This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Mary Anne Opavsky, MD, MSc; Derek Stephens, MSc; Elaine Ee-Ling Wang, MDCM, MSc

Arch Pediatr Adolesc Med. 1995;149(11):1217-1220.

Abstract
Objectives
To determine the sensitivity and specificity of published prognostic models to predict morbidity resulting from lower respiratory tract disease caused by respiratory syncytial virus in an independent pediatric population and to assess the accuracy of single risk factors in predicting adverse outcome.

Design
All articles obtained from a MEDLINE search that used the terms prognosis or sequelae and respiratory syncytial virus, and from the references of these articles, were reviewed. Studies were included if risk factors and outcomes were defined and if information was available in a database of prospectively enrolled patients with respiratory syncytial virus infections. A probability of adverse outcome was assigned to each patient in the cohort using prognostic models described in the articles. A test was considered positive if the probability of the adverse outcome was 5% or more.

Patients
Six hundred eighty-nine patients hospitalized with respiratory syncytial virus in seven tertiary care centers across Canada were prospectively enrolled in the Pediatric Investigators Collaborative Network on Infections in Canada database.

Main Outcome Measures
The sensitivity and specificity of single predictors and of models in predicting severe disease were determined.

Results
The sensitivity of single predictors varied from 17% to 46%. A model that used age and oxygen saturation at admission in previously well infants had a sensitivity of 98% and a specificity of 47% when predicting intensive care unit admission. Another model that included age at hospitalization, gestational age, presence of an underlying condition, and respiratory syncytial virus subtype used to predict the outcome of a high severity index had a sensitivity of 77% and a specificity of 76%. When the above model was modified by exclusion of viral subgroup, sensitivity increased to 94%, but specificity decreased to 46%.

Conclusion
Previously described prognostic models were generalizable to an independent study population.

(Arch Pediatr Adolesc Med. 1995;149:1217-1220)

Author Affiliations
From the Division of Infectious Disease (Drs Opavsky and Wang) and Clinical Epidemiology Unit (Dr Wang and Mr Stephens), The Hospital for Sick Children, Toronto, Ontario. Members of PICNIC are listed in a box on page 1220.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The Impact of Severe Respiratory Syncytial Virus on the Child, Caregiver, and Family During Hospitalization and Recovery
Leidy et al.
Pediatrics 2005;115:1536-1546.
ABSTRACT | FULL TEXT  

Differences in Admission Rates of Children With Bronchiolitis by Pediatric and General Emergency Departments
Johnson et al.
Pediatrics 2002;110:e49-49.
ABSTRACT | FULL TEXT  

Monocyte IL-10 Production during Respiratory Syncytial Virus Bronchiolitis Is Associated with Recurrent Wheezing in a One-Year Follow-up Study
BONT et al.
Am. J. Respir. Crit. Care Med. 2000;161:1518-1523.
ABSTRACT | FULL TEXT  

Respiratory Syncytial Virus Infection: Immune Response, Immunopathogenesis, and Treatment
Domachowske and Rosenberg
Clin. Microbiol. Rev. 1999;12:298-309.
ABSTRACT | FULL TEXT