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. 2006 Mar;91(3):241-4.
doi: 10.1136/adc.2004.068205. Epub 2005 May 12.

Prediction of vesicoureteral reflux after a first febrile urinary tract infection in children: validation of a clinical decision rule

S Leroy  1 , E Marc, C Adamsbaum, D Gendrel, G Bréart, M Chalumeau
Affiliations

Prediction of vesicoureteral reflux after a first febrile urinary tract infection in children: validation of a clinical decision rule

S Leroy et al. Arch Dis Child. 2006 Mar.

Abstract

Aims: To test the reproducibility of a highly sensitive clinical decision rule proposed to predict vesicoureteral reflux (VUR) after a first febrile urinary tract infection in children. This rule combines clinical (family history of uropathology, male gender, young age), biological (raised C reactive protein), and radiological (urinary tract dilation on renal ultrasound) predictors in a score, and provides 100% sensitivity.

Methods: A retrospective hospital based cohort study included all children, 1 month to 4 years old, with a first febrile urinary tract infection. The sensitivities and specificities of the rule at the two previously proposed score thresholds (< or =0 and < or =5) to predict respectively, all-grade or grade > or =3 VUR, were calculated.

Results: A total of 149 children were included. VUR prevalence was 25%. The rule yielded 100% sensitivity and 3% specificity for all-grade VUR, and 93% sensitivity and 13% specificity for grade > or =3 VUR. Some methodological weaknesses explain this lack of reproducibility.

Conclusions: The reproducibility of the previously proposed decision rule was poor and its potential contribution to clinical management of children with febrile urinary tract infection seems to be modest.

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Conflict of interest statement

Competing interests: none declared

Comment in

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