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Clinical prediction model to aid emergency doctors managing febrile children at risk of serious bacterial infections: diagnostic study

Methodology Score: 2.5/5
Usefulness Score: 2/5


Nijman RG, et al. BMJ. 2013 Apr 2;346:f1706

Full Article

This was a derivation, cross-validation, and external validation of a decision rule for the febrile pediatric patient to identify who is at risk of a serious bacterial infection, pneumonia, or not at risk. While the study contained a large number of patients, the rule was felt to not be clinically useful, as it used clinical features many of us already use to make our clinical decisions, had too many indeterminate results, and required blood work to obtain a CRP. 
By: Dr. Hasan Sheikh
(Reviewed March 2015) 


Epi lesson: What is a Clinically Sensible Clinical Decision Rule? 
Clinical decision rules for emergency medicine should be “clinically sensible.” This means the rules should be easy to use and comprised of as few variables as possible. Emergency physicians prefer rules that give a simple yes/no answer or use a basic scoring system that can be quickly calculated. The component variables should make have good face validity for clinicians. 
By: Dr. Ian Stiell

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