Decision trees for intussusception

January 01, 0001

Decision trees for intussusception

Intussusception is both common in young children and can lead to significant morbidities. These US researchers looked at predictive clinical criteria in children aged 1 month to 6 years with intussusception to develop a decision tree for risk-stratify children with possible intussusception. They performed a prospective observational cohort study, enrolling 310 patients with possible intussusception.

The researchers found: "Univariate predictors of intussusception included age older than 6 months, male gender, history of lethargy, and abnormal plain x-ray. Multivariate analysis through recursive partitioning identified decision trees (with and without the result of a plain abdominal x- ray) and allowed identification of patients at low risk. The decision tree based on the results of an abdominal x-ray (negative or positive), age (5 or >5 months), diarrhea (present or absent), and bilious emesis (present or absent) had the best test performance (sensitivity: 97%, negative predictive value: 99%, negative likelihood ratio: 0.08)."

The researchers concluded: "Among children who were being evaluated for intussusception, we prospectively determined clinical criteria and developed a decision tree to risk-stratify children with possible intussusception."

These authors created a decision tree to identify children with abdominal pain that are at low risk of intussusception.

For the full abstract, click here.

Pediatrics 127(2):e296-e303, February 2011 © 2011 American Academy of Pediatrics
Risk Stratification of Children Being Evaluated for Intussusception. Sarah N. Weihmiller, Carlo Buonomo, and Richard Bachur.

Category: D. Digestive. Keywords: intussusception, abdominal pain, age, X-ray, emesis, decision analysis of prospective cohort study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 15 March 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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