Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia
- Autores
- Bilkis, Manuel D.; Gorgal, Nelly; Carbone, Miriam; Vazquez, Mirta; Albanese, Paulo; Branda, María Cecilia; Alterman, Elías; Rodriguez, Daniela Andrea; Orellana, Liliana; Bello Pedrosa, Osvaldo
- Año de publicación
- 2010
- Idioma
- inglés
- Tipo de recurso
- artículo
- Estado
- versión publicada
- Descripción
- 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 (J 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.
Fil: Bilkis, Manuel D.. Hospital de Niños "Ricardo Gutiérrez"; Argentina
Fil: Gorgal, Nelly. Centro Hospitalario "Pereira Rossell"; Uruguay
Fil: Carbone, Miriam. Hospital de Agudos "Diego Paroissien"; Argentina
Fil: Vazquez, Mirta. Policlínico del Docente; Argentina
Fil: Albanese, Paulo. Hospital de Agudos "Enrique Tornú"; Argentina
Fil: Branda, María Cecilia. Hospital de Niños "Ricardo Gutiérrez"; Argentina
Fil: Alterman, Elías. Hospital de Niños "Ricardo Gutiérrez"; Argentina. Universidad de Buenos Aires; Argentina
Fil: Rodriguez, Daniela Andrea. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Cálculo; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Orellana, Liliana. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Cálculo; Argentina
Fil: Bello Pedrosa, Osvaldo. Universidad de la República; Uruguay - Materia
-
Pneumonia
Chest Radiographs
Predictive Factors - Nivel de accesibilidad
- acceso abierto
- Condiciones de uso
- https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
- Repositorio
- Institución
- Consejo Nacional de Investigaciones Científicas y Técnicas
- OAI Identificador
- oai:ri.conicet.gov.ar:11336/16473
Ver los metadatos del registro completo
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Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumoniaBilkis, Manuel D.Gorgal, NellyCarbone, MiriamVazquez, MirtaAlbanese, PauloBranda, María CeciliaAlterman, ElíasRodriguez, Daniela AndreaOrellana, LilianaBello Pedrosa, OsvaldoPneumoniaChest RadiographsPredictive Factorshttps://purl.org/becyt/ford/1.1https://purl.org/becyt/ford/1Objectives: 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 (J 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.Fil: Bilkis, Manuel D.. Hospital de Niños "Ricardo Gutiérrez"; ArgentinaFil: Gorgal, Nelly. Centro Hospitalario "Pereira Rossell"; UruguayFil: Carbone, Miriam. Hospital de Agudos "Diego Paroissien"; ArgentinaFil: Vazquez, Mirta. Policlínico del Docente; ArgentinaFil: Albanese, Paulo. Hospital de Agudos "Enrique Tornú"; ArgentinaFil: Branda, María Cecilia. Hospital de Niños "Ricardo Gutiérrez"; ArgentinaFil: Alterman, Elías. Hospital de Niños "Ricardo Gutiérrez"; Argentina. Universidad de Buenos Aires; ArgentinaFil: Rodriguez, Daniela Andrea. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Cálculo; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Orellana, Liliana. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Cálculo; ArgentinaFil: Bello Pedrosa, Osvaldo. Universidad de la República; UruguayLippincott Williams2010-06info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/16473Bilkis, Manuel D.; Gorgal, Nelly; Carbone, Miriam; Vazquez, Mirta; Albanese, Paulo; et al.; Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia; Lippincott Williams; Pediatric Emergency Care; 26; 6; 6-2010; 399-4050749-5161enginfo:eu-repo/semantics/altIdentifier/doi/10.1097/PEC.0b013e3181e05779info:eu-repo/semantics/altIdentifier/url/http://journals.lww.com/pec-online/pages/articleviewer.aspx?year=2010&issue=06000&article=00001&type=abstractinfo:eu-repo/semantics/altIdentifier/url/https://goo.gl/N5RQDdinfo:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T09:43:23Zoai:ri.conicet.gov.ar:11336/16473instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 09:43:24.251CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse |
dc.title.none.fl_str_mv |
Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia |
title |
Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia |
spellingShingle |
Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia Bilkis, Manuel D. Pneumonia Chest Radiographs Predictive Factors |
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 |
dc.creator.none.fl_str_mv |
Bilkis, Manuel D. Gorgal, Nelly Carbone, Miriam Vazquez, Mirta Albanese, Paulo Branda, María Cecilia Alterman, Elías Rodriguez, Daniela Andrea Orellana, Liliana Bello Pedrosa, Osvaldo |
author |
Bilkis, Manuel D. |
author_facet |
Bilkis, Manuel D. Gorgal, Nelly Carbone, Miriam Vazquez, Mirta Albanese, Paulo Branda, María Cecilia Alterman, Elías Rodriguez, Daniela Andrea Orellana, Liliana Bello Pedrosa, Osvaldo |
author_role |
author |
author2 |
Gorgal, Nelly Carbone, Miriam Vazquez, Mirta Albanese, Paulo Branda, María Cecilia Alterman, Elías Rodriguez, Daniela Andrea Orellana, Liliana Bello Pedrosa, Osvaldo |
author2_role |
author author author author author author author author author |
dc.subject.none.fl_str_mv |
Pneumonia Chest Radiographs Predictive Factors |
topic |
Pneumonia Chest Radiographs Predictive Factors |
purl_subject.fl_str_mv |
https://purl.org/becyt/ford/1.1 https://purl.org/becyt/ford/1 |
dc.description.none.fl_txt_mv |
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 (J 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. Fil: Bilkis, Manuel D.. Hospital de Niños "Ricardo Gutiérrez"; Argentina Fil: Gorgal, Nelly. Centro Hospitalario "Pereira Rossell"; Uruguay Fil: Carbone, Miriam. Hospital de Agudos "Diego Paroissien"; Argentina Fil: Vazquez, Mirta. Policlínico del Docente; Argentina Fil: Albanese, Paulo. Hospital de Agudos "Enrique Tornú"; Argentina Fil: Branda, María Cecilia. Hospital de Niños "Ricardo Gutiérrez"; Argentina Fil: Alterman, Elías. Hospital de Niños "Ricardo Gutiérrez"; Argentina. Universidad de Buenos Aires; Argentina Fil: Rodriguez, Daniela Andrea. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Cálculo; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Orellana, Liliana. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Cálculo; Argentina Fil: Bello Pedrosa, Osvaldo. Universidad de la República; Uruguay |
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 (J 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. |
publishDate |
2010 |
dc.date.none.fl_str_mv |
2010-06 |
dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://purl.org/coar/resource_type/c_6501 info:ar-repo/semantics/articulo |
format |
article |
status_str |
publishedVersion |
dc.identifier.none.fl_str_mv |
http://hdl.handle.net/11336/16473 Bilkis, Manuel D.; Gorgal, Nelly; Carbone, Miriam; Vazquez, Mirta; Albanese, Paulo; et al.; Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia; Lippincott Williams; Pediatric Emergency Care; 26; 6; 6-2010; 399-405 0749-5161 |
url |
http://hdl.handle.net/11336/16473 |
identifier_str_mv |
Bilkis, Manuel D.; Gorgal, Nelly; Carbone, Miriam; Vazquez, Mirta; Albanese, Paulo; et al.; Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia; Lippincott Williams; Pediatric Emergency Care; 26; 6; 6-2010; 399-405 0749-5161 |
dc.language.none.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
info:eu-repo/semantics/altIdentifier/doi/10.1097/PEC.0b013e3181e05779 info:eu-repo/semantics/altIdentifier/url/http://journals.lww.com/pec-online/pages/articleviewer.aspx?year=2010&issue=06000&article=00001&type=abstract info:eu-repo/semantics/altIdentifier/url/https://goo.gl/N5RQDd |
dc.rights.none.fl_str_mv |
info:eu-repo/semantics/openAccess https://creativecommons.org/licenses/by-nc-sa/2.5/ar/ |
eu_rights_str_mv |
openAccess |
rights_invalid_str_mv |
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/ |
dc.format.none.fl_str_mv |
application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Lippincott Williams |
publisher.none.fl_str_mv |
Lippincott Williams |
dc.source.none.fl_str_mv |
reponame:CONICET Digital (CONICET) instname:Consejo Nacional de Investigaciones Científicas y Técnicas |
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CONICET Digital (CONICET) |
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CONICET Digital (CONICET) |
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Consejo Nacional de Investigaciones Científicas y Técnicas |
repository.name.fl_str_mv |
CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas |
repository.mail.fl_str_mv |
dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar |
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1844613366406971392 |
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13.070432 |