Performance of thirteen clinical rules to distinguish bacterial and presumed viral meningitis in Vietnamese children.

<h4>Background and purpose</h4>Successful outcomes from bacterial meningitis require rapid antibiotic treatment; however, unnecessary treatment of viral meningitis may lead to increased toxicities and expense. Thus, improved diagnostics are required to maximize treatment and minimize sid...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Nguyen Tien Huy, Nguyen Thanh Hong Thao, Nguyen Anh Tuan, Nguyen Tuan Khiem, Christopher C Moore, Doan Thi Ngoc Diep, Kenji Hirayama
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/088a3ebb4abb4cc49d70d015c4a5b35d
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:088a3ebb4abb4cc49d70d015c4a5b35d
record_format	dspace
spelling	oai:doaj.org-article:088a3ebb4abb4cc49d70d015c4a5b35d2021-11-18T08:07:14ZPerformance of thirteen clinical rules to distinguish bacterial and presumed viral meningitis in Vietnamese children.1932-620310.1371/journal.pone.0050341https://doaj.org/article/088a3ebb4abb4cc49d70d015c4a5b35d2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23209715/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background and purpose</h4>Successful outcomes from bacterial meningitis require rapid antibiotic treatment; however, unnecessary treatment of viral meningitis may lead to increased toxicities and expense. Thus, improved diagnostics are required to maximize treatment and minimize side effects and cost. Thirteen clinical decision rules have been reported to identify bacterial from viral meningitis. However, few rules have been tested and compared in a single study, while several rules are yet to be tested by independent researchers or in pediatric populations. Thus, simultaneous test and comparison of these rules are required to enable clinicians to select an optimal diagnostic rule for bacterial meningitis in settings and populations similar to ours.<h4>Methods</h4>A retrospective cross-sectional study was conducted at the Infectious Department of Pediatric Hospital Number 1, Ho Chi Minh City, Vietnam. The performance of the clinical rules was evaluated by area under a receiver operating characteristic curve (ROC-AUC) using the method of DeLong and McNemar test for specificity comparison.<h4>Results</h4>Our study included 129 patients, of whom 80 had bacterial meningitis and 49 had presumed viral meningitis. Spanos's rule had the highest AUC at 0.938 but was not significantly greater than other rules. No rule provided 100% sensitivity with a specificity higher than 50%. Based on our calculation of theoretical sensitivity and specificity, we suggest that a perfect rule requires at least four independent variables that posses both sensitivity and specificity higher than 85-90%.<h4>Conclusions</h4>No clinical decision rules provided an acceptable specificity (>50%) with 100% sensitivity when applying our data set in children. More studies in Vietnam and developing countries are required to develop and/or validate clinical rules and more very good biomarkers are required to develop such a perfect rule.Nguyen Tien HuyNguyen Thanh Hong ThaoNguyen Anh TuanNguyen Tuan KhiemChristopher C MooreDoan Thi Ngoc DiepKenji HirayamaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 11, p e50341 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Nguyen Tien Huy Nguyen Thanh Hong Thao Nguyen Anh Tuan Nguyen Tuan Khiem Christopher C Moore Doan Thi Ngoc Diep Kenji Hirayama Performance of thirteen clinical rules to distinguish bacterial and presumed viral meningitis in Vietnamese children.
description	<h4>Background and purpose</h4>Successful outcomes from bacterial meningitis require rapid antibiotic treatment; however, unnecessary treatment of viral meningitis may lead to increased toxicities and expense. Thus, improved diagnostics are required to maximize treatment and minimize side effects and cost. Thirteen clinical decision rules have been reported to identify bacterial from viral meningitis. However, few rules have been tested and compared in a single study, while several rules are yet to be tested by independent researchers or in pediatric populations. Thus, simultaneous test and comparison of these rules are required to enable clinicians to select an optimal diagnostic rule for bacterial meningitis in settings and populations similar to ours.<h4>Methods</h4>A retrospective cross-sectional study was conducted at the Infectious Department of Pediatric Hospital Number 1, Ho Chi Minh City, Vietnam. The performance of the clinical rules was evaluated by area under a receiver operating characteristic curve (ROC-AUC) using the method of DeLong and McNemar test for specificity comparison.<h4>Results</h4>Our study included 129 patients, of whom 80 had bacterial meningitis and 49 had presumed viral meningitis. Spanos's rule had the highest AUC at 0.938 but was not significantly greater than other rules. No rule provided 100% sensitivity with a specificity higher than 50%. Based on our calculation of theoretical sensitivity and specificity, we suggest that a perfect rule requires at least four independent variables that posses both sensitivity and specificity higher than 85-90%.<h4>Conclusions</h4>No clinical decision rules provided an acceptable specificity (>50%) with 100% sensitivity when applying our data set in children. More studies in Vietnam and developing countries are required to develop and/or validate clinical rules and more very good biomarkers are required to develop such a perfect rule.
format	article
author	Nguyen Tien Huy Nguyen Thanh Hong Thao Nguyen Anh Tuan Nguyen Tuan Khiem Christopher C Moore Doan Thi Ngoc Diep Kenji Hirayama
author_facet	Nguyen Tien Huy Nguyen Thanh Hong Thao Nguyen Anh Tuan Nguyen Tuan Khiem Christopher C Moore Doan Thi Ngoc Diep Kenji Hirayama
author_sort	Nguyen Tien Huy
title	Performance of thirteen clinical rules to distinguish bacterial and presumed viral meningitis in Vietnamese children.
title_short	Performance of thirteen clinical rules to distinguish bacterial and presumed viral meningitis in Vietnamese children.
title_full	Performance of thirteen clinical rules to distinguish bacterial and presumed viral meningitis in Vietnamese children.
title_fullStr	Performance of thirteen clinical rules to distinguish bacterial and presumed viral meningitis in Vietnamese children.
title_full_unstemmed	Performance of thirteen clinical rules to distinguish bacterial and presumed viral meningitis in Vietnamese children.
title_sort	performance of thirteen clinical rules to distinguish bacterial and presumed viral meningitis in vietnamese children.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/088a3ebb4abb4cc49d70d015c4a5b35d
work_keys_str_mv	AT nguyentienhuy performanceofthirteenclinicalrulestodistinguishbacterialandpresumedviralmeningitisinvietnamesechildren AT nguyenthanhhongthao performanceofthirteenclinicalrulestodistinguishbacterialandpresumedviralmeningitisinvietnamesechildren AT nguyenanhtuan performanceofthirteenclinicalrulestodistinguishbacterialandpresumedviralmeningitisinvietnamesechildren AT nguyentuankhiem performanceofthirteenclinicalrulestodistinguishbacterialandpresumedviralmeningitisinvietnamesechildren AT christophercmoore performanceofthirteenclinicalrulestodistinguishbacterialandpresumedviralmeningitisinvietnamesechildren AT doanthingocdiep performanceofthirteenclinicalrulestodistinguishbacterialandpresumedviralmeningitisinvietnamesechildren AT kenjihirayama performanceofthirteenclinicalrulestodistinguishbacterialandpresumedviralmeningitisinvietnamesechildren
_version_	1718422149648089088

Performance of thirteen clinical rules to distinguish bacterial and presumed viral meningitis in Vietnamese children.

Ejemplares similares