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. 2012 May 31;7(5):e38300. doi: 10.1371/journal.pone.0038300

Table 3. Validations of rules.

Rule Number of patients Number of episodes Age of patients Outcome Proportion in low risk group Sensitivity Specificity
Klaassen rule
Klaassen [24] (derivation) 140 227 Median 6.8 y (range 6 m to 17 y: derivation set) Significant bacterial infection 37% 87.5% (95% CI 76.4% to 93.8%) 41.2% (95% CI 35.9% to 46.6%)
Amman [7] 206 423 6.9 years (IQR 3.8 years to 11.6 years) Serious adverse medical outcome 38% 86.9% (95% CI 79.8% to 91.8%) 48.5% (95% CI 42.9% to 54.1%)
Macher [20] 167 377 Median 6 y, range7 m to 19 y Significant bacterial infection 40% 79.3% (95% CI 61.6% to 90.2%) 45% (95% CI 35.9% to 54.3%)
Baorto [22] 558 1171 Mean 8.0 y (range 1 y to 23 y) Bacteraemia 21% 88.9% (95% CI 83.6% to 92.6%) 22.4% (95% CI 19.9% to 25.1%)
Madsen [23] 76 157 Mean 8 y (range 2 m to 18 y) Microbiologically documented infection 39% 91.7% (95% CI 74.2% to 97.7%) 41% (95% CI 35.5% to 46.8%)
Rackoff [21] 72 172 Range 9 m to 18 y: derivation set Bacteraemia 19% 100% (95% CI 89.8% to 100%) 23.2% (95% CI 16.9% to 30.9%)
Ammann 2003 rule
Ammann [32] (derivation) 132 364 Not reported Severe bacterial infection 14% 100% (95% CI 95.9% to 100%) 22.7% (95% CI 16.8% to 30%)
SPOG [7] 206 423 6.9 years (IQR 3.8 years to 11.6 years) Severe bacterial infection 10% 96.7% (95% CI 91.9% to 98.7%) 12.3% (95% CI 9.1% to 16.5%)
Macher [20] 167 377 Median 6 y, range7 m to 19 y Severe bacterial infection 8% 95.2% (95% CI 86.9% to 98.4%) 9.1% (95% CI 6.4% to 12.8%)
Alexander rule
Alexander [28] (derivation) 104 188 Mean 8.9 y, SD 5.7 Adverse medical complication 58% 84.6% (95% CI 57.8% to 95.7%) 64.6% (95% CI 53.8% to 74.1%)
SPOG [7] 206 423 6.9 years (IQR 3.8 years to 11.6 years) Adverse medical complication 8% 94.3% (95% CI 88.6% to 97.2%) 8.6% (95% CI 6% to 12.4%)
Dommett [2] 368 762 Median age 5 years 7 months (range 1 month to 17 years 6 months). Adverse medical complication 53% 58.7% (95% CI 52.2% to 65%) 57.9% (95% CI 53.7% to 62%)
Programa Infantil Nacional de Drogas Antineoplásticas (PINDA) Rule
Santolaya (derivation) [26] 257 447 Mean 7 y (range 6 m to 18 y) Invasive bacterial infection 43% 85.4% (95% CI 79.5% to 89.8%) 64.6% (95% CI 58.2% to 70.5%)
Santolaya (validation) [25] 170 263 Mean 7 y (range 7 m to 17 y) Invasive bacterial infection 40% 92.1% (95% CI 86.5% to 95.6%) 76.4% (95% CI 68.2% to 83.1%)
SPOG [7] 206 423 6.9 years (IQR 3.8 years to 11.6 years) Invasive bacterial infection 15% 93.4% (95% CI 87.6% to 96.6%) 18.9% (95% CI 14.9% to 23.7%)
Macher [20] 167 377 Median 6 y, range7 m to 19 y Invasive bacterial infection 46% 66.7% (95% CI 51% to 79.4%) 48.1% (95% CI 41.4% to 54.8%)
Swiss Pediatric Oncology Group (SPOG) 2010 Rule
SPOG [7] (Adverse events rule derivation) 206 423 6.9 years (IQR 3.8 years to 11.6 years) Serious adverse medical outcome 35% 92% (IQR 91% to 93%, range 90% to 98%) 45% (IQR, 38% to 49%, range 12% to 57%)
Miedeima [19] 110 210 Median 6.6 years (IQR 4.3 years to 10.8 years) Serious adverse medical outcome 50% 82% (95% CI, 77% to 87% 57% (95% CI, 50% to 64%)
Rondinelli Rule [27] (no derivation data)
Macher [20] 167 377 Median 6 y, range7 m to 19 y Severe bacterial infection N/A 62% (36–82) 43% (34–52)
SPOG [7] 206 423 6.9 years (IQR 3.8 years to 11.6 years) Severe bacterial infection 35% 84.4% (95% CI 77% to 89.8%) 43.2% (95% CI 37.7% to 48.8%)