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. 2022 Apr 26;19(9):5289.
doi: 10.3390/ijerph19095289.

Temporal Validation of Chiang Mai University Intussusception Failed Reduction Score (CMUI)

Jiraporn Khorana  1   2   3 , Chanathip Sayuen  1 , Sutinee Chanaturakarnnon  1 , Butsarin Nate-Anong  1 , Jesda Singhavejsakul  1   3 , Kanokkan Tepmalai  1   3 , Sireekarn Chantakhow  1   3 , Wilai Sathavornvichit  4
Affiliations

Temporal Validation of Chiang Mai University Intussusception Failed Reduction Score (CMUI)

Jiraporn Khorana et al. Int J Environ Res Public Health. .

Abstract

This study aimed to validate the "Chiang Mai University Intussusception Failed Score (CMUI)" for intussusception non-operative reduction. Both a 2-year retrospective and a 5-year prospective consecutive review of patients with intussusception were conducted. Data were collected from January 2013 to December 2020. Related retrospective data of a developmental set from two centers from January 2006 to December 2012 were used. Ten prespecified prognostic factors for failed reduction were collected and from these a predictive score was calculated. The actual results of non-operative reduction were collected and set as a reference standard. Altogether, 195 episodes of intussusception were found. Twenty-two patients were excluded due to contraindications; therefore, a total of 173 episodes were included in the validation dataset. The development data set comprised 170 episodes. We found that no statistical significance was found from comparing the areas under the ROC of two datasets (p-value = 0.31), while specificity of the validation set was 93.8% (88.1-97.3). This temporal validation showed a high specificity and a high affinity for prediction of failed reduction as the development dataset despite being in an era of a higher successful reduction rate. The intensive reduction protocols might be introduced among patients with high-risk scores.

Keywords: intussusception; nonoperative reduction; pediatric; predictor score.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study flow diagram.
Figure 2
Figure 2
Risk ratio plots of the ten-predictors of CMUI in the development and validation sets.
Figure 3
Figure 3
Score-predicted probability of failure of nonoperative reduction of intussusceptions between the developmental set and the validation sets with a cut point score of 12.
Figure 4
Figure 4
Comparative ROC curve of failure of nonoperative reduction of intussusceptions between the developmental set and the validation set predicted by risk scoring scheme (curved line) and a 50% chance prediction (diagonal line).
Figure 5
Figure 5
Calibration plots of the CMUI score in the development and validation sets. The dash lines at the cutoff point of 12 categorized patients with intussusception into low-risk and high-risk groups of failed non-operative reduction.
Figure 6
Figure 6
Probability of fail of non-operative reduction of intussusception by predicted model stratified by failed vs. successful reduction in the development and the validation sets.
Figure 7
Figure 7
Comparative ROC curve of failure of nonoperative reduction of intussusceptions among 3 score models.
See this image and copyright information in PMC

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