ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2007
Validation of a clinical rule to predict complications of acute cough in preschool children: a prospective study in primary care.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Duration of symptoms of respiratory tract infections in children: systematic review.BMJ (Clinical research ed.) · 2013Pooled it
- Development and internal validation of a clinical rule to improve antibiotic use in children presenting to primary care with acute respiratory tract infection and cough: a prognostic cohort study.The Lancet. Respiratory medicine · 2016Article
- The TARGET cohort study protocol: a prospective primary care cohort study to derive and validate a clinical prediction rule to improve the targeting of antibiotics in children with respiratory tract illnesses.BMC health services research · 2013Observational
- Measuring the financial burden of acute cough in pre-school children: a cost of illness study.BMC family practice · 2008Article
- The case of 'protective fever and chest signs': towards a better understanding of general practice databases.The British journal of general practice : the journal of the Royal College of General Practitioners · 2007Article
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Authors and funding
5 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFew clinical rules have been derived let alone validated in primary care. A rule was derived to predict complications of acute cough in preschool children presenting to primary care. The clinical rule used the presence/absence of fever and/or chest signs to distinguish children at low, medium, and high risk of complications.
aimTo validate a clinical rule for predicting complications of acute cough in preschool children in primary care. DESIGN OF STUDY: Prospective cohort study.
settingThirteen general practices in Bristol and Tayside, UK.
methodPreschool children with cough up to 28 days and without asthma were recruited. The same sociodemographic, clinical history, examination, and complications data as for the derivation study were collected. First, univariable logistic regression was used to explore the associations with complications, and then predictors with stronger relationships (P<0.2) were modelled using multivariable logistic regression. These predictors were compared with derivation predictors with respect to their strength of association with complications. The derivation predictors were used in the validation dataset to allow comparison of the post-test probabilities of complications between derivation and validation studies.
resultsThe presence of fever and chest signs in the validation study tended to be protective for complications, with univariable odds ratios (ORs) of 0.37 and 0.81 respectively, compared with ORs of 4.86 and 2.72 in the derivation study. However, 95% confidence limits were wide and evidence for two other possible reasons for these results were found: spectrum bias and confounding by indication.
conclusionNo evidence was found to validate the clinical rule for predicting complications of acute cough, possibly as a result of spectrum bias, confounding by indication, and/or chance. As paediatric infectious illness is costly and associated with high rates of antibiotic use, further research is needed to derive and validate prediction rules.
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Identifiers
17727745PMC2099635W2112605647What OpenQuestion holds
Registered trials
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