Development and Validation of a New Clinical Scale for Infants with Acute Respiratory Infection: The ReSVinet Scale

Abstract

Background and AimsA properly validated scoring system allowing objective categorization of infants with acute respiratory infections (ARIs), avoiding the need for in-person assessment and that could also be used by non-health professionals is currently not available. We aimed to develop a new clinical assessment scale meeting these specifications.MethodsWe designed a clinical scale (ReSVinet scale) based on seven parameters (feeding intolerance, medical intervention, respiratory difficulty, respiratory frequency, apnoea, general condition, fever) that were assigned different values (from 0 to 3) for a total of 20 points.170 children under two years of age with ARI were assessed independently by three pediatricians using this scale. Parents also evaluated their offspring with an adapted version of the scale in a subset of 61 cases. The scale was tested for internal consistency (Cronbach’s alpha), Pearson correlation coefficient for the items in the scale, inter-observer reliability (kappa index) and floor-ceiling effect.ResultsInternal consistency was good for all the observers, with the lowest Cronbach’s alpha being 0.72. There was a strong correlation between the investigators (r-value ranged 0.76–0.83) and also between the results obtained by the parents and the investigators(r = 0.73). Light’s kappa for the observations of the three investigators was 0.74. Weighted kappa in the group evaluated by the parents was 0.73. The final score was correlated with length of hospital stay, PICU admission and Wood-Downes Score.ConclusionsThe ReSVinet scale may be useful and reliable in the evaluation of infants with ARI, particularly acute bronchiolitis, even with data obtained from medical records and when employed by parents. Although further studies are necessary, ReSVinet scale already complies with more score validation criteria than the vast majority of the alternatives currently available and used in the clinical practice.

Delivery of ALX-0171 by inhalation greatly reduces respiratory syncytial virus disease in newborn lambs

“…Each clinical sign was individually scored, which may not be the best measure for the severity of disease because single clinical signs do not correlate well with the degree of dyspnoea and airway narrowing in acute wheeze in human infants 25 . In infants with acute respiratory infections, clinical scoring usually relies on a combination of clinical symptoms and signs (feeding intolerance, medical intervention, respiratory difficulty, respiratory frequency, apnoea, general condition, fever) 25 .…”

“…In infants with acute respiratory infections, clinical scoring usually relies on a combination of clinical symptoms and signs (feeding intolerance, medical intervention, respiratory difficulty, respiratory frequency, apnoea, general condition, fever) 25 . For this reason, an exploratory composite clinical score was calculated post-hoc for each lamb in the treatment and post-treatment period based on the scoring of the individual clinical signs.…”

Metabolomic Profiling of Infants With Recurrent Wheezing After Bronchiolitis

“…Table 1 shows the characteristics and metadata for these 2 subgroups. The severity of bronchiolitis was assessed using the Respiratory Syncytial Virus Network scale, based on feeding intolerance, medical intervention, respiratory difficulty, respiratory frequency, apnea, general condition, and fever [14]. No significant differences emerged in the metadata between the recurrent wheezing and the no wheezing groups (Table 1).…”

Nebulised hypertonic saline in children with bronchiolitis admitted to the paediatric intensive care unit: A retrospective study

“…Besides that, it is not always clear why certain decisions were made. Although the general severity of disease was scored by the PRISM and PELOD score, no specific clinical score for bronchiolitis could be used in this study as they were either based on clinical examination that could not be retrieved retrospectively, such as the Tal score, modified Tal score or RESVINET score, or were not appropriate for use in exclusively hospitalised children, such as the Larrañaga score . On the other hand, we believe our data are robust enough to be considered as valuable: the two groups did not differ in all considered characteristics including the severity of illness.…”

“…Another explanation for the heterogeneity seen in the included studies is the amount of different scoring systems that can be used for determining the disease severity. A few examples are the respiratory distress assessment instrument, the respiratory assessment change score, the Larrañaga score, the Tal score and the recently designed REspiratory Syncytial Virus Network (RESVINET) score . Finally, there was also a difference seen in outcome measures.…”