Validation of clinical case definition of acute intussusception in infants in Viet Nam and Australia
OBJECTIVE: To test the sensitivity and specificity of a clinical case definition of acute intussusception in infants to assist health-care workers in settings where diagnostic facilities are not available. METHODS: Prospective studies were conducted at a major paediatric hospital in Viet Nam (the Na...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The World Health Organization
2006-07-01
|
| Series: | Bulletin of the World Health Organization |
| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862006000700019&lng=en&tlng=en |
| _version_ | 1797281524609974272 |
|---|---|
| author | Julie E Bines Nguyen Thanh Liem Frances Justice Tran Ngoc Son John B Carlin Margaret de Campo Kris Jamsen Kim Mulholland Peter Barnett Graeme L Barnes |
| author_facet | Julie E Bines Nguyen Thanh Liem Frances Justice Tran Ngoc Son John B Carlin Margaret de Campo Kris Jamsen Kim Mulholland Peter Barnett Graeme L Barnes |
| author_sort | Julie E Bines |
| collection | DOAJ |
| description | OBJECTIVE: To test the sensitivity and specificity of a clinical case definition of acute intussusception in infants to assist health-care workers in settings where diagnostic facilities are not available. METHODS: Prospective studies were conducted at a major paediatric hospital in Viet Nam (the National Hospital of Pediatrics, Hanoi) from November 2002 to December 2003 and in Australia (the Royal Children's Hospital, Melbourne) from March 2002 to March 2004 using a clinical case definition of intussusception. Diagnosis of intussusception was confirmed by air enema or surgery and validated in a subset of participants by an independent clinician who was blinded to the participant's status. Sensitivity of the definition was evaluated in 584 infants aged < 2 years with suspected intussusception (533 infants in Hanoi; 51 in Melbourne). Specificity was evaluated in 638 infants aged < 2 years presenting with clinical features consistent with intussusception but for whom another diagnosis was established (234 infants in Hanoi; 404 in Melbourne). FINDINGS: In both locations the definition used was sensitive (96% sensitivity in Hanoi; 98% in Melbourne) and specific (95% specificity in Hanoi; 87% in Melbourne) for intussusception among infants with sufficient data to allow classification (449/533 in Hanoi; 50/51 in Melbourne). Reanalysis of patients with missing data suggests that modifying minor criteria would increase the applicability of the definition while maintaining good sensitivity (96-97%) and specificity (83-89%). CONCLUSION: The clinical case definition was sensitive and specific for the diagnosis of acute intussusception in infants in both a developing country and a developed country but minor modifications would enable it to be used more widely. |
| first_indexed | 2024-03-07T16:58:44Z |
| format | Article |
| id | doaj.art-26e2e0611b7d419e8ae7f999cf0f556b |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T16:58:44Z |
| publishDate | 2006-07-01 |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-26e2e0611b7d419e8ae7f999cf0f556b2024-03-03T03:30:19ZengThe World Health OrganizationBulletin of the World Health Organization0042-96862006-07-01847569575S0042-96862006000700019Validation of clinical case definition of acute intussusception in infants in Viet Nam and AustraliaJulie E Bines0Nguyen Thanh Liem1Frances Justice2Tran Ngoc Son3John B Carlin4Margaret de Campo5Kris Jamsen6Kim Mulholland7Peter Barnett8Graeme L Barnes9Murdoch Children's Research InstituteNational Hospital for PaediatricsMurdoch Children's Research InstituteNational Hospital for PaediatricsMurdoch Children's Research InstituteMonash Medical CentreMurdoch Children's Research InstituteUniversity of MelbourneRoyal Children's HospitalMurdoch Children's Research InstituteOBJECTIVE: To test the sensitivity and specificity of a clinical case definition of acute intussusception in infants to assist health-care workers in settings where diagnostic facilities are not available. METHODS: Prospective studies were conducted at a major paediatric hospital in Viet Nam (the National Hospital of Pediatrics, Hanoi) from November 2002 to December 2003 and in Australia (the Royal Children's Hospital, Melbourne) from March 2002 to March 2004 using a clinical case definition of intussusception. Diagnosis of intussusception was confirmed by air enema or surgery and validated in a subset of participants by an independent clinician who was blinded to the participant's status. Sensitivity of the definition was evaluated in 584 infants aged < 2 years with suspected intussusception (533 infants in Hanoi; 51 in Melbourne). Specificity was evaluated in 638 infants aged < 2 years presenting with clinical features consistent with intussusception but for whom another diagnosis was established (234 infants in Hanoi; 404 in Melbourne). FINDINGS: In both locations the definition used was sensitive (96% sensitivity in Hanoi; 98% in Melbourne) and specific (95% specificity in Hanoi; 87% in Melbourne) for intussusception among infants with sufficient data to allow classification (449/533 in Hanoi; 50/51 in Melbourne). Reanalysis of patients with missing data suggests that modifying minor criteria would increase the applicability of the definition while maintaining good sensitivity (96-97%) and specificity (83-89%). CONCLUSION: The clinical case definition was sensitive and specific for the diagnosis of acute intussusception in infants in both a developing country and a developed country but minor modifications would enable it to be used more widely.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862006000700019&lng=en&tlng=en |
| spellingShingle | Julie E Bines Nguyen Thanh Liem Frances Justice Tran Ngoc Son John B Carlin Margaret de Campo Kris Jamsen Kim Mulholland Peter Barnett Graeme L Barnes Validation of clinical case definition of acute intussusception in infants in Viet Nam and Australia Bulletin of the World Health Organization |
| title | Validation of clinical case definition of acute intussusception in infants in Viet Nam and Australia |
| title_full | Validation of clinical case definition of acute intussusception in infants in Viet Nam and Australia |
| title_fullStr | Validation of clinical case definition of acute intussusception in infants in Viet Nam and Australia |
| title_full_unstemmed | Validation of clinical case definition of acute intussusception in infants in Viet Nam and Australia |
| title_short | Validation of clinical case definition of acute intussusception in infants in Viet Nam and Australia |
| title_sort | validation of clinical case definition of acute intussusception in infants in viet nam and australia |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862006000700019&lng=en&tlng=en |
| work_keys_str_mv | AT julieebines validationofclinicalcasedefinitionofacuteintussusceptionininfantsinvietnamandaustralia AT nguyenthanhliem validationofclinicalcasedefinitionofacuteintussusceptionininfantsinvietnamandaustralia AT francesjustice validationofclinicalcasedefinitionofacuteintussusceptionininfantsinvietnamandaustralia AT tranngocson validationofclinicalcasedefinitionofacuteintussusceptionininfantsinvietnamandaustralia AT johnbcarlin validationofclinicalcasedefinitionofacuteintussusceptionininfantsinvietnamandaustralia AT margaretdecampo validationofclinicalcasedefinitionofacuteintussusceptionininfantsinvietnamandaustralia AT krisjamsen validationofclinicalcasedefinitionofacuteintussusceptionininfantsinvietnamandaustralia AT kimmulholland validationofclinicalcasedefinitionofacuteintussusceptionininfantsinvietnamandaustralia AT peterbarnett validationofclinicalcasedefinitionofacuteintussusceptionininfantsinvietnamandaustralia AT graemelbarnes validationofclinicalcasedefinitionofacuteintussusceptionininfantsinvietnamandaustralia |