| Title: |
External validation of a multivariable prediction model for identification of pneumonia and other serious bacterial infections in febrile immunocompromised children |
| Authors: |
Martin, Alexander James; van der Velden, Fabian Johannes Stanislaus; von Both, Ulrich; Tsolia, Maria N; Zenz, Werner; Sagmeister, Manfred; Vermont, Clementien; de Vries, Gabriella; Kolberg, Laura; Lim, Emma; Pokorn, Marko; Zavadska, Dace; Martinón-Torres, Federico; Rivero-Calle, Irene; Hagedoorn, Nienke N; Usuf, Effua; Schlapbach, Luregn; Kuijpers, Taco W; Pollard, Andrew J; Yeung, Shunmay; Fink, Colin; Voice, Marie; Carrol, Enitan; Agyeman, Philipp K A; Khanijau, Aakash; Paulus, Stephane; De, Tisham; Herberg, Jethro Adam; Levin, Michael; van der Flier, Michiel; de Groot, Ronald; Nijman, Ruud; Emonts, Marieke; on behalf of the PERFORM consortium; Cunnington, Aubrey; Herberg, Jethro; Kaforou, Myrsini; Wright, Victoria; Baumard, Lucas; Bellos, Evangelos; D’Souza, Giselle; Galassini, Rachel; Habgood-Coote, Dominic; Hamilton, Shea; Hoggart, Clive; Hourmat, Sara; Jackson, Heather; Maconochie, Ian; Menikou, Stephanie; Lin, Naomi; Nichols, Samuel; Powell, Oliver; Paz, Ivonne Pena; Shah, Priyen; Shen, Ching-Fen; Vito, Ortensia; Wilson, Clare; Abdulla, Amina; Ali, Ladan; Darnell, Sarah; Jorgensen, Rikke; Mustafa, Sobia; Persand, Salina; Stevens, Molly M.; Kim, Nayoung; Kim, Eunjung; Fidler, Katy; Dudley, Julia; Richmond, Vivien; Tavliavini, Emma; Liu, Ching-Chuan; Wang, Shih-Min; Salas, Antonio; González, Fernando Álvez; Farto, Cristina Balo; Barral-Arca, Ruth; Castro, María Barreiro; Bello, Xabier; García, Mirian Ben; Carnota, Sandra; Cebey-López, Miriam; Curras-Tuala, María José; Suárez, Carlos Durán; Vicente, Luisa García; Gómez-Carballa, Alberto; Rial, Jose Gómez; Iglesias, Pilar Leboráns; Martinón-Torres, Nazareth; Sánchez, JoséMaría; Pérez, Belén Mosquera; Pardo-Seco, Jacobo; Rodríguez, Lidia Piñeiro; Pischedda, Sara; Vázquez, Sara Rey; Calle, Irene Rivero; Rodríguez-Tenreiro, Carmen; Redondo-Collazo, Lorenzo; Ora, Miguel Sadiki; Fernández, Sonia Serén; Trasorras, Cristina Serén; Iglesias, Marisol Vilas; Balode, Anda; Barzdina, Arta; Deksne, Darta; Gardovska, Dace; Gravele, Dagne; Grope, Ilze; Meiere, Anija; Nokalna, Ieva; Pavare, Jana; Pucuka, Zanda; Selecka, Katrina; Rudzate, Aleksandra; Svile, Dace; Urbane, Urzula Nora; Bojang, Kalifa; Zaman, Syed M. A.; Secka, Fatou; Anderson, Suzanne; Sarr, Anna RocaIsatou; Saidykhan, Momodou; Darboe, Saffiatou; Ceesay, Samba; D’alessandro, Umberto; Moll, Henriëtte A.; Vermont, Clementien L; Borensztajn, Dorine M.; Hagedoorn, Nienke N.; Tan, Chantal; Zachariasse, Joany; Dik, W; Agyeman, Philipp KA; Berger, Christoph; Giannoni, Eric; Stocker, Martin; Posfay-Barbe, Klara M; Heininger, Ulrich; Bernhard-Stirnemann, Sara; Niederer-Loher, Anita; Kahlert, Christian R.; Natalucci, Giancarlo; Relly, Christa; Riedel, Thomas; Aebi, Christoph; Schlapbach, Luregn J; Carrol, Enitan D; Cocklin, Elizabeth; Jennings, Rebecca; Johnston, Joanne; Leigh, Simon; Lewis-Burke, Nadia; Newall, Karen; Romaine, Sam; Tsolia, Maria; Eleftheriou, Irini; Tambouratzi, Maria; Marmarinos, Antonis; Xagorari, Marietta; Syggelou, Kelly; Calvo-Bado, Leo; Kohlmaier, Benno; Schweintzger, Nina A.; Sagmeister, Manfred G.; Kohlfürst, Daniela S.; Zurl, Christoph; Binder, Alexander; Hösele, Susanne; Leitner, Manuel; Pölz, Lena; Rajic, Glorija; Bauchinger, Sebastian; Baumgart, Hinrich; Benesch, Martin; Ceolotto, Astrid; Eber, Ernst; Gallistl, Siegfried; Gores, Gunther; Haidl, Harald; Hauer, Almuthe; Hude, Christa; Keldorfer, Markus; Krenn, Larissa; Pilch, Heidemarie; Pfleger, Andreas; Pfurtscheller, Klaus; Nordberg, Gudrun; Niedrist, Tobias; Rödl, Siegfried; Skrabl-Baumgartner, Andrea; Sperl, Matthias; Stampfer, Laura; Strenger, Volker; Till, Holger; Trobisch, Andreas; Löffler, Sabine; Dewez, Juan Emmanuel; Hibberd, Martin; Bath, David; Miners, Alec; Fitchett, Elizabeth; Groot, Ronald de; Flier, Michiel van der; de Jonge, Marien I.; Aerde, Koen van; Alkema, Wynand; Broek, Bryan van den; Gloerich, Jolein; van Gool, Alain J.; Henriet, Stefanie; Huijnen, Martijn; Philipsen, Ria; Willems, Esther; Gerrits, G.P.J.M.; van Leur, M.; Heidema, J.; de Haan, L.; Miedema, C.J.; Neeleman, C.; Obihara, C.C.; Tramper-Stranders, G.A.; Pollard, Andrew J.; Kandasamy, Rama; Paulus, Stéphane; Carter, Michael J.; O'Connor, Daniel; Bibi, Sagida; Kelly, Dominic F.; Gurung, Meeru; Thorson, Stephen; Ansari, Imran; Murdoch, David R.; Shrestha, Shrijana; Oliver, Zoe; Valentine, Lucille; Allen, Karen; Bell, Kathryn; Chan, Adora; Crulley, Stephen; Devine, Kirsty; Fabian, Daniel; King, Sharon; McAlinden, Paul; McDonald, Sam; McDonnell, Anne; Pickering, Ailsa; Thomson, Evelyn; Wood, Amanda; Wallia, Diane; Woodsford, Phil; Baxter, Frances; Bell, Ashley; Rhodes, Mathew; Agbeko, Rachel; Mackerness, Christine; Baas, Bryan; Kloosterhuis, Lieke; Oosthoek, Wilma; Arif, Tasnim; Bennet, Joshua; Collings, Kalvin; Giessen, Ilona van der; Martin, Alex; Rashid, Aqeela; Rowlands, Emily; Vries, Gabriella de; Velden, Fabian van der; Soon, Joshua; Martin, Mike; Mistry, Ravi; Both, Ulrich von; Zwerenz, Manuela; Bidlingmaier, Christoph; Binder, Vera; Haas, Nikolaus; Griese, Matthias; Feuchtinger, Tobias; Keil, Julia; Kappler, Matthias; Lurz, Eberhard; Muench, Georg; Reiter, Karl; Schoen, Carola; Mallet, Francois; Brengel-Pesce, Karen; Pachot, Alexandre; Mommert, Marine; Kolnik, Mojca; Vincek, Katarina; Srovin, Tina Plankar; Bahovec, Natalija; Prunk, Petra; Osterman, Veronika; Avramoska, Tanja; Kuijpers, Taco; Jongerius, Ilse; van den Berg, J.M.; Schonenberg, D.; Barendregt, A.M.; Pajkrt, D.; van der Kuip, M.; van Furth, A.M.; Sprenkeler, Evelien; Zandstra, Judith; van Mierlo, G.; Geissler, J.; Danhauser, Katharina |
| Publisher Information: |
BMJ Publishing Group Ltd |
| Publication Year: |
2024 |
| Collection: |
HighWire Press (Stanford University) |
| Subject Terms: |
Original research |
| Description: |
Objective To externally validate and update the Feverkids tool clinical prediction model for differentiating bacterial pneumonia and other serious bacterial infections (SBIs) from non-SBI causes of fever in immunocompromised children. Design International, multicentre, prospective observational study embedded in PErsonalised Risk assessment in Febrile illness to Optimise Real-life Management across the European Union (PERFORM). Setting Fifteen teaching hospitals in nine European countries. Participants Febrile immunocompromised children aged 0–18 years. Methods The Feverkids clinical prediction model predicted the probability of bacterial pneumonia, other SBI or no SBI. Model discrimination, calibration and diagnostic performance at different risk thresholds were assessed. The model was then re-fitted and updated. Results Of 558 episodes, 21 had bacterial pneumonia, 104 other SBI and 433 no SBI. Discrimination was 0.83 (95% CI 0.71 to 0.90) for bacterial pneumonia, with moderate calibration and 0.67 (0.61 to 0.72) for other SBIs, with poor calibration. After model re-fitting, discrimination improved to 0.88 (0.79 to 0.96) and 0.71 (0.65 to 0.76) and calibration improved. Predicted risk 10% ruled in bacterial pneumonia with specificity 0.91 (0.88 to 0.94) and positive LR 6.51 (3.71 to 10.3). Predicted risk 30% ruled in other SBIs with specificity 0.89 (0.86 to 0.92) and positive LR 2.86 (1.91 to 4.25). Conclusion Discrimination and calibration were good for bacterial pneumonia but poorer for other SBIs. The rule-out thresholds have the potential to reduce unnecessary investigations and antibiotics in this high-risk group. |
| Document Type: |
text |
| File Description: |
text/html |
| Language: |
English |
| Relation: |
http://adc.bmj.com/cgi/content/short/109/1/58; http://dx.doi.org/10.1136/archdischild-2023-325869 |
| DOI: |
10.1136/archdischild-2023-325869 |
| Availability: |
http://adc.bmj.com/cgi/content/short/109/1/58; https://doi.org/10.1136/archdischild-2023-325869 |
| Rights: |
Copyright (C) 2024, BMJ Publishing Group Ltd |
| Accession Number: |
edsbas.AF31B8AE |
| Database: |
BASE |