{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T09:29:59Z","timestamp":1740130199732,"version":"3.37.3"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T00:00:00Z","timestamp":1665187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,28]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Individual symptoms and signs of infectious mononucleosis (IM) are of limited value for diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To develop and validate risk scores based on signs and symptoms with and without haematologic parameters for the diagnosis of IM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>Data were extracted from electronic health records of a university health centre and were divided into derivation (9\/1\/2015\u201310\/31\/2017) and a prospective temporal internal validation (11\/1\/2017\u20131\/31\/2019) cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Independent predictors for the diagnosis of IM were identified in univariate analysis using the derivation cohort. Logistic regression models were used to develop 2 risk scores: 1 with only symptoms and signs (IM-NoLab) and 1 adding haematologic parameters (IM-Lab). Point scores were created based on the regression coefficients, and patients were grouped into risk groups. Primary outcomes were area under the receiver operating characteristic curve (AUROCC) and classification accuracy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The IM-NoLab model had 4 predictors and identified a low-risk group (7.9% with IM) and a high-risk group (22.2%) in the validation cohort. The AUROCC was 0.75 in the derivation cohort and 0.69 in the validation cohort. The IM-Lab model had 3 predictors and identified a low-risk group (3.6%), a moderate-risk group (12.5%), and a high-risk group (87.6%). The AUROCC was 0.97 in the derivation cohort and 0.93 in the validation cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We derived and internally validated the IM-NoLab and IM-Lab risk scores. The IM-Lab score in particular had very good discrimination and have the potential to reduce the need for diagnostic testing for IM.<\/jats:p><\/jats:sec>","DOI":"10.1093\/fampra\/cmac105","type":"journal-article","created":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T13:46:17Z","timestamp":1665236777000},"page":"261-267","source":"Crossref","is-referenced-by-count":0,"title":["Development and internal validation of risk scores to diagnose infectious mononucleosis among college students"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4782-6531","authenticated-orcid":false,"given":"Xinyan","family":"Cai","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia , Athens, GA , United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3228-2877","authenticated-orcid":false,"given":"Mark H","family":"Ebell","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia , Athens, GA , United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Garth","family":"Russo","sequence":"additional","affiliation":[{"name":"University Health Center, University of Georgia , Athens, GA , United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7264-7055","authenticated-orcid":false,"given":"Kevin K","family":"Dobbin","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia , Athens, GA , United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose F","family":"Cordero","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia , Athens, GA , United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,10,8]]},"reference":[{"issue":"6","key":"2023032818141086100_","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1093\/oxfordjournals.aje.a121577","article-title":"Infectious mononucleosis in Rochester, Minnesota, 1950 through 1969","volume":"98","author":"Henke","year":"1973","journal-title":"Am J Epidemiol"},{"issue":"2","key":"2023032818141086100_","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/S0095-4543(21)00177-9","article-title":"Infectious mononucleosis.","volume":"2","author":"Hoagland","year":"1975","journal-title":"Prim Care"},{"issue":"6","key":"2023032818141086100_","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.3122\/jabfm.2021.06.210217","article-title":"Accuracy of signs, symptoms, and hematologic parameters for the diagnosis of infectious mononucleosis: a systematic review and meta-analysis","volume":"34","author":"Cai","year":"2021","journal-title":"J Am Board Fam Med"},{"issue":"14","key":"2023032818141086100_","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1001\/jama.2016.2111","article-title":"Does this patient have infectious mononucleosis? 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