Screening Multisystem Inflammatory Syndrome in Children: Accuracy of the American College of Rheumatology Screening...

Area of Science:

• Pediatrics
• Rheumatology
• Infectious Diseases

Background:

• Diagnosing multisystem inflammatory syndrome in children (MIS-C) is challenging due to overlapping symptoms with other febrile illnesses.
• The American College of Rheumatology (ACR) developed a screening algorithm to aid in MIS-C diagnosis during the pandemic.

Purpose of the Study:

• To evaluate the accuracy of the ACR MIS-C screening algorithm in differentiating MIS-C from other febrile conditions in children.
• To compare the ACR algorithm's performance against established case definitions.

Main Methods:

• A single-center case-control study included 402 children (241 MIS-C, 161 febrile controls) from March 2020 to March 2022.
• The ACR MIS-C screening algorithm was retrospectively applied.
• Performance was assessed against World Health Organization (WHO) and CSTE/CDC case definitions.

Main Results:

• Against the WHO definition, the ACR algorithm showed 74.3% sensitivity, 99.2% specificity, and 86.7% balanced accuracy.
• Against the CSTE/CDC definition, sensitivity was 86.2%, specificity 95.8%, and balanced accuracy 91%.

Conclusions:

• The ACR MIS-C screening algorithm demonstrates high specificity and accuracy in identifying MIS-C in children.
• The algorithm effectively differentiates MIS-C from febrile controls, even with its early development during the pandemic.