Diagnostic Accuracy of Severe Acute Respiratory Infection Definitions in Hospitalized Children
Notice bibliographique
Résumé
Importance: Following the 2009 H1N1 influenza pandemic, the World Health Organization (WHO) established a new case definition for severe acute respiratory infection (SARI) for viral surveillance. Several studies have suggested that SARI case definitions are inaccurate at detecting pediatric disease burden. Understanding the performance of SARI case definitions in children is important for pandemic preparedness. Objectives: To evaluate the diagnostic accuracy of SARI case definitions in detecting microbiologically confirmed viral respiratory tract infections among hospitalized children. Data Sources: The MEDLINE(R), Embase Classic + Embase, Ovid EBM Reviews Cochrane Central Register of Controlled Trials, Elsevier SCOPUS, and the WHO Global Index Medicus databases were searched from inception to March 31, 2025. Study Selection: Study screening was conducted in duplicate by 2 independent reviewers. Any studies that assessed any SARI definition in hospitalized children were included. There were no restrictions by design, time period, or geographical location. Data Extraction and Synthesis: Data extraction using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline was conducted by 1 author using a predefined template and independently validated by a second author. Diagnostic accuracy was extracted as 2 × 2 tables from each study and pooled using a bivariate random-effects model. Quality assessments were conducted using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Main Outcomes and Measures: The primary outcomes were sensitivity and specificity. For each case definition-virus combination with at least 4 included studies, pooled estimates of sensitivity and specificity were calculated. Results: Of 1144 studies identified, 13 were included. Included studies represent surveillance data from 65 inpatient sites across 8 countries, using data from 2007 to 2023. The most common definition was the 2014 WHO SARI (9 studies). Viral pathogens included influenza (10 studies) and respiratory syncytial virus (RSV; 6 studies). Meta-analysis of the WHO 2014 SARI definition yielded a sensitivity of 75.7% (95% CI, 65.0%-83.9%; I2 = 89.2%) and specificity of 30.6% (95% CI, 19.8%-44.0%; I2 = 99.0%) for influenza (7 studies) and sensitivity of 70.6% (95% CI, 56.9%-81.9%; I2 = 98.8%) and specificity of 38.7% (95% CI, 25.7%-53.5%; I2 = 99.5%) for RSV (5 studies). In younger subgroups, sensitivity appeared to decrease while specificity appeared to increase for both influenza and RSV. Conclusions and Relevance: In this systematic review and meta-analysis of 13 studies, the WHO 2014 SARI definition demonstrated reduced sensitivity and increased specificity in younger pediatric cohorts, suggesting that surveillance systems that rely on SARI case definitions may potentially underestimate disease burden in children.
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 | 0,096 | 0,356 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,010 | 0,014 |
| Bibliométrie | 0,014 | 0,008 |
| Études des sciences et des technologies | 0,001 | 0,002 |
| Communication savante | 0,005 | 0,004 |
| Science ouverte | 0,004 | 0,003 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
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 ».