Evidence map›Paper›PMID 33417918›Full record

ArticleThe Journal of pediatrics2021

Predicting Adverse Outcomes for Shiga Toxin-Producing Escherichia coli Infections in Emergency Departments.

Chu Yang Lin, Jianling Xie, Stephen B Freedman, Ryan S McKee, David Schnadower, Phillip I Tarr, Yaron Finkelstein, Neil M Desai, Roni D Lane, Kelly R Bergmann and 25 more

Open access · greenAbstract read
In one paragraph

Article in The Journal of pediatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 27% of its field
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

35 authors at 20 institutions in 3 countries.

Chu Yang LinFaculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Jianling XieSection of Pediatric Emergency Medicine, Department of Pediatric, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Stephen B FreedmanSection of Pediatric Gastroenterology, Department of Pediatrics, Alberta Children's Hospital and Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Ryan S McKeeSection of Pediatric Emergency Medicine, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
David SchnadowerDivision of Emergency Medicine, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.
Phillip I TarrDivision of Gastroenterology, Hepatology, & Nutrition, Department of Pediatrics, Washington University in St Louis, School of Medicine, St Louis, MO.
Yaron FinkelsteinDivisions of Emergency Medicine and Clinical Pharmacology & Toxicology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Neil M DesaiDivision of Pediatric Emergency Medicine, British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
Roni D LaneDivision of Pediatric Emergency Medicine, University of Utah School of Medicine, Salt Lake City, UT.
Kelly R BergmannDepartment of Emergency Medicine, Children's Minnesota, Minneapolis, MN.
Ron L KaplanDepartment of Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, WA.
Selena HariharanDivision of Emergency Medicine, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.
Andrea T CruzPediatric Emergency Medicine and Pediatric Infectious Diseases, Baylor College of Medicine, Houston, TX.
Daniel M CohenNationwide Children's Hospital & The Ohio State University, Columbus, OH.
Andrew DixonUniversity of Alberta, Stollery Children's Hospital, Women's and Children's Health Research Institute, Edmonton, Alberta, Canada.
Sriram RamgopalDivision of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL.
Elizabeth C PowellDivision of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL.
Jennifer KilgarDepartment of Pediatrics, Schulich School of Medicine and Dentistry, London, Ontario, Canada.
Kenneth A MichelsonDivision of Emergency Medicine, Boston Children's Hospital, Boston, MA.
Martin BitzanDivision of Nephrology, Montreal Children's Hospital, McGill University Health Centre, Montreal, Canada; Al Jalila Children's Hospital, Kidney Centre of Excellence, Dubai, United Arab Emirates.
Kenneth YenPediatric Emergency Medicine, Children's Medical Center, UT Southwestern, Dallas, TX.
Garth D MecklerPediatrics and Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Amy C PlintDepartments of Pediatrics and Emergency Medicine, University of Ottawa and the Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
Fran BalamuthDepartment of Pediatrics, University of Pennsylvania Perelman School of Medicine, Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, PA.
Stuart BradinChildren's Emergency Services, Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI.
Serge GouinDepartments of Pediatric Emergency Medicine & Pediatrics, CHU Sainte-Justine, Universite de Montreal, Quebec, Canada.
April J KamDepartment of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada.
James A MeltzerDivision of Emergency Medicine, Department of Pediatrics, Jacobi Medical Center, Bronx, NY.
Tracy E HunleyDivision of Pediatric Nephrology, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, TN.
Usha AvvaDepartment of Pediatrics, Joseph M. Sanzari Women and Children's Hospital, Hackensack University Medical Center, Hackensack, NJ.
Robert PorterDiscipline of Pediatrics, Memorial University of Newfoundland, St John's, Newfoundland, Canada.
Daniel M FeinDivision of Pediatric Emergency Medicine, Department of Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY.
Jeffrey P LouieDivision of Emergency Medicine, University of Minnesota, Masonic Children's Hospital, Minneapolis, MN.
Gillian A M TarrDivision of Environmental Health Sciences, University of Minnesota, Minneapolis, MN. Electronic address: gtarr@umn.edu.
Pediatric Emergency Research Canada (PERC) and Pediatric Emergency Medicine Collaborative Research Committee (PEMCRC) STEC Study Group
Cincinnati Children's Hospital Medical Center · USNorthwestern University · USUniversity of Alberta · CAUniversity of Calgary · CAAlbert Einstein College of Medicine · USBaylor College of Medicine · USBC Children's Hospital · CABoston Children's Hospital · USCentre Hospitalier Universitaire Sainte-Justine · CAChildren's Hospital of Philadelphia · USChildren's Medical Center · USChildren's Minnesota · USHackensack University Medical Center · USJacobi Medical Center · USMcMaster Children's Hospital · CAMemorial University of Newfoundland · CAMonroe Carell Jr. Children's Hospital · USMontreal Children's Hospital · CANationwide Children's Hospital · USSeattle Children's Hospital · US

Funding

Washington University DDRCC Supplemental Equipment RequestP30DK052574 · NIDDK · WASHINGTON UNIVERSITY · PI Nicholas O. Davidson · 2000 to 2026
$30.8M
Delayed Diagnosis of Serious Pediatric Emergency ConditionsK08HS026503 · AHRQ · LURIE CHILDREN'S HOSPITAL OF CHICAGO · PI MICHELSON, KENNETH · 2019 to 2023
$763k
AHRQ HHS K08 HS026503CIHRNIDDK NIH HHS P30 DK052574
6 · The paper itself

Abstract

objectiveTo assess the performance of a hemolytic uremic syndrome (HUS) severity score among children with Shiga toxin-producing Escherichia coli (STEC) infections and HUS by stratifying them according to their risk of adverse events. The score has not been previously evaluated in a North American acute care setting. STUDY

designWe reviewed medical records of children <18 years old infected with STEC and treated in 1 of 38 participating emergency departments in North America between 2011 and 2015. The HUS severity score (hemoglobin [g/dL] plus 2-times serum creatinine [mg/dL]) was calculated using first available laboratory results. Children with scores >13 were designated as high-risk. We assessed score performance to predict severe adverse events (ie, dialysis, neurologic complication, respiratory failure, and death) using discrimination and net benefit (ie, threshold probability), with subgroup analyses by age and day-of-illness.

resultsA total of 167 children had HUS, of whom 92.8% (155/167) had relevant data to calculate the score; 60.6% (94/155) experienced a severe adverse event. Discrimination was acceptable overall (area under the curve 0.71, 95% CI 0.63-0.79) and better among children <5 years old (area under the curve 0.77, 95% CI 0.68-0.87). For children <5 years, greatest net benefit was achieved for a threshold probability >26%.

conclusionsThe HUS severity score was able to discriminate between high- and low-risk children <5 years old with STEC-associated HUS at a statistically acceptable level; however, it did not appear to provide clinical benefit at a meaningful risk threshold.

Indexed as

Clinical Decision RulesEmergency Service, HospitalSeverity of Illness IndexShiga-Toxigenic Escherichia coliAdolescentChildChild, PreschoolEscherichia coli InfectionsFemaleHemolytic-Uremic SyndromeHumansInfantInfant, NewbornMaleNorth AmericaPrognosishemolytic uremic syndromeprognostic indexstx1stx2

Identifiers

PMID33417918
PMCPMC8084908
OpenAlexW3119003936

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.