Validation of clinical case definition of acute intussusception in infants in Viet Nam and Australia

被引:22
作者
Bines, Julie E. [1 ]
Liem, Nguyen Thanh
Justice, Frances
Son, Tran Ngoc
Carlin, John B.
de Campo, Margaret
Jamsen, Kris
Mulholland, Kim
Barnett, Peter
Barnes, Graeme L.
机构
[1] Murdoch Childrens Res Inst, Clin Epidemiol & Biostat Unit, Melbourne, Vic, Australia
[2] Natl Hosp Paediat, Dept Surg, Hanoi, Vietnam
[3] Monash Med Ctr, Dept Med Imaging, Clayton, Vic 3168, Australia
[4] Univ Melbourne, Dept Paediat, Ctr Int Child Hlth, Parkville, Vic 3052, Australia
[5] Royal Childrens Hosp, Dept Emergency Med, Melbourne, Vic, Australia
关键词
D O I
10.2471/BLT.05.025445
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
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.
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页码:569 / 575
页数:7
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