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      Validation of a Clinical Instrument for Measuring the Severity of Acute Bronchitis in Children – The BSS-ped

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          Abstract

          Background:

          There are no validated standardised clinical procedures for severity measurement of acute bronchitis in children. The “BSS-ped”, a short version of the physician-rated assessment scale BSS (Bronchitis Severity Scale), can fill this gap, if it is valid.

          Objective:

          To examine the scale´s validity.

          Methods:

          Investigations were planned according to classical clinical-psychometric validity criteria including a formal competence evaluation of the scale´s authors and statistical analyses of data from 78 patients aged 1-6 and diagnosed with “acute bronchitis”. Cross-validation was provided by analysis of data from 70 children with matching age, sex and diagnosis. All children were examined three times (day 0, 3-5 and 7) using the BSS-ped in addition to other clinical and psychometric monitoring procedures.

          Results:

          The evidently high level of expertise of the scale’s authors substantiates pronounced content validity and relevance of the BSS-ped and its items. The validity criterion, i.e. to reflect the unidimensional severity of acute bronchitis and its change using the BSS-ped score, was fulfilled. There were substantial correlations with other scales measuring the current health-related quality of life, as well as satisfaction and success of treatment. Severity change prognoses for acute bronchitis under placebo and an active substance were correct. The BSS-ped was found to be a feasible instrument because it can be repeated at short intervals (minute range) without any special technical aids or extended training.

          Conclusion:

          The BSS-ped is a valid procedure for measuring the severity of acute bronchitis in children.

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          Most cited references32

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          Assessing health-related quality of life in chronically ill children with the German KINDL: first psychometric and content analytical results.

          Health-related quality of life is increasingly being considered as a relevant end-point and outcome criterion in evaluating the effects of medical treatment. While in adults quality of life instruments have been developed in terms of generic as well as disease-specific measures, quality of life assessment and children is a relatively new area. The current paper describes the application of a German generic quality of life instrument for children (the KINDL) in a group of 45 chronically ill children suffering from diabetes or asthma in comparison to 45 age- and gender-matched healthy children. The results of psychometric testing in these populations showed that the German KINDL is a reliable, valid and practical instrument to assess the health-related quality of life of children which should be supplemented by disease-specific modules and needs to be further tested in clinical populations.
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            A checklist for evaluating the usefulness of rating scales.

            D Streiner (1993)
            Rating scales of various sorts are very useful for both clinical and research purposes. However, they vary greatly regarding their reliability, validity, and utility. This article provides a guide for people who need to evaluate scales, either to incorporate them into their own research or clinical activities, or to determine if the results of studies which use scales are meaningful. The different types of reliability and validity are discussed and guidelines are offered to evaluate how well these were assessed. Finally, other aspects of scales which can affect their usefulness, such as completion time, training, and scoring ease, are discussed.
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              Observer agreement for respiratory signs and oximetry in infants hospitalized with lower respiratory infections.

              To determine observer agreement for a clinical score and oximetry in lower respiratory infection in children less than 2 yr of age, a convenience sample of 56 infants hospitalized with bronchiolitis or pneumonia was assessed independently by two observers. A total of 12 infants had chronic lung disease of prematurity or congenital heart disease. Infants in whom oxygen supplementation could not be discontinued for at least 5 min were excluded. A severity score was assigned for each of four categories (respiratory rate, retractions, wheeze, and general appearance). A total for each patient was obtained by summing the score for each category. Oxygen saturation was measured using a Nellcor oximeter. Agreement beyond chance was measured using the kappa statistic. The relationship between observers for total score and oximetry and the mean total score and mean oximetry value for each patient was expressed as a Pearson correlation coefficient. A total of 56 infants and children were studied: 2 had pneumonia, 11 had an exacerbation of pulmonary signs and symptoms with their underlying cardiac or pulmonary disease, and 43 had bronchiolitis. Kappa was 0.48 for general assessment, 0.38 for respiratory rate, 0.31 for wheeze, and 0.25 for retractions. All values were statistically significantly greater than 0 at p less than 0.01. Correlations for total score and for oximetry were 0.68 and 0.88, respectively. The median difference between oximetry readings was 1. The correlation coefficient between total score and oximetry was -0.04. The limited agreement for clinical signs makes comparison of patient illness severity between studies difficult.(ABSTRACT TRUNCATED AT 250 WORDS)
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                Author and article information

                Journal
                Open Respir Med J
                Open Respir Med J
                TORMJ
                The Open Respiratory Medicine Journal
                Bentham Open
                1874-3064
                26 October 2018
                2018
                : 12
                : 50-66
                Affiliations
                [1 ]Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
                [2 ]Group Practice and Centre for Pneumology, Center for Respiratory, Allergy and Sleep Medicine at Red Cross Maingau Hospital, Frankfurt am Main, Germany
                [3 ]Department of Pneumology, University Hospital Freiburg, Freiburg, Germany
                [4 ]Clinic for Paediatrics, Evangelic Hospital Hamm, Hamm, Germany
                Author notes
                [* ] Address correspondence to this author at the Clinic for Paediatrics, Evangelic Hospital Hamm, Werler Straße 130, 59063 Hamm, Germany; Tel: 49 2381 589 3476; Fax: 49 2381 589 3477; E-mail: sk-paediatrie@ 123456evkhamm.de
                Article
                TORMJ-12-50
                10.2174/1874306401812010050
                6210530
                30505368
                08e4b06d-31ef-49d1-9a42-ccc664bd0922
                © 2018 Lehrl et al .

                This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 1 August 2018
                : 8 September 2018
                : 13 September 2018
                Categories
                Respiratory Medicine

                Respiratory medicine
                acute bronchitis,bronchitis severity scale,clinical psychometry,outcome assessment,severity of illness index,validation

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