Development and Validation of a New Clinical Scale for Infants with Acute Respiratory Infection: The ReSVinet Scale

作者:Jose Justicia Grande Antonio; Pardo Seco Jacobo; Cebey Lopez Miriam; Vilanova Trillo Lucia; Gomez Carballa Alberto; Rivero Calle Irene; Puente Puig Maria; Curros Novo Carmen; Gomez Rial Jose; Salas Antonio; Maria Martinon Sanchez Jose; Redondo Collazo Lorenzo; Rodriguez Tenreiro Carmen; Martinon Torres Federico
来源:PLos One, 2016, 11(6): e0157665.
DOI:10.1371/journal.pone.0157665

摘要

Background and Aims A properly validated scoring system allowing objective categorization of infants with acute respiratory infections (ARIs), avoiding the need for in-person assessment and that could also be used by non-health professionals is currently not available. We aimed to develop a new clinical assessment scale meeting these specifications. Methods We designed a clinical scale (ReSVinet scale) based on seven parameters (feeding intolerance, medical intervention, respiratory difficulty, respiratory frequency, apnoea, general condition, fever) that were assigned different values (from 0 to 3) for a total of 20 points. 170 children under two years of age with ARI were assessed independently by three pediatricians using this scale. Parents also evaluated their offspring with an adapted version of the scale in a subset of 61 cases. The scale was tested for internal consistency (Cronbach's alpha), Pearson correlation coefficient for the items in the scale, inter-observer reliability (kappa index) and floor-ceiling effect. Results Internal consistency was good for all the observers, with the lowest Cronbach's alpha being 0.72. There was a strong correlation between the investigators (r-value ranged 0.76-0.83) and also between the results obtained by the parents and the investigators(r = 0.73). Light's kappa for the observations of the three investigators was 0.74. Weighted kappa in the group evaluated by the parents was 0.73. The final score was correlated with length of hospital stay, PICU admission and Wood-Downes Score. Conclusions The ReSVinet scale may be useful and reliable in the evaluation of infants with ARI, particularly acute bronchiolitis, even with data obtained from medical records and when employed by parents. Although further studies are necessary, ReSVinet scale already complies with more score validation criteria than the vast majority of the alternatives currently available and used in the clinical practice.

  • 出版日期2016-6-21