Establishment and validation of a prediction model for myocarditis in Chinese children below 14 years old: a protocol for a retrospective cohort study

Introduction Paediatric myocarditis, a rare inflammatory disease, often presents without clear early symptoms. Although cardiac troponin I levels can aid in diagnosing myocarditis, they are not definitive indicators. Troponin I levels frequently fluctuate within and outside the reference range, pote...

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Main Authors: Jie Chen, YuZhan Lin, Weidan Ji, Lifeng Wu, Yumao Huang, Huanxuan Zeng, Yueling Zou, Weiguo Lin
Format: Article
Language:English
Published: BMJ Publishing Group 2023-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/13/12/e075453.full
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author Jie Chen
YuZhan Lin
Weidan Ji
Lifeng Wu
Yumao Huang
Huanxuan Zeng
Yueling Zou
Weiguo Lin
author_facet Jie Chen
YuZhan Lin
Weidan Ji
Lifeng Wu
Yumao Huang
Huanxuan Zeng
Yueling Zou
Weiguo Lin
author_sort Jie Chen
collection DOAJ
description Introduction Paediatric myocarditis, a rare inflammatory disease, often presents without clear early symptoms. Although cardiac troponin I levels can aid in diagnosing myocarditis, they are not definitive indicators. Troponin I levels frequently fluctuate within and outside the reference range, potentially causing misinterpretations by clinicians. Although a negative troponin I result is valuable for excluding myocarditis, its specificity is low. Moreover, the clinical diagnosis of paediatric myocarditis is exceptionally challenging, and accurate early-stage diagnosis and treatment pose difficulties. Currently, the Dallas criteria, involving cardiac biopsy, serves as the gold standard for myocarditis diagnosis. However, this method has several drawbacks and is unsuitable for children, resulting in its limited use.Methods and analysis In this study, we will employ multiple logistic regression analysis to develop a predictive model for early childhood myocarditis. This model will assess the patient’s condition at onset and provide the probability of a myocarditis diagnosis. Model performance will be evaluated for accuracy and calibration, and the results will be presented through receiver operating characteristic (ROC) curves and calibration plots. Clinical decision curve analysis, in conjunction with ROC curve analysis, will be employed to determine the optimal cut-off value and calculate the net clinical benefit value for assessing clinical effectiveness. Finally, internal model validation will be conducted using bootstrapping.Ethics and dissemination Approval from the Clinical Research Ethics Committee of The Third Affiliated Hospital of Wenzhou Medical University has been obtained. The research findings will be disseminated through presentations at scientific conferences and publication in peer-reviewed journals.
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spelling doaj-art-599344df23e84b0fa64ba5e12e3271db2025-08-20T01:47:33ZengBMJ Publishing GroupBMJ Open2044-60552023-12-01131210.1136/bmjopen-2023-075453Establishment and validation of a prediction model for myocarditis in Chinese children below 14 years old: a protocol for a retrospective cohort studyJie Chen0YuZhan Lin1Weidan Ji2Lifeng Wu3Yumao Huang4Huanxuan Zeng5Yueling Zou6Weiguo Lin7Department of Gastroenterology, Third Xiangya Hospital, Central South University, Changsha, China1 Department of Clinical Laboratory, Ruian People`s Hospital, Ruian, ChinaDepartment of Clinical Laboratory, The Third Affiliated Hospital of Wenzhou Medical University, Ruian 325200, Zhejiang, People`s Republic of ChinaDepartment of Clinical Laboratory, The Third Affiliated Hospital of Wenzhou Medical University, Ruian 325200, Zhejiang, People`s Republic of ChinaPediatric Department, The Third Affiliated Hospital of Wenzhou Medical University, Ruian 325200, Zhejiang, People`s Republic of ChinaPediatric Department, The Third Affiliated Hospital of Wenzhou Medical University, Ruian 325200, Zhejiang, People`s Republic of ChinaDepartment of Clinical Laboratory, Ruian Maternity and Child Care Hospital, Ruian 325200, Zhejiang, People`s Republic of ChinaUrological Surgery, The Third Affiliated Hospital of Wenzhou Medical University, Ruian 325200, Zhejiang, People`s Republic of ChinaIntroduction Paediatric myocarditis, a rare inflammatory disease, often presents without clear early symptoms. Although cardiac troponin I levels can aid in diagnosing myocarditis, they are not definitive indicators. Troponin I levels frequently fluctuate within and outside the reference range, potentially causing misinterpretations by clinicians. Although a negative troponin I result is valuable for excluding myocarditis, its specificity is low. Moreover, the clinical diagnosis of paediatric myocarditis is exceptionally challenging, and accurate early-stage diagnosis and treatment pose difficulties. Currently, the Dallas criteria, involving cardiac biopsy, serves as the gold standard for myocarditis diagnosis. However, this method has several drawbacks and is unsuitable for children, resulting in its limited use.Methods and analysis In this study, we will employ multiple logistic regression analysis to develop a predictive model for early childhood myocarditis. This model will assess the patient’s condition at onset and provide the probability of a myocarditis diagnosis. Model performance will be evaluated for accuracy and calibration, and the results will be presented through receiver operating characteristic (ROC) curves and calibration plots. Clinical decision curve analysis, in conjunction with ROC curve analysis, will be employed to determine the optimal cut-off value and calculate the net clinical benefit value for assessing clinical effectiveness. Finally, internal model validation will be conducted using bootstrapping.Ethics and dissemination Approval from the Clinical Research Ethics Committee of The Third Affiliated Hospital of Wenzhou Medical University has been obtained. The research findings will be disseminated through presentations at scientific conferences and publication in peer-reviewed journals.https://bmjopen.bmj.com/content/13/12/e075453.full
spellingShingle Jie Chen
YuZhan Lin
Weidan Ji
Lifeng Wu
Yumao Huang
Huanxuan Zeng
Yueling Zou
Weiguo Lin
Establishment and validation of a prediction model for myocarditis in Chinese children below 14 years old: a protocol for a retrospective cohort study
BMJ Open
title Establishment and validation of a prediction model for myocarditis in Chinese children below 14 years old: a protocol for a retrospective cohort study
title_full Establishment and validation of a prediction model for myocarditis in Chinese children below 14 years old: a protocol for a retrospective cohort study
title_fullStr Establishment and validation of a prediction model for myocarditis in Chinese children below 14 years old: a protocol for a retrospective cohort study
title_full_unstemmed Establishment and validation of a prediction model for myocarditis in Chinese children below 14 years old: a protocol for a retrospective cohort study
title_short Establishment and validation of a prediction model for myocarditis in Chinese children below 14 years old: a protocol for a retrospective cohort study
title_sort establishment and validation of a prediction model for myocarditis in chinese children below 14 years old a protocol for a retrospective cohort study
url https://bmjopen.bmj.com/content/13/12/e075453.full
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