Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia
Objectives: To develop a mathematical model to predict the probability of having community-acquired pneumonia and to evaluate an already developed prediction rule that has not been validated in a clinical scenario. Methods: Children who presented with fever and had presumptive clinical diagnosis of...
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2010
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paper:paper_07495161_v26_n6_p399_Bilkis2023-06-08T15:45:41Z Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia Rodríguez, Daniela Andrea Chest radiographs Pneumonia Predictive factors abdominal pain abnormal respiratory sound adolescent age distribution anorexia article body temperature breathing rate child community acquired pneumonia controlled study correlation coefficient coughing false negative result false positive result fatigue female fever human infant intercostal retraction major clinical study male mathematical model nose congestion pediatrician pneumonia prediction probability receiver operating characteristic sensitivity and specificity sex ratio sleep disorder tachypnea thorax disease thorax pain thorax radiography validation process wheezing clinical trial Community-Acquired Infections differential diagnosis multicenter study pneumonia predictive value preschool child radiography risk factor statistical model validation study Adolescent Child Child, Preschool Community-Acquired Infections Diagnosis, Differential Female Humans Infant Male Models, Statistical Pneumonia Predictive Value of Tests Probability Radiography, Thoracic Risk Factors ROC Curve Sensitivity and Specificity Adolescent Child Child, Preschool Community-Acquired Infections Diagnosis, Differential Female Humans Infant Male Models, Statistical Pneumonia Predictive Value of Tests Probability Radiography, Thoracic Risk Factors ROC Curve Sensitivity and Specificity Objectives: To develop a mathematical model to predict the probability of having community-acquired pneumonia and to evaluate an already developed prediction rule that has not been validated in a clinical scenario. Methods: Children who presented with fever and had presumptive clinical diagnosis of pneumonia were evaluated in 4 institutions of different complexity during 1 year. The variables assessed were sex, age, respiratory rate, days with fever, maximum body temperature, presence of tachypnea, cough, chest pain, intercostal retraction, nasal flaring, abdominal pain, vomiting, grunting, rales, decreased breath sounds, wheezing, fatigue, loss of appetite, loss of sleep, and season of the year. The chest radiographs were photographed and then interpreted by 2 pediatric radiologists. Results: A total of 257 children were evaluated: 179 (69%) had clinical and radiological diagnosis of community-acquired pneumonia, and 78 (30%) had no radiological confirmation. A total of 96 photographs were recorded, and in 64 of the cases, there was agreement in the diagnosis between the evaluating pediatrician and the radiologists (κ index = 0.68).With the calculated probabilities, it was possible to build a receiving operating characteristic curve and, based on the estimated coefficients we calculated, a value associated to the probability of having pneumonia. Conclusions: We developed a model including 5 variables of high level of sensitivity for the diagnosis of pneumonia. To use it, it would be useful to apply the appropriate software. In addition, we validated a clinical prediction rule of 4 variables that proved to have 93.8% sensitivity to diagnose pneumonia in children with a fever and localized rales, or decreased breath sounds, or tachypnea, or any combination of these 4 variables. Copyright © 2010 by Lippincott Williams & Wilkins. Fil:Rodriguez, D. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; Argentina. 2010 https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_07495161_v26_n6_p399_Bilkis http://hdl.handle.net/20.500.12110/paper_07495161_v26_n6_p399_Bilkis |
| institution |
Universidad de Buenos Aires |
| institution_str |
I-28 |
| repository_str |
R-134 |
| collection |
Biblioteca Digital - Facultad de Ciencias Exactas y Naturales (UBA) |
| topic |
Chest radiographs Pneumonia Predictive factors abdominal pain abnormal respiratory sound adolescent age distribution anorexia article body temperature breathing rate child community acquired pneumonia controlled study correlation coefficient coughing false negative result false positive result fatigue female fever human infant intercostal retraction major clinical study male mathematical model nose congestion pediatrician pneumonia prediction probability receiver operating characteristic sensitivity and specificity sex ratio sleep disorder tachypnea thorax disease thorax pain thorax radiography validation process wheezing clinical trial Community-Acquired Infections differential diagnosis multicenter study pneumonia predictive value preschool child radiography risk factor statistical model validation study Adolescent Child Child, Preschool Community-Acquired Infections Diagnosis, Differential Female Humans Infant Male Models, Statistical Pneumonia Predictive Value of Tests Probability Radiography, Thoracic Risk Factors ROC Curve Sensitivity and Specificity Adolescent Child Child, Preschool Community-Acquired Infections Diagnosis, Differential Female Humans Infant Male Models, Statistical Pneumonia Predictive Value of Tests Probability Radiography, Thoracic Risk Factors ROC Curve Sensitivity and Specificity |
| spellingShingle |
Chest radiographs Pneumonia Predictive factors abdominal pain abnormal respiratory sound adolescent age distribution anorexia article body temperature breathing rate child community acquired pneumonia controlled study correlation coefficient coughing false negative result false positive result fatigue female fever human infant intercostal retraction major clinical study male mathematical model nose congestion pediatrician pneumonia prediction probability receiver operating characteristic sensitivity and specificity sex ratio sleep disorder tachypnea thorax disease thorax pain thorax radiography validation process wheezing clinical trial Community-Acquired Infections differential diagnosis multicenter study pneumonia predictive value preschool child radiography risk factor statistical model validation study Adolescent Child Child, Preschool Community-Acquired Infections Diagnosis, Differential Female Humans Infant Male Models, Statistical Pneumonia Predictive Value of Tests Probability Radiography, Thoracic Risk Factors ROC Curve Sensitivity and Specificity Adolescent Child Child, Preschool Community-Acquired Infections Diagnosis, Differential Female Humans Infant Male Models, Statistical Pneumonia Predictive Value of Tests Probability Radiography, Thoracic Risk Factors ROC Curve Sensitivity and Specificity Rodríguez, Daniela Andrea Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia |
| topic_facet |
Chest radiographs Pneumonia Predictive factors abdominal pain abnormal respiratory sound adolescent age distribution anorexia article body temperature breathing rate child community acquired pneumonia controlled study correlation coefficient coughing false negative result false positive result fatigue female fever human infant intercostal retraction major clinical study male mathematical model nose congestion pediatrician pneumonia prediction probability receiver operating characteristic sensitivity and specificity sex ratio sleep disorder tachypnea thorax disease thorax pain thorax radiography validation process wheezing clinical trial Community-Acquired Infections differential diagnosis multicenter study pneumonia predictive value preschool child radiography risk factor statistical model validation study Adolescent Child Child, Preschool Community-Acquired Infections Diagnosis, Differential Female Humans Infant Male Models, Statistical Pneumonia Predictive Value of Tests Probability Radiography, Thoracic Risk Factors ROC Curve Sensitivity and Specificity Adolescent Child Child, Preschool Community-Acquired Infections Diagnosis, Differential Female Humans Infant Male Models, Statistical Pneumonia Predictive Value of Tests Probability Radiography, Thoracic Risk Factors ROC Curve Sensitivity and Specificity |
| description |
Objectives: To develop a mathematical model to predict the probability of having community-acquired pneumonia and to evaluate an already developed prediction rule that has not been validated in a clinical scenario. Methods: Children who presented with fever and had presumptive clinical diagnosis of pneumonia were evaluated in 4 institutions of different complexity during 1 year. The variables assessed were sex, age, respiratory rate, days with fever, maximum body temperature, presence of tachypnea, cough, chest pain, intercostal retraction, nasal flaring, abdominal pain, vomiting, grunting, rales, decreased breath sounds, wheezing, fatigue, loss of appetite, loss of sleep, and season of the year. The chest radiographs were photographed and then interpreted by 2 pediatric radiologists. Results: A total of 257 children were evaluated: 179 (69%) had clinical and radiological diagnosis of community-acquired pneumonia, and 78 (30%) had no radiological confirmation. A total of 96 photographs were recorded, and in 64 of the cases, there was agreement in the diagnosis between the evaluating pediatrician and the radiologists (κ index = 0.68).With the calculated probabilities, it was possible to build a receiving operating characteristic curve and, based on the estimated coefficients we calculated, a value associated to the probability of having pneumonia. Conclusions: We developed a model including 5 variables of high level of sensitivity for the diagnosis of pneumonia. To use it, it would be useful to apply the appropriate software. In addition, we validated a clinical prediction rule of 4 variables that proved to have 93.8% sensitivity to diagnose pneumonia in children with a fever and localized rales, or decreased breath sounds, or tachypnea, or any combination of these 4 variables. Copyright © 2010 by Lippincott Williams & Wilkins. |
| author |
Rodríguez, Daniela Andrea |
| author_facet |
Rodríguez, Daniela Andrea |
| author_sort |
Rodríguez, Daniela Andrea |
| title |
Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia |
| title_short |
Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia |
| title_full |
Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia |
| title_fullStr |
Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia |
| title_full_unstemmed |
Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia |
| title_sort |
validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia |
| publishDate |
2010 |
| url |
https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_07495161_v26_n6_p399_Bilkis http://hdl.handle.net/20.500.12110/paper_07495161_v26_n6_p399_Bilkis |
| work_keys_str_mv |
AT rodriguezdanielaandrea validationanddevelopmentofaclinicalpredictionruleinclinicallysuspectedcommunityacquiredpneumonia |
| _version_ |
1768541802391928832 |