S77 Benchmarking standards in paediatric pleural infection management

Abstract

Content validity:The scoring instrument was applied to infants (n = 115) by HCPs who were asked to rate each item/ domain for clinical relevance. All items/domains were assessed as relevant. However there were substantial missing data for two domains (chest auscultation/blood gas analysis) as certain HCP groups could not undertake these procedures. These two domains were consequently removed.Cognitive interviewing: HCPs (n = 15) were interviewed in order to assess comprehension, interpretation and how they arrived at their responses for each item/domain in the scoring instrument. Understanding of medical vocabulary was assessed. 'Sub-sternal recession' was removed and 'anuric' changed to 'not passed urine'. Construct validity & paediatrician inter-rater reliability:HCPs applied the scoring instrument to infants (n = 128) whilst two senior doctors assessed whether the infant had 'mild', 'moderate' or 'severe' bronchiolitis. Cut points within the score have now been established for 'mild', 'moderate' and 'severe' bronchiolitis. Conclusions We have developed and partially validated a clinical severity score for infants with bronchiolitis. Criterion and reliability testing of the score is planned for the 2013/14 bronchiolitis season. Responsiveness to change will be assessed in a future clinical trial.