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Table 2 External validation of SICK, LODS and PEDIA in febrile Ugandan children admitted to hospital

From: Prospective validation of pediatric disease severity scores to predict mortality in Ugandan children presenting with malaria and non-malaria febrile illness

Score

Discrimination AUC, 95% CI

Compare AUCs

Youden Index J, Cut-off

Sensitivity, 95% CIa

Specificity, 95% CIa

Calibration Hosmer-Lemeshow

Overall Score Performance

      

SICK

0.846, 0.83-0.86

P = 0.032 (S v. L)*

0.6328, >2.4

81.8, 72.8-88.9

81.5, 79.7-83.1

χ2 = 21.11, df = 8, P = 0.007

LODS

0.898, 0.88-0.91

P = 0.865 (L v. P)

0.6926, >1

81.8, 72.8-88.9

87.4, 85.9-88.9

χ2 = 0.072, df = 1, P = 0.789

PEDIA

0.896, 0.88-0.91

P = 0.016 (P v. S)*

0.6727, >2

86.9, 78.6-97.1

80.4, 78.6-82.1

χ2 = 4.45, df = 3, P = 0.217

Modified Score Performanceb

      

SICK

0.854, 0.84-0.87

P = 0.059 (S v. L)

0.6269, >2.4

85.9, 77.4-92.0

76.8, 74.9-78.7

χ2 = 20.42, df = 8, P = 0.009

LODS

0.897, 0.88-0.91

P = 0.801 (L v. P)

0.6915, >1

81.8, 72.8-88.9

87.3, 85.8-88.8

χ2 = 0.066, df = 1, P = 0.797

PEDIA

0.894, 0.88-0.91

P = 0.041 (P v. S)*

0.6703, >3

86.9, 78.6-92.8

78.4, 76.5-80.2

χ2 = 3.60, df = 4, P = 0.462

Malariac

      

SICK

0.856, 0.84-0.87

P = 0.036 (S v. L)*

0.6718, >2.4

85.9, 75.0-93.4

81.3, 79.2-83.2

χ2 = 20.54, df = 8, P = 0.008

LODS

0.919, 0.90-0.93

P = 0.964 (L v. P)

0.7282, >1

85.9, 75.0-93.4

86.9, 85.1-88.5

χ2 = 0.59, df = 1, P = 0.447

PEDIA

0.918, 0.90-0.93

P = 0.018 (P v. S)*

0.7186, >2

92.2, 82.7-97.4

79.7, 77.6-81.7

χ2 = 8.14, df = 3, P = 0.043

NMFId

      

SICK

0.824, 0.79-0.86

P = 0.390 (S v. L)

0.5955, >2.9

72.7, 54.5-86.7

82.3, 78.5-85.7

χ2 = 6.79, df = 8, P = 0.560

LODS

0.862, 0.83-0.89

P = 0.859 (L v. P)

0.6517, >1

75.8, 57.7-88.9

89.4, 86.3-92.1

χ2 = 1.37, df = 1, P = 0.242

PEDIA

0.865, 0.83-0.89

P = 0.234 (P v. S)

0.6173, >2

78.8, 61.1-91.0

82.9, 79.2-86.3

χ2 = 0.34, df = 3, P = 0.952

Early Deathe

      

SICK

0.853, 0.84-0.87

P = 0.009 (S v. L)*

0.6499, >2.4

83.5, 73.9-90.7

81.5, 79.7-83.1

χ2 = 15.66, df = 8, P = 0.049

LODS

0.919, 0.91-0.93

P = 0.396 (L v. P)

0.7450, >1

87.1, 78.0-93.4

87.4, 85.9-88.9

χ2 = 0.33, df = 1, P = 0.565

PEDIA

0.910, 0.90-0.92

P = 0.012 (P v. S)*

0.6981, >2

89.4, 80.8-95.0

80.4, 78.6-82.1

χ2 = 5.83, df = 3, P = 0.120

Late Deathf

      

SICK

0.803, 0.79-0.82

P = 0.646 (S v. L)

0.5943, >2.2

71.4, 41.9-91.6

81.5, 79.7-83.1

χ2 = 9.88, df = 8, P = 0.273

LODS

0.769, 0.75-0.79

P = 0.243 (L v. P)

0.4546, >0

50.0, 23.0-77.0

87.4, 85.9-88.9

χ2 = 0.34, df = 1, P = 0.560

PEDIA

0.815, 0.80-0.83

P = 0.833 (P v. S)

0.5942, >3

71.4, 41.9-91.6

88.0, 86.5-89.4

χ2 = 0.061, df = 3, P = 0.996

  1. Total data missing: LODS, 1.2%; SICK, 10.3%; PEDIA, 4.8%), default models consider missing data normal. aSensitivity and specificity calculated based on the following cut-offs (LODS, >1; SICK, >2.4; PEDIA, >2); bmissing data considered abnormal in score calculation (see Additional file 1: Table S1 for description of missing data by variable); cmalaria positive: positive by RDT (pLDH or HRP2) or microscopy (n = 1,589, 64 deaths; prevalence, 4.03%); dmalaria negative: negative by RDT (pLDH and HRP2) and microscopy (n = 496, 33 deaths; prevalence, 6.65%); en = 2,075 (1,990 survivors and 85 deaths); fn = 2,004 (1,990 survivors and 14 deaths).*Compare AUCs (SICK, S; LODS, L; PEDIA, P) by method of Delong et al. AUC, area under the curve; CI, confidence interval; LODS, Lambaréné Organ Dysfunction Score; PEDIA, Pediatric Early Death Index for Africa; SICK, Signs of Inflammation in Children that Kill.
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