Michal Stein (Israel)
Hillel Yaffe Infectious diseasesAuthor Of 1 Presentation
BV SCORE’S PERFORMANCE WHEN APPLIED ACCORDING TO INDICATIONS FOR USE AS PART OF ROUTINE CARE FOR CHILDREN PRESENTING TO THE ED WITH FEVER WITHOUT SOURCE
Abstract
Backgrounds:
Up to 20% of febrile pediatric patients presenting to the emergency department (ED) will not have a source identified by history or physical examination. Most of these patients have self-limiting viral illnesses, but ~10% could be bacterially infected. A host-protein bacterial likelihood score (BV score) based on TRAIL, IP-10 and CRP has demonstrated high performance for differentiating bacterial from viral infections in multiple validation studies. Here we evaluate for the first time BV Score's performance when applied according to instructions for use in routine care of children presenting to the ED with fever without source (FWS).
Methods
A retrospective analysis of patients aged 3 months to 18 years at two medical centers for whom BV score was measured as part of routine care (NCT03075111; 2014–2017). For each patient, the physician documented suspected clinical syndrome at the time of blood draw for BV score. TRAIL and IP-10 were measured, and BV score calculated using ImmunoXpert™. CRP was measured using COBASc501. Reference standard for infection etiology was adjudicated by 3 independent experts based on the patient’s clinical, laboratory and microbiologic data.
Results:
2160 of 3006 patients met the current indication for use for measuring the BV score, of whom 788 were documented by the physician as suspected FWS; 69 patients were adjudicated as bacterial, 518 as viral and 201 as indeterminate. Median age was 2 years (IQR 4.08), 53% were male. The BV score attained sensitivity of 88.1% (95% CI, 77.1%-95.1%), specificity of 93.7% (91.1%-95.8%) and NPV of 98.4% (96.8%-99.2%). The equivocal rate was 13.1%.
Conclusions/Learning Points:
The BV score demonstrated high diagnostic performance when applied according to it indication for use as part of routine care for children presenting to the ED with FWS.
Presenter of 1 Presentation
BV SCORE’S PERFORMANCE WHEN APPLIED ACCORDING TO INDICATIONS FOR USE AS PART OF ROUTINE CARE FOR CHILDREN PRESENTING TO THE ED WITH FEVER WITHOUT SOURCE
Abstract
Backgrounds:
Up to 20% of febrile pediatric patients presenting to the emergency department (ED) will not have a source identified by history or physical examination. Most of these patients have self-limiting viral illnesses, but ~10% could be bacterially infected. A host-protein bacterial likelihood score (BV score) based on TRAIL, IP-10 and CRP has demonstrated high performance for differentiating bacterial from viral infections in multiple validation studies. Here we evaluate for the first time BV Score's performance when applied according to instructions for use in routine care of children presenting to the ED with fever without source (FWS).
Methods
A retrospective analysis of patients aged 3 months to 18 years at two medical centers for whom BV score was measured as part of routine care (NCT03075111; 2014–2017). For each patient, the physician documented suspected clinical syndrome at the time of blood draw for BV score. TRAIL and IP-10 were measured, and BV score calculated using ImmunoXpert™. CRP was measured using COBASc501. Reference standard for infection etiology was adjudicated by 3 independent experts based on the patient’s clinical, laboratory and microbiologic data.
Results:
2160 of 3006 patients met the current indication for use for measuring the BV score, of whom 788 were documented by the physician as suspected FWS; 69 patients were adjudicated as bacterial, 518 as viral and 201 as indeterminate. Median age was 2 years (IQR 4.08), 53% were male. The BV score attained sensitivity of 88.1% (95% CI, 77.1%-95.1%), specificity of 93.7% (91.1%-95.8%) and NPV of 98.4% (96.8%-99.2%). The equivocal rate was 13.1%.
Conclusions/Learning Points:
The BV score demonstrated high diagnostic performance when applied according to it indication for use as part of routine care for children presenting to the ED with FWS.
Poster Author Of 1 e-Poster
