients (validation dataset). KD subjects met the American Heart Association definition. Using clinical data and lab test results, we integrated our previously developed linear discriminant analysis (LDA)-based clinical model with a newly developed decision tree-based algorithm to improve KD diagnosis. To train the decision trees, sub cohorts were constructed based upon the 5 KD classic criteria. Our 1st clinical model (LDA) stratified the subjects into FC (FC diagnosis, negative predictive value NPV >=95%), undecided (88/802 KD, 167/479 FC), an...