How well do clinical prediction rules perform in identifying serious infections in acutely ill children across an international network of ambulatory care datasets?

BMC Medicine

Volumn 11, Issue 1, 2013, Pages

  Verbakel, Jan Y ^a   Van den Bruel, Ann ^b   Thompson, Matthew ^b   Stevens, Richard ^b   Aertgeerts, Bert ^a   Oostenbrink, Rianne ^c   Moll, Henriette A ^c   Berger, Marjolein Y ^d   Lakhanpaul, Monica ^e   Mant, David ^b   Buntinx, Frank ^a,f  

^a UNIVERSITY OF LEUVEN   (Belgium)

^b UNIVERSITY OF OXFORD   (United Kingdom)

^c SOPHIA CHILDREN S HOSPITAL   (Netherlands)

^d UNIVERSITY MEDICAL CENTER GRONINGEN   (Netherlands)

^e UNIVERSITY COLLEGE LONDON   (United Kingdom)

^f MAASTRICHT UNIVERSITY   (Netherlands)

Author keywords

Clinical prediction rules; Diagnostic accuracy; External validation; NICE guidelines feverish illness; Serious infection in children; Yale Observation Scale

Indexed keywords

AMBULATORY CARE; ARTICLE; BELGIUM; CHILD; DIAGNOSTIC ACCURACY; EMERGENCY WARD; HUMAN; INFANT; INFECTION; MAJOR CLINICAL STUDY; MENINGITIS; NETHERLANDS; PNEUMONIA; PRACTICE GUIDELINE; PREDICTION; PRESCHOOL CHILD; PRIMARY MEDICAL CARE; PROBABILITY; RATING SCALE; RETROSPECTIVE STUDY; SENSITIVITY ANALYSIS; SENSITIVITY AND SPECIFICITY; UNITED KINGDOM; YALE OBSERVATION SCALE;

ACUTE DISEASE; ADOLESCENT; AMBULATORY CARE; BELGIUM; CHILD; CHILD, PRESCHOOL; CLINICAL MEDICINE; COMMUNICABLE DISEASES; DECISION SUPPORT TECHNIQUES; FEMALE; GREAT BRITAIN; HUMANS; INFANT; INFANT, NEWBORN; INTERNATIONAL COOPERATION; MALE; NETHERLANDS; PRACTICE GUIDELINES AS TOPIC; SENSITIVITY AND SPECIFICITY;

EID: 84873506846     PISSN: None     EISSN: 17417015     Source Type: Journal    
DOI: 10.1186/1741-7015-11-10     Document Type: Article

References (43)

1. Hay AD, Heron J, Ness A. The prevalence of symptoms and consultations in pre-school children in the Avon Longitudinal Study of Parents and Children (ALSPAC): a prospective cohort study. Fam Pract 2005, 22:367-374. 10.1093/fampra/cmi035, 15897210.
2. Van den Bruel A, Bartholomeeusen S, Aertgeerts B, Truyers C, Buntinx F. Serious infections in children: an incidence study in family practice. BMC Fam Pract 2006, 7:23-23. 10.1186/1471-2296-7-23, 1435901, 16569232.
3. Van den Bruel A, Haj-Hassan T, Thompson M, Buntinx F, Mant D. Diagnostic value of clinical features at presentation to identify serious infection in children in developed countries: a systematic review. Lancet 2010, 375:834-845. 10.1016/S0140-6736(09)62000-6, 20132979.
4. Strang JR, Pugh EJ. Meningococcal infections: reducing the case fatality rate by giving penicillin before admission to hospital. BMJ 1992, 305:141-143. 10.1136/bmj.305.6846.141, 1883221, 1515826.
5. Koomen I, Grobbee DE, Roord JJ, Donders R, Jennekens-Schinkel A, van Furth AM. Hearing loss at school age in survivors of bacterial meningitis: assessment, incidence, and prediction. Pediatrics 2003, 112:1049-1053. 10.1542/peds.112.5.1049, 14595044.
6. CEMACH Why children die: a pilot study 2006; England (South West, North East and West Midlands), Wales and Northern Ireland. CEMACH 2008, CEMACH.
7. Van den Bruel A, Aertgeerts B, Bruyninckx R, Aerts M, Buntinx F. Signs and symptoms for diagnosis of serious infections in children: a prospective study in primary care. Br J Gen Pract 2007, 57:538-546. 2099636, 17727746.
8. Buntinx F, Mant D, Van den Bruel A, Donner-Banzhof N, Dinant GJ. Dealing with low-incidence serious diseases in general practice. Br J Gen Pract 2011, 61:43-46. 10.3399/bjgp11X548974, 3020049, 21401991.
9. Oostenbrink R, Thompson M, Steyerberg EW. Barriers to translating diagnostic research in febrilechildren to clinical practice: a systematic review. Arch Dis Child 2012,
10. McCarthy PL, Sharpe MR, Spiesel SZ, Dolan TF, Forsyth BW, DeWitt TG, Fink HD, Baron MA, Cicchetti DV. Observation scales to identify serious illness in febrile children. Pediatrics 1982, 70:802-809.
11. Baker MD, Avner JR, Bell LM. Failure of infant observation scales in detecting serious illness in febrile, 4- to 8-week-old infants. Pediatrics 1990, 85:1040-1043.
12. Bang A, Chaturvedi P. Yale Observation Scale for prediction of bacteremia in febrile children. Indian J Pediatr 2009, 76:599-604. 10.1007/s12098-009-0065-6, 19390817.
13. Hsiao AL, Chen L, Baker MD. Incidence and predictors of serious bacterial infections among 57- to 180-day-old infants. Pediatrics 2006, 117:1695-1701. 10.1542/peds.2005-1673, 16651326.
14. Teach SJ, Fleisher GR. Efficacy of an observation scale in detecting bacteremia in febrile children three to thirty-six months of age, treated as outpatients. Occult Bacteremia Study Group. J Pediatr 1995, 126:877-881. 10.1016/S0022-3476(95)70200-8, 7776087.
15. NICE National Institute for Clinical Excellence: Feversh illness in children - assessment and initial management in children younger than 5 years. London: National Institute for Health and Clinical Excellence, 2007 2007, [cited June 29, 2007], NICE.
16. Berger MY BL, Albeda FW, Dijkstra RH, Graafmans TA, Van der Laan JR, Lemmen WH, Oteman N. NHG-Standaard Kinderen met koorts - Tweede Herziening. Huisarts Wet 2008, 51:287-296.
17. Craig JC, Williams GJ, Jones M, Codarini M, Macaskill P, Hayen A, Irwig L, Fitzgerald DA, Isaacs D, McCaskill M. The accuracy of clinical symptoms and signs for the diagnosis of serious bacterial infection in young febrile children: prospective cohort study of 15 781 febrile illnesses. BMJ 2010, 340:c1594. 10.1136/bmj.c1594, 2857748, 20406860.
18. Thompson M, Coad N, Harnden A, Mayon-White R, Perera R, Mant D. How well do vital signs identify children with serious infections in paediatric emergency care?. Arch Dis Child 2009, 94:888-893. 10.1136/adc.2009.159095, 19608555.
19. Oostenbrink R, Thompson M, Steyerberg EW. Barriers to translating diagnostic research in febrile children to clinical practice: a systematic review. Arch Dis Child 2011,
20. Jaeschke R, Guyatt GH, Sackett DL. Users' guides to the medical literature. III. How to use an article about a diagnostic test. B. What are the results and will they help me in caring for my patients? The Evidence-Based Medicine Working Group. JAMA 1994, 271:703-707. 10.1001/jama.1994.03510330081039, 8309035.
21. Macaskill P, Gatsonis C, Deeks J, Harbord R, Takwoingi Y. Analysing and presenting results. Chapter 10. Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy 2010, Version 1.0. The Cochrane Collaboration, Deeks J, Bossuyt PM, Gatsonis C, Available from: [http://srdta.cochrane.org/] (released December 23rd, 2010).
22. Monteny M, Berger MY, van der Wouden JC, Broekman BJ, Koes BW. Triage of febrile children at a GP cooperative: determinants of a consultation. Br J Gen Pract 2008, 58:242-247. 10.3399/bjgp08X279643, 2277109, 18494175.
23. Brent AJ, Lakhanpaul M, Thompson M, Collier J, Ray S, Ninis N, Levin M, Macfaul R. Risk score to stratify children with suspected serious bacterial infection: observational cohort study. Arch Dis Child 2011, 96:6.
24. Roukema J, Steyerberg EW, van der Lei J, Moll HA. Randomized trial of a clinical decision support system: impact on the management of children with fever without apparent source. J Am Med Inform Assoc 2008, 15:107-113. 2273109, 17947627.
25. Bleeker SE, Derksen-Lubsen G, Grobbee DE, Donders AR, Moons KG, Moll HA. Validating and updating a prediction rule for serious bacterial infection in patients with fever without source. Acta paediatrica 2007, 96:100-104.
26. Oostenbrink R, Moons KG, Derksen-Lubsen AG, Grobbee DE, Moll HA. A diagnostic decision rule for management of children with meningeal signs. Eur J Epidemiol 2004, 19:109-116.
27. Offringa M, Beishuizen A, Derksen-Lubsen G, Lubsen J. Seizures and fever: can we rule out meningitis on clinical grounds alone?. Clin Pediatr (Phila) 1992, 31:514-522.
28. Joffe A, McCormick M, DeAngelis C. Which children with febrile seizures need lumbar puncture? A decision analysis approach. Am J Dis Child 1983, 137:1153-1156.
29. Brent AJ, Lakhanpaul M, Thompson M, Collier J, Ray S, Ninis N, Levin M, Macfaul R. Risk score to stratify children with suspected serious bacterial infection: observational cohort study. Arch Dis Child 2011, 96:361-367. 10.1136/adc.2010.183111, 3158666, 21266341.
30. Gorelick MH, Shaw KN, Murphy KO. Validity and reliability of clinical signs in the diagnosis of dehydration in children. Pediatrics 1997, 99:E6.
31. Andreola B, Bressan S, Callegaro S, Liverani A, Plebani M, Da Dalt L. Procalcitonin and C-reactive protein as diagnostic markers of severe bacterial infections in febrile infants and children in the emergency department. Pediatr Infect Dis J 2007, 26:672-677. 10.1097/INF.0b013e31806215e3, 17848876.
32. Galetto-Lacour A, Zamora SA, Gervaix A. Bedside procalcitonin and C-reactive protein tests in children with fever without localizing signs of infection seen in a referral center. Pediatrics 2003, 112:1054-1060. 10.1542/peds.112.5.1054, 14595045.
33. Lacour AG, Gervaix A, Zamora SA, Vadas L, Lombard PR, Dayer JM, Suter S. Procalcitonin, IL-6, IL-8, IL-1 receptor antagonist and C-reactive protein as identificators of serious bacterial infections in children with fever without localising signs. Eur J Pediatr 2001, 160:95-100. 10.1007/s004310000681, 11271398.
34. Pulliam PN, Attia MW, Cronan KM. C-reactive protein in febrile children 1 to 36 months of age with clinically undetectable serious bacterial infection. Pediatrics 2001, 108:1275-1279. 10.1542/peds.108.6.1275, 11731648.
35. Thayyil S, Shenoy M, Hamaluba M, Gupta A, Frater J, Verber IG. Is procalcitonin useful in early diagnosis of serious bacterial infections in children?. Acta paediatrica 2005, 94:155-158. 10.1080/08035250410025140, 15981747.
36. Almond S, Mant D, Thompson M. Diagnostic safety-netting. Br J Gen Pract 2009, 59:872-874. discussion 874, 10.3399/bjgp09X472971, 2765844, 19861036.
37. Reilly BM, Evans AT. Translating clinical research into clinical practice: impact of using prediction rules to make decisions. Ann Intern Med 2006, 144:201-209.
38. Maguire JL, Kulik DM, Laupacis A, Kuppermann N, Uleryk EM, Parkin PC. Clinical prediction rules for children: a systematic review. Pediatrics 2011,
39. Wallace E, Smith SM, Perera-Salazar R, Vaucher P, McCowan C, Collins G, Verbakel J, Lakhanpaul M, Fahey T. Framework for the impact analysis and implementation of clinical prediction rules (CPRs). BMC Med Inform Decis Mak 2011, 11:62. 10.1186/1472-6947-11-62, 3216240, 21999201.
40. Justice AC, Covinsky KE, Berlin JA. Assessing the generalizability of prognostic information. Ann Intern Med 1999, 130:515-524.
41. Van den Bruel A, Cleemput I, Aertgeerts B, Ramaekers D, Buntinx F. The evaluation of diagnostic tests: evidence on technical and diagnostic accuracy, impact on patient outcome and cost-effectiveness is needed. Journal of clinical epidemiology 2007, 60:1116-1122. 10.1016/j.jclinepi.2007.03.015, 17938052.
42. Maguire S, Ranmal R, Komulainen S, Pearse S, Maconochie I, Lakhanpaul M, Davies F, Kai J, Stephenson T. Which urgent care services do febrile children use and why?. Arch Dis Child 2011, 96:810-816. 10.1136/adc.2010.210096, 21642270.
43. Van den Bruel A, Thompson MJ, Haj-Hassan T, Stevens R, Moll H, Lakhanpaul M, Mant D. Diagnostic value of laboratory tests in identifying serious infections in febrile children: systematic review. BMJ 2011, 342:d3082. 10.1136/bmj.d3082, 21653621.