Yang P, et al. - Experts developed and assessed a set of diagnostic criteria for Vogt-Koyanagi-Harada (VKH) disease using data from Chinese patients. A high sensitivity, negative predictive value (NPV), and area under the receiver operating characteristic curve were demonstrated in comparison with the Revised Diagnostic Criteria for VKH Disease (RDC).

Methods

• In this case-control study authors reviewed medical records of patients from a tertiary referral center between October 2011 and October 2016.
• They used the data from 634 patients with VKH disease and 623 patients with non-VKH uveitis from southern China to develop the Diagnostic Criteria for VKH Disease (DCV).
• In order to evaluate the diagnostic criteria, they used the data from an additional group of 537 patients with a definite VKH disease diagnosis and 525 patients with non-VKH uveitis from northern China.
• Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristic were the main outcomes and measures.

Results

• As per data, out 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.
• Findings suggested that the latent class analysis selected the 3-class model and 21 clinical findings.
• Results demonstrated that variables with a high positive rate in the early-phase or late-phase VKH group or high specificity constituted essential parameters.
• The DCV was constructed by the constellations of these essential parameters.
• Compared to those of the Revised Diagnostic Criteria for VKH Disease (RDC), the sensitivity and NPV of the DCV were higher (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).
• Researchers noted that there was no difference in the specificity and PPV of the DCV 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).
• They found the area under the receiver operating characteristic curve of the DCV and the RDC to be 0.934 (95% CI, 0.917-0.951) and 0.829 (95% CI, 0.803-0.855), respectively.