Box 1.

Example scenario for rating by panellists^a

Clinical stem: For the parent of a child aged (a) 12–23 months/(b) 24 months–4 years and 11 months/(c) 5–12 years with ≤1 week of respiratory infection symptoms, for example, cough, sore throat, and/or runny nose, with or without eating adequately and normal conscious level, and with the (d) following past medical history and (e) combination of symptoms — what would be the most appropriate next step (f)? (Rate on scale 1–9: 1 = inappropriate; 9 = appropriate):

(d) Past medical history	(e) Symptoms						(f) Next step? Three options:	Rate the appropriateness by age (scale score 1–9: 1 = totally inappropriate and 9 = totally appropriate)
	1. Ear pain	2. Wheezing or ‘noisy breathing’	3. Shortness of breath	4. Reduced fluid intake	5. Less active or socially interactive than usual	6. High fever	1. Monitor, home care, go to pharmacy, or routine (non- urgent) GP appointment	(a) 12–23 months	(b) 24 months–4 years and 11 months	(c) 5–12 years
							2. Same-day GP if daytime or 111 for out-of-hours appointment
							3. Go to ED or telephone 999
None (previously well aside from usual childhood illnesses)							1
							2
							3
Previous admission for asthma, bronchiolitis, or other respiratory condition							1
							2
							3

^aThis scenario shows a situation of only one symptom, denoted by the yellow fill for symptom 1 — ear pain.