Observational Assessment in the Febrile Infant

McCarthy, Paul L.

doi:10.1542/peds.2017-1100

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…The high sensitivity of the YOS to predict patients with serious illness in our study was also comparable with that reported in other studies [4,6,12,15]. Three of these were conducted in developed or semi-developed countries (2 studies in USA, 1 study in UK and 1 in Turkey) and included relatively older children (<24 months or <36 months) than those included in other studies (<60 days) [3,17]. These findings indicate that the YOS may be more useful in children aged >3 months rather than in younger infants.…”

Section: Discussionsupporting

confidence: 90%

“…The difference with our results may be attributable to a younger cohort compared to that in our study. Indeed, the YOS has been reported to have limited diagnostic efficacy when evaluating febrile infants in the first 2-3 months of life [3]. That is because this group has less-developed repertoire of responses to stimuli compared with older children.…”

Section: Discussionmentioning

confidence: 99%

“…The Yale Observation Scale (YOS), also called the Acute Illness Observation Scale, was developed to help detect serious illness in febrile children. The sensitivity and specificity of the scale vary from poor to good depending on the setting in which it is applied [1][2][3]. The diagnostic value of the YOS has been tested in different groups [4][5][6][7][8][9][10][11][12][13][14][15][16][17], but never in general clinical settings in Japan.…”

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confidence: 99%

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Yale Observation Scale for Predicting Serious Illness in Japanese Primary Care Settings

Masuda

Muto

Kishino

et al. 2019

Preprint

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Objectives The Yale observation scale (YOS), also called the Acute Illness Observation Scale, was developed to help detect serious illness in febrile children. We conducted this study to evaluate the clinical utility of the YOS for predicting serious illness in Japanese primary care settings. Method We conducted a prospective observational study from June 2015 to January 2018. We enrolled patients younger than 10 years, who attended the primary care centre at the Aichi Medical University Hospital and who had recorded YOS scores. Serious illnesses included invasive bacterial infections and any conditions requiring artificial ventilation, surgical treatment, or cardiopulmonary resuscitation. We calculated point estimates for YOS sensitivity and specificity for predicting serious illness and hospitalisation. We evaluated the area under the receiver operating characteristic curve (AUC) by the Youden index. Results The 260 participants (227 outpatients and 33 inpatients) had a median age of 1.75 years (range, 0–10); 80 (30.8%) were younger than 1 year, 131 (50.4 %) between 1 and 3 years, 44 (16.9%) between 4 and 7 years, and 5 (1.9%) between 8 and 10 years. Infectious illness was the most common diagnosis (n = 211), followed by allergic disease (n = 11) and trauma (n = 10). Among the 211 patients with infectious illness, upper respiratory tract infections were the most common (n = 55). Fourteen patients among the 29 with YOS >10, and 19 among those with YOS ≤10 were hospitalised. We found 6 patients with serious illnesses: intussusception (n = 1; YOS, 22), encephalitis (n = 1; YOS, 16) and urinary tract infection (n = 4; YOSs, 18, 16, 8 and 6). The sensitivity and specificity of the YOS for predicting serious illness at a cut-off point of 10 were 0.67 and 0.90, respectively. The corresponding values for hospitalisation at that cut-off point were 0.42 and 0.93, respectively. The AUCs of the YOS for predicting serious illness and hospitalisation were 0. 82 (excellent) and 0.74 (acceptable). Conclusions We conclude that a YOS >10 may be useful to predict severe paediatric diseases in Japanese primary care settings.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Yale Observation Scale for Predicting Serious Illness in Japanese Primary Care Settings

Masuda

Muto

Kishino

et al. 2019

Preprint

View full text Add to dashboard Cite

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“…The Yale Observation Scale (YOS) is an illness severity scale using simple observations which is easily applicable. [5][6][7][8][9][10][11][12] The objective of this study was to observe the efficacy of YOS in detecting serious bacterial infection in febrile children 1 to 36 months of age. Permission was taken from hospital authority.…”

Section: Introductionsmentioning

confidence: 99%