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
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/16473
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/16473
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling 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 Técnicas2025-10-22T11:12:04Zoai: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:34982025-10-22 11:12:04.323CONICET 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
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str 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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score 12.982451

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