Centre for International Child Health, BC Children's Hospital, Vancouver, BC, Canada.
Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
PLoS One. 2019 Jan 28;14(1):e0211274. doi: 10.1371/journal.pone.0211274. eCollection 2019.
Sepsis is a life-threatening dysfunction of the immune system leading to multiorgan failure that is precipitated by infectious diseases and is a leading cause of death in children under 5 years of age. It is necessary to be able to identify a sick child at risk of developing sepsis at the earliest point of presentation to a healthcare facility so that appropriate care can be provided as soon as possible. Our study objective was to generate a list of consensus-driven predictor variables for the derivation of a prediction model that will be incorporated into a mobile device and operated by low-skilled healthcare workers at triage. By conducting a systematic literature review and examination of global guideline documents, a list of 72 initial candidate predictor variables was generated. A two-round modified Delphi process involving 26 experts from both resource-rich and resource-limited settings, who were also encouraged to suggest new variables, yielded a final list of 45 predictor variables after evaluating each variable based on three domains: predictive potential, measurement reliability, and level of training and resources required. The final list of predictor variables will be used to collect data and contribute to the derivation of a prediction model.
败血症是一种危及生命的免疫系统功能障碍,可导致多器官衰竭,由传染病引发,是 5 岁以下儿童死亡的主要原因。在儿童前往医疗机构就诊的最早时刻,必须能够识别出有败血症风险的患病儿童,以便尽快提供适当的护理。我们的研究目的是生成一组基于共识的预测变量清单,以便推导出一个预测模型,该模型将被纳入移动设备中,并由分诊时技能水平较低的医疗保健工作者操作。通过进行系统的文献回顾和全球指南文件的检查,生成了一份 72 个初始候选预测变量的清单。两轮改良德尔菲法涉及来自资源丰富和资源有限环境的 26 名专家,他们还被鼓励提出新的变量,在根据三个领域评估每个变量后:预测潜力、测量可靠性以及所需的培训和资源水平,最终得到了 45 个预测变量的清单。最终的预测变量清单将用于收集数据,并有助于推导出预测模型。