External validation of the discriminative validity of the ReSVinet score & development of simplified ReSVinet scores in secondary care

PROMISE Investigators, Zakariya Sheikh, Ellie Potter, You Li, Simon B Drysdale, Joanne G Wildenbeest, Hannah Robinson, Joseph McGinley, Gu-Lung Lin, Deniz Öner, Antonio José Justicia-Grande, Federico Martinón-Torres, Andrew J Pollard, Louis Bont, Harish Nair*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Background
There is no consensus on how to best quantify disease severity in infants with respiratory syncytial virus (RSV) and/or bronchiolitis; this lack of a sufficiently validated score complicates the provision of clinical care and, the evaluation of trials of therapeutics and vaccines. The ReSVinet score appears to be one of the most promising; however it is too time-consuming to be incorporated into routine clinical care. We aimed to develop and externally validate simplified versions of this score.

Methods
Data were used from a multinational (Netherlands, Spain & United Kingdom) multicentre case-control observational study of infants with RSV to develop simplified versions of the ReSVinet by conducting a grid search to determine the best combination of equally weighted parameters to maximise for the discriminative ability of the scores across a range of outcomes (hospitalisation, intensive care unit admission, ventilation requirement). Subsequently discriminative validity of the score for a range of secondary care outcomes was externally validated by conducting a secondary analysis of data collected in infants with respiratory infection from tertiary hospitals in Rwanda and Colombia.

Results
Three candidate simplified scores were identified using the development dataset; they were excellent (area under the receiver-operator characteristic curve [AUROC] >0.9) in the development dataset at discriminating for a range of outcomes, and their performance was not statistically significantly different to the original ReSVinet score despite having fewer parameters. In the external validation datasets, the simplified scores were moderate-excellent (AUROC 0.7-1) across a range of outcomes. In all outcomes, except for in a single dataset at predicting admission to the high dependency unit, they performed at least as well as the original ReSVinet score.

Conclusions
Three promising candidate simplified scores were developed; however further external validation work in larger datasets, ideally from resource-limited settings needs to be conducted before any recommendation regarding their use.
Original languageEnglish
Article numberjiad388
Number of pages18
JournalThe Journal of Infectious Diseases
Early online date15 Sept 2023
DOIs
Publication statusE-pub ahead of print - 15 Sept 2023

Keywords / Materials (for Non-textual outputs)

  • RSV
  • Severity score
  • Validity

Fingerprint

Dive into the research topics of 'External validation of the discriminative validity of the ReSVinet score & development of simplified ReSVinet scores in secondary care'. Together they form a unique fingerprint.

Cite this