Table 3. Comparison of the discrimination and clinical utility of the PICNICC rule in the original derivation study and the external validation study (with 95% confidence intervals).
| Outcome | AUC-ROC | Low-risk, n (%) | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) |
|---|---|---|---|---|---|---|
|
Original PICNICC CDR (derivation study results)
(Phillips et al, 2016) | ||||||
| MDI | 0.72 (0.71–0.76) | 163 (18.1) | 91.5 (87.3–94.4), | 21.2 (18.3–24.5) | 29 (25.8–32.2) | 87.7 (81.8–91.9) |
|
Non-recalibrated PICNICC CDR (presentation validation results) | ||||||
| MDI | 0.64 (0.59–0.69) | 21 (3.2) | 98.7 (95.4–99.8) | 3.8 (2.5–6.0) | 24 (20.8–27.5) | 90.5 (71.1–98.3) |
|
Recalibrated PICNICC CDR (presentation validation results) | ||||||
| MDI | 0.64 (0.59–0.69) | 231 (35.5) | 78.4 (71.3–84.2) | 39.8 (35.6–44.2) | 28.6 (24.5–33.1) | 85.7 (80.6–89.6) |
| Bacteraemia | 0.71 (0.64–0.77) | 231 (35.5) | 85.2 (74.3–92.0) | 37.8 (34–41.8) | 12.4 (9.6–15.9) | 96.1 (92.8–97.9) |
| Bacterial MDIa | 0.67 (0.61–0.73) | 231 (35.5) | 80.5 (70.6–87.6) | 37.9 (34.0–41.9) | 15.8 (12.6–19.5) | 93.1 (89.0–95.7) |
|
PICNICC CDR (day 2 validation results) | ||||||
| MDI (n=443) | ND | 193 (43.6) | 61.6 (50.2–71.9) | 44.6 (39.6–49.7) | 18.0 (13.7–23.2) | 85.5 (79.8–89.8) |
Abbreviations: AUC-ROC=area under the receiver operating characteristic curve; CDR=clinical decision rule; MDI=microbiologically documented infection; ND=not done; NPV=negative predictive value; PICNICC=Predicting Infectious ComplicatioNs in Children with Cancer; PPV=positive predictive value.
a
Bacterial MDI includes any of bacteraemia, urinary tract infection, skin and soft tissue infection.