DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20192024

Simplified bronchiolitis severity score for health care providers

Rachel P. Rudhan, Niranjan Biswal

Abstract


Background: Bronchiolitis is a viral lower respiratory infection of young infants. It requires monitoring by outpatient health care providers and rarely needs hospitalization. Scoring of severity in community helps in early referral. A simplified bronchiolitis scoring for rural health care providers with no facility for measurement of oxygen saturation (SpO2) and chest X-ray (CXR) is a long-felt need. This study proposes a simplified score.

Methods: The proposed bronchiolitis severity score (PSS) has to be validated against the standard bronchiolitis severity score (SSS). The PSS was administered by a physician, nurse and researcher. The reliability was measured by the comportment of internal consistency and inter-observer agreement.

Results: The physicians rating of severity by SSS and PSS was similar in 97% of cases. The internal consistency of 0.72 and the kappa index of 0.86 were obtained. The inter-rater agreements between physician, nurse, researcher was 0.94, 0.94 and 0.93 respectively.

Conclusions: The PSS is reliable, valid and can be administered by nurses in peripheral health care settings.


Keywords


Bronchiolitis, Health care providers, Respiratory infection, Severity score

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References


Chatterjee K, Sen S, Nabendu N. Acute Bronchiolitis-Update on Management. New Ind J Pediatr. 2016;5-1:20-7.

Mccallum GB, Morris PS, Wilson CC. Severity scoring system: are they internally valid, reliable and predictive of oxygen use in children with acute bronchiolitis? Pediatr Pulmonol. 2013;48:797-803.

Singh S, Badaya S. Health care in rural India: a lack between need and feed. South Asian J Cancer. 2014;3(2):143-4.

Liu LL, Gallaher MM. Use of respiratory clinical score among different providers. Pediatr Pulmonol. 2004;37:243-8.

Tal A, Bavilski C, Yohai D, Bearman JE, Gorodischer R, Moses SW. Dexamethasone and salbutamol in the treatment of acute wheezing in infants. Pediatrics. 1983;71:13-18.

Fernández RJM, Martínez CA, Zavala GR, Cardona UA. Validation of an acute bronchiolitis severity scale. An Pediatr. 2014;81(1):3-8.

Wood DW, Downes JJ, Lecks HI. A clinical scoring system for the diagnosis of respiratory failure. Am J Dis Child. 1972;123:227-8.

Duarte-Dorado DM, Duarte-Dorado DS, Rodriguez-Martinez CE, Nino G. Validation of a scale to assess the severity of bronchiolitis in a population of hospitalized infants. J Asthma. 2013;50(10):1056-61.

Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159-74.

McHugh ML. Interrater reliability: the kappa statistic. Biochem Medica. 2012;22(3):276-82.

Gajdos V, Beydon N, Bommenel L, Pellegrino B, Pontual L, Bailleux S, et al. Inter-observer agreement between physicians, nurses, and respiratory therapists for respiratory clinical evaluation in bronchiolitis. Pediatr Pulmonol. 2009;44:754-62.