Table 3.

Expert panel qualitative assessments of potential prognostic indicators

Prognostic indicator	Overall favorability	Selected performance comments	Selected feasibility comments
Fever	Unfavorable	Low specificity for identifying children who will not fail treatment	High feasibility since already implemented and measurement tools simple
Rapid breathing	Minimally favorable	Normal range highly variable	Measurement tools inaccurate
		Low sensitivity for hypoxemic children	Low feasibility with respect to sequential monitoring of respiratory rates over time
		Performance profile improves with sequential monitoring of respiratory rates over time
Lower chest wall indrawing	Favorable	Low specificity for identifying children who will not fail treatment	Subjective sign with variable inter-provider agreement levels
Abnormal oxygen saturation	Highly favorable	High specificity for identifying children who will not fail treatment	Objective measurement but inter-provider agreement levels unknown
		Later indicator decreases sensitivity for identifying children who will fail treatment at the community-level	Robust, precise, low-cost point-of-care instrument needed
			Likely costly to implement and sustain
High blood lactate levels	Unfavorable	Low specificity for identifying children who will not fail treatment	Point-of-care tool appropriate for community use not available, likely costly
		Very late indicator decreases sensitivity for identifying children who will fail treatment at the community-level
Moderate malnutrition	Highly favorable	Mid-range sensitivity and specificity which likely improves greatly in combination with other indicators	High feasibility since measurement tools simple and accurate
		High positive predictive value
HIV-affected	Minimally favorable	Geographically limited in relevancy (e.g. primarily in eastern and southern Africa)	Low feasibility since difficult to obtain HIV status at community-level (e.g. stigma)
		High positive predictive value

HIV: Human Immunodeficiency Virus