Validation and Development of a Clinical Prediction Rule in Clinically Suspected Community-Acquired Pneumonia

Abstract

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.

Characteristics of Community-Acquired Pneumonia in Hospitalized Lebanese Children and their Correlation

“…Abdominal pain was the only clinical sign that showed significant difference with the presence of lung consolidation. This result was seen in a study done by Bilkis et al (p=0.009) [10], where cough and chest pain were also correlated with pneumonia, however, patients younger than 1 year of age or who were treated with "more than one bronchodilator treatment in the emergency unit" were excluded from the study. This can explain the variation in the results, as children younger than 12 months of age are more prone to having a viral respiratory infection specifically bronchiolitis than a pneumonia [11].…”

“…Till now, there is no criterion standard for the diagnosis of pneumonia in children. [19,20] The chest radiograph remains the diagnostic test of choice in tertiary care centers [11,21]. Several studies tried to generate a clinical prediction algorithm for bacterial pneumonia [11,19] but no one succeeded [5].…”

Impact assessment of a decision rule for using antibiotics in pneumonia: A randomized trial

“…Other attempts to guide therapeutic decisions more appropriately evaluated clinical data, laboratory tests, and chest radiography as indicators of etiology, but the wide variability in their diagnostic accuracy makes their use in daily practice difficult . To address this challenge, several other clinical prediction rules consisting exclusively of clinical elements have been designed; although these rules achieved reasonable sensitivity, their specificity was not superior to the World Health Organization diagnostic criteria . In contrast, the BPS incorporates clinical and laboratory elements and chest radiography (Fig.…”

Clinical Policy for Well-Appearing Infants and Children Younger Than 2 Years of Age Presenting to the Emergency Department With Fever

“…Based on study selection criteria, 1 Class II study 41 and 8 Class III studies [42][43][44][45][46][47][48][49] were included to answer this critical question.…”