ArticleBMJ (Clinical research ed.)2012
Derivation and validation of age and temperature specific reference values and centile charts to predict lower respiratory tract infection in children with fever: prospective observational study.
Article in BMJ (Clinical research ed.), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 47 citations in OpenAlex.
- Trial
- A primary healthcare approach to children with fever.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2026Article
- Axial length normative data and percentile curves for schoolchildren in Taiwan: A tool for myopia monitoring.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2025Article
- The Impact of Inflammation on Thermal Hyperpnea: Relevance for Heat Stress and Febrile Seizures.American journal of respiratory cell and molecular biology · 2024Article
- Heart rate and respiratory rate in predicting risk of serious bacterial infection in febrile children given antipyretics: prospective observational study.European journal of pediatrics · 2023Observational
- Pediatric triage modifications based on vital signs: a nationwide study.Clinical and experimental emergency medicine · 2022Article
- Noncontact Longitudinal Respiratory Rate Measurements in Healthy Adults Using Radar-Based Sleep Monitor (Somnofy): Validation Study.JMIR biomedical engineering · 2022Article
- Shock Index in the early assessment of febrile children at the emergency department: a prospective multicentre study.Archives of disease in childhood · 2022Observational
- Acute kidney injury in children hospitalized for community acquired pneumonia.Pediatric nephrology (Berlin, Germany) · 2021Article
- The role of body temperature on respiratory rate in children with acute respiratory infections.African health sciences · 2021Article
- Variations in Elite Female Soccer Players' Sleep, and Associations With Perceived Fatigue and Soccer Games.Frontiers in sports and active living · 2021Article
- [Paediatric Life Support].Notfall & rettungsmedizin · 2021Review
- Distribution of Pediatric Vital Signs in the Emergency Department: A Nationwide Study.Children (Basel, Switzerland) · 2020Article
- Clinical Outcome of Febrile Tanzanian Children with Severe Malnutrition Using Anthropometry in Comparison to Clinical Signs.The American journal of tropical medicine and hygiene · 2020Article
- Management of Children With Fever at Risk for Pediatric Sepsis: A Prospective Study in Pediatric Emergency Care.Frontiers in pediatrics · 2020Article
- Effectiveness of a Training Course on Accuracy of Triaging of Pediatric Patients.Open access Macedonian journal of medical sciences · 2019Article
- The Association Between Fever and Subsequent Deterioration Among Hospitalized Children With Elevated PEWS.Hospital pediatrics · 2019Article
- Validation of the Feverkidstool and procalcitonin for detecting serious bacterial infections in febrile children.Pediatric research · 2018Observational
- Clinical Considerations When Applying Vital Signs in Pediatric Korean Triage and Acuity Scale.Journal of Korean medical science · 2017Article
- Fever in Children: Pearls and Pitfalls.Children (Basel, Switzerland) · 2017Review
Corrections and comments
- Commented on by
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo develop reference values and centile charts for respiratory rate based on age and body temperature, and to determine how well these reference values can predict the presence of lower respiratory tract infections (LRTI) in children with fever.
designProspective observational study.
participantsFebrile children aged at least 1 month to just under 16 years (derivation population, n = 1555; validation population, n = 671) selected from patients attending paediatric emergency departments or assessment units in hospitals.
settingOne hospital in the Netherlands in 2006 and 2008 (derivation population); one hospital in the Netherlands in 2003-05 and one hospital in the United Kingdom in 2005-06 (validation population).
interventionWe used the derivation population to produce respiratory rate centile charts, and calculated 50th, 75th, 90th, and 97th centiles of respiratory rate at a specific body temperature. Multivariable regression analysis explored associations between respiratory rate, age, and temperature; results were validated in the validation population by calculating diagnostic performance measures, z scores, and corresponding centiles of children with diagnoses of pneumonic LRTI (as confirmed by chest radiograph), non-pneumonic LRTI, and non-LRTI.
main outcome measureAge, respiratory rate (breaths/min) and body temperature (°C), presence of LRTI.
resultsRespiratory rate increased overall by 2.2 breaths/min per 1°C rise (standard error 0.2) after accounting for age and temperature in the model. We observed no interactions between age, temperature, and respiratory rates. Age and temperature dependent cut-off values at the 97th centile were more useful for ruling in LRTI (specificity 0.94 (95% confidence interval 0.92 to 0.96), positive likelihood ratio 3.66 (2.34 to 5.73)) than existing respiratory rate thresholds such as Advanced Pediatrics Life Support values (0.53 (0.48 to 0.57), 1.59 (1.41 to 1.80)). However, centile cut-offs could not discriminate between pneumonic LRTI and non-pneumonic LRTI.
conclusionsAge specific and temperature dependent centile charts describe new reference values for respiratory rate in children with fever. Cut-off values at the 97th centile were more useful in detecting the presence of LRTI than existing respiratory rate thresholds.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.