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Validation of two algorithms for managing children with a non-blanching rash.

Riordan, F Andrew I and Jones, Laura and Clark, Julia (2016) Validation of two algorithms for managing children with a non-blanching rash. Archives of disease in childhood, 101 (8). pp. 709-13. ISSN 1468-2044. This article is available to all HEFT staff and students via ASK HEFT Discovery tool http://tinyurl.com/z795c8c using their HEFT Athens Login.

Full text not available from this repository.
Official URL: http://adc.bmj.com/content/101/8/709.long

Abstract

BACKGROUND

Paediatricians are concerned that children who present with a non-blanching rash (NBR) may have meningococcal disease (MCD). Two algorithms have been devised to help identify which children with an NBR have MCD.

AIM

To evaluate the NBR algorithms' ability to identify children with MCD.

METHODS

The Newcastle-Birmingham-Liverpool (NBL) algorithm was applied retrospectively to three cohorts of children who had presented with NBRs. This algorithm was also piloted in four hospitals, and then used prospectively for 12 months in one hospital. The National Institute for Health and Care Excellence (NICE) algorithm was validated retrospectively using data from all cohorts.

RESULTS

The cohorts included 625 children, 145 (23%) of whom had confirmed or probable MCD. Paediatricians empirically treated 324 (52%) children with antibiotics. The NBL algorithm identified all children with MCD and suggested treatment for a further 86 children (sensitivity 100%, specificity 82%). One child with MCD did not receive immediate antibiotic treatment, despite this being suggested by the algorithm. The NICE algorithm suggested 382 children (61%) who should be treated with antibiotics. This included 141 of the 145 children with MCD (sensitivity 97%, specificity 50%).

CONCLUSIONS

These algorithms may help paediatricians identify children with MCD who present with NBRs. The NBL algorithm may be more specific than the NICE algorithm as it includes fewer features suggesting MCD. The only significant delay in treatment of MCD occurred when the algorithms were not followed.

Item Type: Article
Additional Information: This article is available to all HEFT staff and students via ASK HEFT Discovery tool http://tinyurl.com/z795c8c using their HEFT Athens Login.
Subjects: WS Paediatrics. Child health
Divisions: Womens and Childrens > Paediatrics
Related URLs:
Depositing User: Miss Adele Creak
Date Deposited: 07 Mar 2017 15:23
Last Modified: 07 Mar 2017 15:23
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1252

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