Evidence map›Paper›PMID 42147701›Full record

ArticleIndian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine2026

Development and Validation of a Comprehensive Acute Encephalitis Syndrome Severity Score in Children with Acute Encephalitis Syndrome.

Indar K Sharawat, Prateek K Panda, Vyas K Rathaur, Achanya Palayullakandi, Suthiraj Sopanam, Diksha Gupta, Poonam Sherwani, Lokesh K Tiwari

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

8 authors.

Indar K SharawatDepartment of Pediatrics, Pediatric Neurology Division, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.ORCID https://orcid.org/0000-0002-7003-7218
Prateek K PandaDepartment of Pediatrics, Pediatric Neurology Division, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.ORCID https://orcid.org/0000-0001-7831-9271
Vyas K RathaurDepartment of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.ORCID https://orcid.org/0000-0002-9442-6912
Achanya PalayullakandiDepartment of Pediatrics, Pediatric Neurology Division, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.ORCID https://orcid.org/0009-0006-1050-1900
Suthiraj SopanamDepartment of Pediatrics, Pediatric Neurology Division, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.ORCID https://orcid.org/0009-0003-4713-3257
Diksha GuptaDepartment of Pediatrics, Pediatric Neurology Division, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.ORCID https://orcid.org/0009-0005-9472-1486
Poonam SherwaniDepartment of Radiodiagnosis and Imaging, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.ORCID https://orcid.org/0000-0002-6816-5018
Lokesh K TiwariDepartment of Pediatrics, Pediatric Intensive Care and Pulmonology Division, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.ORCID https://orcid.org/0000-0002-2231-0152

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and aims: No comprehensive scoring system is currently available to predict functional neurological outcomes in children with acute encephalitis syndrome (AES). We therefore developed and validated a score specifically tailored for these children. Patients and methods: We developed the comprehensive acute encephalitis syndrome severity score (CAESS), which consists of five items [Glasgow Coma Scale (GCS)], focal deficit, status epilepticus, features of raised intracranial pressure (ICP), and pediatric logistic organ dysfunction-2 (PELOD-2) score selected after reviewing published literature. The content validity was assessed through the content validity index (CVI) and content validity ratio (CVR). The model's fit was examined using confirmatory factor analysis (CFA). Functional outcome was determined as good or poor at 6 months, based on the pediatric cerebral performance category (PCPC) score. Construct validity was established by correlating CAESS scores with the functional status scale (FSS), the intelligence quotient (IQ), and the gross motor function measure (GMFM-88). Results: Comprehensive acute encephalitis syndrome severity score was evaluated in 159 children with AES; 114 (71%) had favorable outcomes at 6 months. Inter-rater reliability was good to excellent across items [intraclass correlation coefficient (ICC) range 0.82-0.94; kappa 0.80-0.92]. Internal consistency was good (Cronbach's alpha = 0.80). Content validity was also good (I-CVI 0.9-1.0; CVR 0.8-1.0). Confirmatory factor analysis supported a unidimensional structure, demonstrating good model fit [Tucker-Lewis index (TLI) = 0.98, comparative fit index (CFI) = 0.99, and root mean square error of approximation (RMSEA) = 0.05]. Comprehensive acute encephalitis syndrome severity score demonstrated strong discriminant validity (AUC = 0.91). At a cut-off ≥6, CAESS showed sensitivity of 88.9%, specificity of 84.2%, and a Youden index of 0.73. Strong correlations were observed with FSS ( Conclusion: The CAESS score may be a valid and reliable tool for predicting functional outcomes in children with acute encephalitis syndrome. However, given the absence of internal split-sample validation and external validation in an independent population, further prospective studies with robust internal validation and external replication are required before it can be recommended for routine clinical use. How to cite this article: Sharawat IK, Panda PK, Rathaur VK, Palayullakandi A, Sopanam S, Gupta D,

Indexed as

Acute encephalitis syndromeChildrenFunctional status scale scoreNeurocritical careNeurological outcomePediatric cerebral performance category score

Identifiers

PMID42147701
PMCPMC13177895

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.