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Dengue disease severity in Indonesian children: an evaluation of the World Health Organization classification system
BACKGROUND: Dengue disease severity is usually classified using criteria set up by the World Health Organization (WHO). We aimed to assess the diagnostic accuracy of the WHO classification system and modifications to this system, and evaluated their potential practical usefulness. METHODS: Patients,...
Autores principales: | , , , , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2007
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1847434/ https://www.ncbi.nlm.nih.gov/pubmed/17386105 http://dx.doi.org/10.1186/1471-2334-7-22 |
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author | Setiati, Tatty E Mairuhu, Albert TA Koraka, Penelopie Supriatna, Mohamed Mac Gillavry, Melvin R Brandjes, Dees PM Osterhaus, Albert DME van der Meer, Jos WM van Gorp, Eric CM Soemantri, Augustinus |
author_facet | Setiati, Tatty E Mairuhu, Albert TA Koraka, Penelopie Supriatna, Mohamed Mac Gillavry, Melvin R Brandjes, Dees PM Osterhaus, Albert DME van der Meer, Jos WM van Gorp, Eric CM Soemantri, Augustinus |
author_sort | Setiati, Tatty E |
collection | PubMed |
description | BACKGROUND: Dengue disease severity is usually classified using criteria set up by the World Health Organization (WHO). We aimed to assess the diagnostic accuracy of the WHO classification system and modifications to this system, and evaluated their potential practical usefulness. METHODS: Patients, admitted consecutively to the hospital with severe dengue, were classified using the WHO classification system and modifications to this system. Treating physicians were asked to classify patients immediately after discharge. We calculated the sensitivity of the various classification systems for the detection of shock and the agreement between the various classification systems and the treating physician's classification. RESULTS: Of 152 patients with confirmed dengue, sixty-six (43%) had evidence of circulatory failure. The WHO classification system had a sensitivity of 86% (95%CI 76–94) for the detection of patients with shock. All modifications to the WHO classification system had a higher sensitivity than the WHO classification system (sensitivity ranging from 88% to 99%). The WHO classification system was in only modest agreement with the intuitive classification by treating physicians whereas several modified classification systems were in good agreement. CONCLUSION: The use of the WHO classification system to classify dengue disease severity is to be questioned, because it is not accurate in correctly classifying dengue disease severity and it lacks sufficient agreement with clinical practice. |
format | Text |
id | pubmed-1847434 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2007 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-18474342007-04-03 Dengue disease severity in Indonesian children: an evaluation of the World Health Organization classification system Setiati, Tatty E Mairuhu, Albert TA Koraka, Penelopie Supriatna, Mohamed Mac Gillavry, Melvin R Brandjes, Dees PM Osterhaus, Albert DME van der Meer, Jos WM van Gorp, Eric CM Soemantri, Augustinus BMC Infect Dis Research Article BACKGROUND: Dengue disease severity is usually classified using criteria set up by the World Health Organization (WHO). We aimed to assess the diagnostic accuracy of the WHO classification system and modifications to this system, and evaluated their potential practical usefulness. METHODS: Patients, admitted consecutively to the hospital with severe dengue, were classified using the WHO classification system and modifications to this system. Treating physicians were asked to classify patients immediately after discharge. We calculated the sensitivity of the various classification systems for the detection of shock and the agreement between the various classification systems and the treating physician's classification. RESULTS: Of 152 patients with confirmed dengue, sixty-six (43%) had evidence of circulatory failure. The WHO classification system had a sensitivity of 86% (95%CI 76–94) for the detection of patients with shock. All modifications to the WHO classification system had a higher sensitivity than the WHO classification system (sensitivity ranging from 88% to 99%). The WHO classification system was in only modest agreement with the intuitive classification by treating physicians whereas several modified classification systems were in good agreement. CONCLUSION: The use of the WHO classification system to classify dengue disease severity is to be questioned, because it is not accurate in correctly classifying dengue disease severity and it lacks sufficient agreement with clinical practice. BioMed Central 2007-03-26 /pmc/articles/PMC1847434/ /pubmed/17386105 http://dx.doi.org/10.1186/1471-2334-7-22 Text en Copyright © 2007 Setiati et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Setiati, Tatty E Mairuhu, Albert TA Koraka, Penelopie Supriatna, Mohamed Mac Gillavry, Melvin R Brandjes, Dees PM Osterhaus, Albert DME van der Meer, Jos WM van Gorp, Eric CM Soemantri, Augustinus Dengue disease severity in Indonesian children: an evaluation of the World Health Organization classification system |
title | Dengue disease severity in Indonesian children: an evaluation of the World Health Organization classification system |
title_full | Dengue disease severity in Indonesian children: an evaluation of the World Health Organization classification system |
title_fullStr | Dengue disease severity in Indonesian children: an evaluation of the World Health Organization classification system |
title_full_unstemmed | Dengue disease severity in Indonesian children: an evaluation of the World Health Organization classification system |
title_short | Dengue disease severity in Indonesian children: an evaluation of the World Health Organization classification system |
title_sort | dengue disease severity in indonesian children: an evaluation of the world health organization classification system |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1847434/ https://www.ncbi.nlm.nih.gov/pubmed/17386105 http://dx.doi.org/10.1186/1471-2334-7-22 |
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