Validating a decision tree for serious infection: Diagnostic accuracy in acutely ill children in ambulatory care

BMJ Open

Volumn 5, Issue 8, 2015, Pages

  Verbakel, Jan Y ^a,b   Lemiengre, Marieke B ^c   De Burghgraeve, Tine ^a   De Sutter, An ^c   Aertgeerts, Bert ^a   Bullens, Dominique M A ^a,d   Shinkins, Bethany ^b   Van Den Bruel, Ann ^b   Buntinx, Frank ^a,e  

^a UNIVERSITY OF LEUVEN   (Belgium)

^b UNIVERSITY OF OXFORD   (United Kingdom)

^c GHENT UNIVERSITY   (Belgium)

^d UNIVERSITY HOSPITALS LEUVEN   (Belgium)

^e MAASTRICHT UNIVERSITY   (Netherlands)

Author keywords

[No Author keywords available]

Indexed keywords

ACUTE DISEASE; ADOLESCENT; AMBULATORY CARE; APPENDICITIS; ARTICLE; BACTERIAL INFECTION; CELLULITIS; CHILD; CHILDHOOD DISEASE; CLINICAL ASSESSMENT; CONTROLLED STUDY; DECISION TREE; DEHYDRATION; DIAGNOSTIC ACCURACY; DIAGNOSTIC VALUE; EMERGENCY WARD; FEMALE; GASTROENTERITIS; GENERAL PRACTICE; HOSPITAL ADMISSION; HUMAN; INFANT; MAJOR CLINICAL STUDY; MALE; MEDICAL DECISION MAKING; MENINGITIS; OSTEOMYELITIS; OUTCOME ASSESSMENT; PATIENT REFERRAL; PHYSICIAN ATTITUDE; PNEUMONIA; POPULATION; PREDICTIVE VALUE; PRIMARY MEDICAL CARE; PROSPECTIVE STUDY; SENSITIVITY AND SPECIFICITY; SEPSIS; URINARY TRACT INFECTION; VIRUS MENINGITIS; BELGIUM; CLINICAL TRIAL; DECISION SUPPORT SYSTEM; INFECTION; MULTICENTER STUDY; PRESCHOOL CHILD; VALIDATION STUDY;

ACUTE DISEASE; ADOLESCENT; AMBULATORY CARE; BELGIUM; CHILD; CHILD, PRESCHOOL; DECISION SUPPORT TECHNIQUES; DECISION TREES; FEMALE; HUMANS; INFANT; INFECTION; MALE; PROSPECTIVE STUDIES; SENSITIVITY AND SPECIFICITY;

EID: 84941551154     PISSN: None     EISSN: 20446055     Source Type: Journal    
DOI: 10.1136/bmjopen-2015-008657     Document Type: Article

References (22)

1. Fleming DM, Smith GE, Charlton JR, et al. Impact of infections on primary care-greater than expected. Commun Dis Public Health 2002; 5: 7-12.
2. Van den Bruel A, Bartholomeeusen S, Aertgeerts B, et al. Serious infections in children: an incidence study in family practice. BMC Fam Pract 2006; 7: 23.
3. Hoogwijs I, Verbakel JY, Aertgeerts B, et al. Severe infections in a paediatric emergency department. Tijdschr Geneeskd 2014; 70: 362-8.
4. Bleeker S, Moons K, Derksen-Lubsen G, et al. Predicting serious bacterial infection in young children with fever without apparent source. Acta Paediatr 2001: 90: 1226-32.
5. Van den Bruel A, Haj-Hassan T, Thompson M, et al. Diagnostic value of clinical features at presentation to identify serious infection in children in developed countries: a systematic review. Lancet 2010; 375: 834-45.
6. Van den Bruel A, Aertgeerts B, Bruyninckx R, et al. Signs and symptoms for diagnosis of serious infections in children: a prospective study in primary care. Br J Gen Pract 2007: 57: 538-46.
7. Verbakel JY, Van den Bruel A, Thompson M, et al. How well do clinical prediction rules perform in identifying serious infections in acutely ill children across an international network of ambulatory care datasets? BMC Med 2013; 11: 10.
8. Kerkhof E, Lakhanpaul M, Ray S, et al. The predictive value of the NICE "Red Traffic Lights" in acutely ill children. PLoS ONE 2014; 9: e90847.
9. McCarthy P, Sharpe M, Spiesel S, et al. Observation scales to identify serious illness in febrile children. Pediatrics 1982: 70: 802-9.
10. Craig JV, Lancaster GA, Taylor S, et al. Infrared ear thermometry compared with rectal thermometry in children: a systematic review. Lancet 2002; 360: 603-9.
11. Craig JV, Lancaster GA, Williamson PR, et al. Temperature measured at the axilla compared with rectum in children and young people: systematic review. BMJ 2000: 320: 1174-8.
12. NICE. Diarrhoea and vomiting caused by gastroenteritis diagnosis, assessment and management in children younger than 5 years. London: National Institute for Health and Clinical Excellence, 2009.
13. NICE. National Institute for Clinical Excellence: feverish illness in children-assessment and initial management in children younger than 5 years. London: National Institute for Health and Clinical Excellence, 2007.
14. Flahault A, Cadilhac M, Thomas G. Sample size calculation should be performed for design accuracy in diagnostic test studies. J Clin Epidemiol 2005: 58: 859-62.
15. Craig J, Williams G, Jones M, et al. 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.
16. Elshout G, van Ierland Y, Bohnen AM, et al. Alarming signs and symptoms in febrile children in primary care: an observational cohort study in the Netherlands. PLoS ONE 2014; 9: e88114.
17. Whiting P, Rutjes AW, Reitsma JB, et al. Sources of variation and bias in studies of diagnostic accuracy: a systematic review. Ann Intern Med 2004: 140: 189-202.
18. De S, Williams GJ, Hayen A, et al. Accuracy of the "traffic light" clinical decision rule for serious bacterial infections in young children with fever: a retrospective cohort study. BMJ 2013; 346: f866.
19. Verbakel JY, MacFaul R, Aertgeerts B, et al. Sepsis and meningitis in hospitalized children: performance of clinical signs and their prediction rules in a case-control study. Pediatr Emerg Care 2014; 30: 373-80.
20. Van den Bruel A, Thompson M. Research into practice: acutely ill children. Br J Gen Pract 2014; 64: 311-13.
21. Berger MY, Albeda FW, Dijkstra RH, et al. NHG-Standaard Kinderen met koorts-Tweede Herziening. Huisarts Wet 2008: 51: 287-96.
22. Cals J, Butler C, Hopstaken R, et al. Effect of point of care testing for C reactive protein and training in communication skills on antibiotic use in lower respiratory tract infections: cluster randomised trial. BMJ 2009: 338: b1374.