In:
Frontiers in Pediatrics, Frontiers Media SA, Vol. 11 ( 2023-10-4)
Abstract:
Pulse oximeters are not routinely available in outpatient clinics in low- and middle-income countries. We derived clinical scores to identify hypoxemic child pneumonia. Methods This was a retrospective pooled analysis of two outpatient datasets of 3–35 month olds with World Health Organization (WHO)-defined pneumonia in Bangladesh and Malawi. We constructed, internally validated, and compared fit & amp; discrimination of four models predicting SpO 2 & lt; 93% and & lt;90%: (1) Integrated Management of Childhood Illness guidelines, (2) WHO-composite guidelines, (3) Independent variable least absolute shrinkage and selection operator (LASSO); (4) Composite variable LASSO. Results 12,712 observations were included. The independent and composite LASSO models discriminated moderately (both C-statistic 0.77) between children with a SpO 2 & lt; 93% and ≥94%; model predictive capacities remained moderate after adjusting for potential overfitting (C-statistic 0.74 and 0.75). The IMCI and WHO-composite models had poorer discrimination (C-statistic 0.56 and 0.68) and identified 20.6% and 56.8% of SpO 2 & lt; 93% cases. The highest score stratum of the independent and composite LASSO models identified 46.7% and 49.0% of SpO 2 & lt; 93% cases. Both LASSO models had similar performance for a SpO 2 & lt; 90%. Conclusions In the absence of pulse oximeters, both LASSO models better identified outpatient hypoxemic pneumonia cases than the WHO guidelines. Score external validation and implementation are needed.
Type of Medium:
Online Resource
ISSN:
2296-2360
DOI:
10.3389/fped.2023.1233532
DOI:
10.3389/fped.2023.1233532.s001
DOI:
10.3389/fped.2023.1233532.s002
DOI:
10.3389/fped.2023.1233532.s003
DOI:
10.3389/fped.2023.1233532.s004
Language:
Unknown
Publisher:
Frontiers Media SA
Publication Date:
2023
detail.hit.zdb_id:
2711999-3
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