89 Validation of the Severe Illness Getting Noticed Sooner (SIGNS) for Kids Tool in Children with Severe Illness
Notice bibliographique
Résumé
Abstract Background Severe illness in children is associated with significant risk of permanent disability, cardiac arrest, and death. The Severe Illness Getting Noticed Sooner (SIGNS) for Kids was created by an expert panel to help parents and other caregivers identify and articulate signs of severe illness to enable timely escalation of care. SIGNS for Kids consists of 5 major items: Behaviour, Breathing, Skin, Fluids, and Response to usually effective treatments. Expert development ensured face validity, however there is no formal validity evidence to suggest the tool can identify children with severe illness. Objectives To provide preliminary validity evidence of the sensitivity of the SIGNS criteria as markers of severe illness. Design/Methods A retrospective review of paediatric deaths was performed using records from the coroner’s office. Eligible patients had an index event described and were <18 years and >36 weeks gestational age at the time of event, had observations/reports for > 6 hours prior to the index event, and were not in an intensive care unit (ICU) or under anaesthetist supervision. The index events were defined as cardiac arrest, respiratory arrest, intubation, transfer to ICU, interfacility transfer, or urgent surgical procedure. Traumatic events and infants with sudden unexplained death were excluded from analysis. The main outcome was the presence of SIGNS items. Secondary measures were the time before index events that each of the SIGNS were present, and the time to death from the index event. Analyses were descriptive. Results Two hundred records were screened. After exclusion of 145 cases with incomplete records or traumatic deaths and 5 infants with sudden unexplained death, the records of 50 children met inclusion criteria. One or more SIGNS criteria were present before index event in 48 (96%). Breathing abnormality n=26 (52%) was the most frequently observed item with a mean (SD) duration of 47 (51) hours prior to index event. Over half (n=28, 56%) had SIGNS documented for ≥24 hours before initial escalation and 42 (84%) died within 48 hours after index event. Conclusion Forty-eight of 50 children had SIGNS criteria present before index event, and half had SIGNS present >24 hours. These data provide evidence of the sensitivity of the SIGNS criteria as markers of severe illness. Future studies will focus on establishing specificity and construct validity as well as caregiver usability prior to implementation of the screening tool.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,020 | 0,043 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,003 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».