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Bilkis, M.D.; Gorgal, N.; Carbone, M.; Vazquez, M.; Albanese, P.; Branda, M.C.; Alterman, E.; Rodriguez, D.; Orellana, L.; Pedrosa, O.B. "Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia" (2010) Pediatric Emergency Care. 26(6):399-405
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Abstract:

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.

Registro:

Documento: Artículo
Título:Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia
Autor:Bilkis, M.D.; Gorgal, N.; Carbone, M.; Vazquez, M.; Albanese, P.; Branda, M.C.; Alterman, E.; Rodriguez, D.; Orellana, L.; Pedrosa, O.B.
Filiación:Emergency Department, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina
Pediatric Emergency Department, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
Emergency Department, Hospital de Agudos Diego Paroissien, La Matanza, Spain
Policlínico Del Docente, Italy
Emergency Department, Hospital de Agudos Enrique Tornú, Italy
Department of Images, Hospital de Niños Ricardo Gutiérrez, Universidad de Buenos Aires, Argentina
Instituto de Cálculo, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
Facultad de Medicina, Universidad de la República, Uruguay
Palabras clave: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
Año:2010
Volumen:26
Número:6
Página de inicio:399
Página de fin:405
DOI: http://dx.doi.org/10.1097/PEC.0b013e3181e05779
Título revista:Pediatric Emergency Care
Título revista abreviado:Pediatr. Emerg. Care
ISSN:07495161
CODEN:PECAE
Registro:https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_07495161_v26_n6_p399_Bilkis

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Citas:

---------- APA ----------
Bilkis, M.D., Gorgal, N., Carbone, M., Vazquez, M., Albanese, P., Branda, M.C., Alterman, E.,..., Pedrosa, O.B. (2010) . Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia. Pediatric Emergency Care, 26(6), 399-405.
http://dx.doi.org/10.1097/PEC.0b013e3181e05779
---------- CHICAGO ----------
Bilkis, M.D., Gorgal, N., Carbone, M., Vazquez, M., Albanese, P., Branda, M.C., et al. "Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia" . Pediatric Emergency Care 26, no. 6 (2010) : 399-405.
http://dx.doi.org/10.1097/PEC.0b013e3181e05779
---------- MLA ----------
Bilkis, M.D., Gorgal, N., Carbone, M., Vazquez, M., Albanese, P., Branda, M.C., et al. "Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia" . Pediatric Emergency Care, vol. 26, no. 6, 2010, pp. 399-405.
http://dx.doi.org/10.1097/PEC.0b013e3181e05779
---------- VANCOUVER ----------
Bilkis, M.D., Gorgal, N., Carbone, M., Vazquez, M., Albanese, P., Branda, M.C., et al. Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia. Pediatr. Emerg. Care. 2010;26(6):399-405.
http://dx.doi.org/10.1097/PEC.0b013e3181e05779